Patho Chapter 2: Cell Injury and Adaptions

Cell injury occurs when cells are exposed to a severe stress that no longer allows them to maintain homeostasis. What basic changes occur as a result of cell injury? Select all that apply. -Inadequate oxygen diffusion at the alveoli -Increase in mitochondria number -Cellular swelling -Defects in protein synthesis -Dysfunction of the sodium-potassium pump

-Cellular swelling -Defects in protein synthesis -Dysfunction of the sodium-potassium pump

Which of the following are examples of necrosis? Select all that apply. -Cellular turnover at the surface of the skin -Third-degree burn -Changes in ovarian cells during menopause -Myocardial cell damage caused by myocardial infarction -Cell death caused by exposure to snake venom

-Third-degree burn -Myocardial cell damage caused by myocardial infarction -Cell death caused by exposure to snake venom

A friend comes to you concerned, as her recent Pap tests revealed the presence of cervical dysplasia. Which of the following responses to your friend's comment is correct?

Dysplasia indicates a change in the cellular appearance

Walter, age 62, had to undergo an endoscopic examination of his esophagus due to his complaint of frequent "heartburn" after most meals. Examination of the cells shows that rather than normal squamous cells lining the esophagus, Walter had columnar cells. The physician explained to Walter that this change in cell shape likely occurred in response to harmful stomach acid in the esophagus, resulting in the "burning" sensation.

METAPLASIA Metaplasia is the replacement of one type of cell within another type of cell. In Walter's case, squamous cells were replaced with columnar cells. Normally, such cellular changes are brought on by injury or insult to the cells. The change in cell type is the body's attempt to create cells better capable of withstanding the insult or injury.

Which of the following is incorrectly matched? Metaplasia - increase in cell number Hypertrophy - increase in cell size Atrophy - decrease in cell size Neoplasia - uncontrolled cell growth Apoptosis - programmed cell death

Metaplasia - increase in cell number

An echocardiogram reveals Charles, an ultramarathon runner, has an enlarged left ventricle. As this increase in ventricular size is supported by increased blood flow and ATP production due to the training Charles has undertaken, this increase in heart size demonstrates ________________. Physiological hyperplasia Pathological hypertrophy Physiological hypertrophy Benign neoplasia Pathological metaplasia

Physiological hypertrophy

In pathological hypertrophy, -cells are poorly differentiated with an increased risk of metastasis. -an increase in tissue size is not matched by an increase in supportive structures. -cell number increases in mitotically active tissues. -programmed cell death occurs at an accelerated rate. one cell type is replaced by another.

an increase in tissue size is not matched by an increase in supportive structures.

Karen was infected with HIV (human immunodeficiency virus) 5 years ago. As the virus attacks important cells of her immune system, known as CD4 cells, Karen is at an increased risk for infection. Recently, Karen learned that not only does HIV directly attack CD4 cells, but the presence of the virus seems to activate pathways responsible for programmed cell death in CD4 cells. Thus, infection of HIV appears to increase the rate of "suicide" for CD4 cells.

apoptosis Apoptosis is programmed cell death. Apoptosis is a regulated pathway by which damaged or unneeded cells begin the death process. As this is a genetically regulated process, it is controlled and predictable. Necrosis, on the other hand, is cellular death induced by damage to the cell, which the cell cannot withstand. In Karen's case, HIV appears to be activating the pathways of CD4 apoptosis.

Vern, a 65-year-old male, was diagnosed with amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease. This disease damages the upper and lower motor neurons, eventually preventing neural signals from reaching the muscles. In response to the lack of signaling, the muscles become weaker and smaller.

atrophy Atrophy is the partial or complete degeneration of cells or tissues in the body, most commonly due to lack of use. In this case, Vern's muscle began to shrink, as the body was unable to signal the muscles to move. Similar reductions in muscle size due to lack of use can be observed as a result of the casting of an injured limb.

Which of the following relate to a change in cell size? Select all that apply. metaplasia hyperplasia atrophy dysplasia hypertrophy

atrophy and hypertrophy

A biopsy of a skin lesion is conducted on Leann, a 48-year-old Caucasian woman. Biopsy results revealed proliferating cells that were well-differentiated and resembled surrounding cells. The cells were contained within a well-defined area.

benign neoplasia Neoplasia is uncontrolled and unregulated cell growth. The mass of tissue resulting is known as a "neoplasm." In a benign neoplasm, the cells do not have the characteristics associated with malignancy. The cells, although cancerous, are well-differentiated, meaning they resemble normal, mature cells. The cells are also in a contained area and are unlikely to spread.

