Duke PA pathology
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| How can radiation affect cells? | damage cell membranes and DNA
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| What are the six morphologic responses to non-lethal injury? | atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia, intracellular storage
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| Morphology | study of shape
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| Atrophy | decrease in size, and often function, of cells, generally associated with a decrease in size and/or function of a tissue or organ
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| What are some causes of atrophy? | disuse of muscle, decreased blood supply, inadequate nutrition, loss of endocrine stimulation, loss of growth factors
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| What are the two types of disuse atrophy of muscle? | voluntary or denervation-induced
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| Hypertrophy | increase in size of cells, due to an increase in the amount of protein and organelles, which results in an increase in the size of the tissue or organ
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| Examples of mechanical stimulus in hypertrophy | cardiac and skeletal muscle hypertrophy
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| example of growth factor stimuluation in hypertrophy | endocrine stimulation at puberty, pregnancy
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| Example of increase functional demand in hypertrophy | unilateral nephrectomy
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| What are the three causes of hypertrophy? | mechanical stimulus, growth factor stimulation, increased functional demand
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| hyperplasia | increase in number of cells in organ or tissue
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| Causes of hyperplasia | growth factor stimulation: endocrine or stress-induced, viral-induced
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| example of growth factor stimuluation in hyperplasia | endometrial proliferation w/ menstrual cycle, callus formation during bone healing, erythroid hyperlasia under chronic hypoxic conditions
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| example of viral-induced hyperplasia | warts
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| metaplasia | replacement of one differentiated cell type with another
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| What is the main cause of metaplasia? | chronic irritation
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| What are examples of chronic irriation in metaplasia? | respiratory tract of smokers, cervix of sexually active females, esophagus in response to gastric acid
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| dysplasia | abnormal or disorderly growth, recognized by a change in size, shape, and/or organization of cells within a tissue
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| What can dysplasia be a precursor to? | cancer
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| What are examples of intracellular storage? | lipid accumulation in hepatocytes, anthracotic pigment in alveolar macrophages, lipofuscin
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| Lipofuscin | aging related pigment, "stuff in the cytoplasm that can't get broken down"
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| Antracotic | black particles, from smoke and other things
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| What is the most common genetic disease in the US? | hemochromatosis
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| What does hemochromatosis cause? | systemic overload of iron
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| How do organ or tissue dysfunction occur? | as the result of the cumulative impact of injury to individual cells
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| What is a good way to understand disease processes? | focus on individual cells and their response to noxious stimuli
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| How can acute cell injury manifest itself? | in many different ways, some of which are fully reversible and some of which are not
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| Can cells exhibit persistent dysfunction after noxious stimulus is over and still fully recover over time? | yes
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| What is an example of cells being permanently injured without affecting their viability directly? | radiation - prevent cells from dividing without killing them
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| What does cell injury but intact viability result in? | lag between cell injury and organ dysfunction
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| **go back to slide 55*** |
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| necrosis | a morphologic expression of cell death
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| What happens to the cellular structure in necrosis? | progressive disintegration
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| What is necrosis generally initiated by? | overwhelming stress
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| What does necrosis generally elicit? | acute inflammatory cell response
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| Apoptosis | an alternate pathway of cell deaht, called "programmed cell death" or "physiologic cell death"
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| What is apoptosis controlled by? | specific genes
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| What happens to DNA and nucleus in apoptosis? | fragmentation of DNA and nucleus
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| What is the process of apoptosis? | blebs form and "apoptotic bodies" are released, "apoptotic bodies" phagocytized, no neutrophils
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| What are the pathologic states where apoptosis may be important? | embryogenesis, withdrawal of trophic hormones, growth factors, ionizing radiation, free radical generation, mild thermal injury, steroids
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| How can apoptosis be important in viral infection? | potent defense mechanism against virus - some viruses encode proteins to block apoptosis
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| In AIDS, what may be mediating loss of CD4+ T lymphocytes? | apoptosis
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| How is apoptosis involved in cell-mediated immunity? | cytotoxic T lymphocytes can kill target cells by inducing apoptosis
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| How is apoptosis important in autoimmune disease? | removal of autoreactive immature lymphocytes is by apoptosis
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| What types of cell death may be involved in degenerative diseases of the central nervous system? | apoptosis
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| How may apoptosis be important in neoplasia? | eliminating cells with genetic defects + inhibition of apoptosis may contribute to prolonged life span of malignant cells
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| What size of areas does necrosis usually affect? | large areas - contiguous cells
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| What size of areas does apoptosis usually affect? | scattered individual cells
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| When is control of intracellular environment lost in necrosis? | early
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