Term
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Definition
allow a cell to respond to injury and preserve the viability of the cell
atrophy
hyperplasia (breast development, endometrial hyperplasia)
hypertrophy
metaplasia
adaptation, dysplasia, and risk for cancer
-e.g. endometrial hyperplasia, if it continues, can become abnormal hyperplasia -> dysplasia, precancerous
hyperplasia, hypertophy, atrophy, metaplasia |
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Term
| reversible cell injury (include morphological expression) |
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Definition
cellular swelling (hydrophobic change), fatty change (lipid)
blebs
clumping of nuclear chromatin
lysosomal autophagy
ER swelling
dispersion of ribosomes
mitochondrial swelling |
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Term
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Definition
| --> cell death (apoptosis, necrosis) |
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Term
| hyperplasia & hypertrophy - examples? |
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Definition
Postpartum uterus
-The i/c in the size of the uterus is primarily the result of i/c smooth muscle size in the myometrium (hypertophy) and number of smooth muscle cells in the myometrium (hyperplasia)
Ectopic pregnancy
-RLQ pain, rupture of the fallopian tube due to implantation site other than myometrium
-poor attachment to wall of fallopian tube
-continued growth -> dilatation, weakening of the muscularis with transmural rupture |
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Term
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Definition
Female breast development (physiologic)
-i/c estrogen -> stroma, ductile system, fat deposition
-i/c progesterone -> lobules, alveoli
Uterine endometrial cycle
-i/c estrogen -> proliferative phase
-endometrial hyperplasia is excessive proliferative changes in the endometrial glands and stroma caused by prolonged estrogen stimulation w/o progesterone, occurs around menopause
-estrogen producing tumors can induce endometrial hyperplasia, may progress to atypical hyperplasia -> dysplasia, precancerous
Gynecomastia in an alcoholic
-cirrhotic liver does not metabolize estrogen, i/c estrogen:androgen ratio
-estrogen induced proliferation of ductal epithelium and stromal hyperplasia (but not lobular units)
BPH
-nodular prostatic hyperplasia compresses the urethra -> "urgency"
-mediated by androgens and estrogens, occurs in older patients
-glands/stromal hyperplasia in the periurethral prostate
-develops in the TZ in older patients
-75% of prostate cancer develops in the PZ
-no relationship b/t BPH and prostate cancer |
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Term
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Definition
Exercise hypertrophy
-nerve, cardiac, and skeletal muscle cells have little/no capacity for hyperplastic growth
-i/c soleus muscle in a marathon runner
Heart attack/HTN
-myocardial response to injury is hypertrophy |
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Term
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Definition
Hashimoto thyroiditis
-Hypothyroidism due to glandular atrophy
-atrophy in thyroid epithelium, results from TSH-R blocking Ab
-heavy lymphocytic infiltrates destroy thyroid follicles in the parenchyma
Addison's disease (Primary adrenal insufficiency)
-hyperpigmentation, weakness, fatigue, N&V, hypotension, hyperkalemia, low Na/Cl/HCO3-/glucose
-high ACTH, low cortisol, high melanotropin
-atrophy of the adrenal glands |
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Term
*metaplasia*
-what can it progress to? |
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Definition
GERD
-leads to GE reflux -> metaplasia from squamous to glandular epithelium
-metaplastic epithelium carries a risk of dysplasia - either gastric or intestinal glands (goblet cells & villi)
-glands may become disorganized, with an i/c N:C ratio
Smoking
-columnar w/ goblet cells -> dysplastic squamous epithelium
-squamous cell carcinoma
Cervical Transformation Zone
-the squamous-columnar junction b/t the ectocervix & endocervix
-hormones and physical factors lead to adaptation, possible *squamous metaplasia*
-cervical inflammation -> metaplasia -> dysplasia -> squamous cell carcinoma |
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Term
| In a pt with a hx of GERD who has an occlusion of the esophageal lumen, what might be an expected finding? |
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Definition
metaplasia -> dysplasia
adenocarcinoma of the distal esophagus arising in site of chronic inflammation due to reflux, metaplasia, and dysplasia |
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Term
coagulative necrosis
-where might you see this? |
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Definition
kidney (glomeruli, tubules)
recent MI: absence of myocardial cell nuclei, acute inflammation |
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Term
liquefactive necrosis
-where might you see this?
-associated bacteria? |
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Definition
kidney - neutrophils in an abscess
pneumonia - lots of neutrophils
acute suppurative appendicitis with numerous neutrophils
Pelvic Inflammatory Disease
-bacterial/fungal infxn
-neutrophils & lysosomal enzymes, digest bacteria & tissue
-liquid mass
-abscess formation, *pus*
-fallopian tube: neutrophils cause pus to surround the tube & ovaries
Stroke
-lipid content in brain leads to a different type of ischemic necrosis than that seen in solid tissue
-cerebrovascular occlusion, soft & filled with fluid
E. coli, Klebsiella pneumo, Proteus fecalis, Strep faecalis, Staph aureus |
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Term
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Definition
Mycobacteria tuberculosis
-inhaled mycobacteria proliferate in macrophages
-mediators activate macrophages to kill, form granulomas
-CD8 T cells kill macrophages with mycobacteria -> caseous necrosis (e.g. in lungs) |
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Term
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Definition
Acute pancreatitis, release of lipases
-focal area of fat destruction
-enzymatic due to release of pancreatic lipases or from macrophages
Inflammatory mass
-hard mass, may resemble cancer in breast
-damaged, necrotic fat is phagocytosed by macrophages |
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Term
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Definition
3 primary influences on thrombus formation
-endothelial injury (heart wall, atherosclerosis)
-abnormal blood flow (turbulence and stasis in dilated veins & arterial aneurysms)
-hypercoagulability: i/c tendency to form thrombi |
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Term
| Trousseau sign of malignancy |
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Definition
"Migratory thrombophlebitis" - occurs in ~10% of pts with pancreatic adenocarcinoma
-elaboration of platelet-aggregating factors and procoagulants from the tumor or its necrotic products
-venous and arterial thrombi can occur
-Venous thrombi can embolize to the lungs
-"saddle" pulmonary embolus may result in sudden severe dyspnea and demise of the patient
-Smaller emboli may produce pulmonary infarctions with some dyspnea and chest pain
a medical sign found in certain cancers that's associated with hypercoagulability |
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