Ruth, age 52, needs to have a follow-up Pap smear. While counseling Ruth, the nurse explains that the last Pap smear results revealed cells that looked abnormal. The cells were not uniform in size and shape, and had an altered appearance when compared to normal, healthy cell.

dysplasia Feedback: Dysplasia occurs when cells take on an abnormal appearance. Compared to normal cells, cells demonstrating dysplasia are atypical in size and shape. Dysplasia does not mean the cells are cancerous. However, some screening tests, such as the Pap smear, examine tissues to determine if any cellular changes are taking place. Any changes in the cells can then be monitored over time.

At a construction site, a support fell and crushed the patient's left ankle. Surgical repair was necessary. Now, upon entering the room, you smell a foul odor and see significant discoloration of the injured area. You are concerned a specific bacterial infection may be present.

gangrene Gangrene can exist in several forms and it occurs when the blood supply to tissue is disrupted. In this scenario, a specific form of gangrene, known as gas gangrene, is present. Gas gangrene is the result of infection with Clostridium perfringens. This infection begins deep in the body in traumatized tissues. An exotoxin produced by the bacteria causes the destruction of healthy muscle tissue and produces a foul odor.

Janae experienced a frightening ATV accident, in which her ATV flipped over and she ended up catching a portion of her upper arm on a barbed wire fence. Although Janae's injuries healed fully, enlarged, keloid scar formations remain at the injury site.

hyperplasia In Janae's situation, cell proliferation, known as hyperplasia, was stimulated as a result of her injury. Skin cells are mitotically active and will replicate to replace the cells lost to injury. A keloid results from overgrowth of granulation tissue during the wound repair process.

Julianne, who suffers from familial hypercholesterolemia, presents with xanthomas. Xanthomas are excess cholesterol deposits, which appear as yellow skin lesions.

intracellular accumulation Some disease processes stimulate intracellular accumulations of particles, such as calcium, cholesterol, and triglycerides, among other substances. In familial hypercholesterolemia, a genetic defect causes decreased cellular uptake of cholesterol, resulting in high serum cholesterol levels. Cholesterol deposits, known as xanthomas, may appear to form under the skin.

Apoptosis _____________. -is cell death that results from injury. -results in irreversible damage to tissues. -is genetically programmed cell death. -is a rare occurrence in a healthy individual. -should be prevented with medical interventions.

is genetically programmed cell death.

Cardiac troponin (a protein in heart cells) levels often elevate following a myocardial infarction. This is related to which of the following disrupted cellular processes? -Disruption of calcium transporters. -Increased extracellular potassium. -Decreased membrane potential. -Increased intracellular accumulations. -Loss of ATP production.

loss of ATP production

Andy has undergone a colonoscopy because his family has a history of colon cancer. Biopsy of the colon reveals poorly differentiated cells in the samples. Cells were abnormally organized, with distorted borders. Infiltration of the abnormal cells occurred throughout several samples.

malignant neoplasia Neoplasia is uncontrolled, unregulated cell growth. Malignancy, when applied to neoplasm, indicates the cancerous cells are likely to infiltrate other tissues and spread. The appearance of malignant cells is far from normal. Such cells are poorly differentiated and appear to have a random organization. Biopsy samples of malignant neoplasia reveal cells moving beyond the borders or edges of the growth.

Biopsy results of the airways of a long-term smoker reveal squamous epithelium have replaced pseudostratified columnar cells. This is an example of _______________. -dysplasia -pathological hypertrophy -neoplasia -metaplasia -atrophy

metaplasia

Miguel, a retired warehouse supervisor, had a myocardial infarction. Further evaluation revealed he had significant blockage in his left descending coronary artery. The blockage resulted in ischemia and cell death for those cells served by the artery.

necrosis Necrosis is premature cell death caused by cell injury. Necrosis differs from apoptosis, in that the cellular destruction results from some form of trauma, rather than genetic programming. In Miguel's case, ischemia, which is a lack of oxygen delivery to the cells, caused metabolic processes to fail, leading to death of the cell.

Cardiac catheterization results for Beatrice, a 54-year-old patient, show plaque build-up, appearing as hardened areas in the coronary arteries. Beatrice, who is overweight and leads a sedentary lifestyle, has several risk factors for arteriosclerosis. A coronary calcium scan is conducted to help analyze the state of the arterial plaques.

pathologic calcification Pathologic calcification is, as the name implies, calcification of tissues that does not occur normally, but rather as part of the diseases process. Atherosclerotic plaques are the result of endothelial injury within the vessel, cholesterol accumulation, and foam cell formation. At times, muscle tissue near the borders of the plaques becomes calcified due to the deposition of extracellular calcium. A coronary calcium scan helps to determine the extent of calcification.

Miles, a 62-year-old African American male, has been treated for hypertension for 15 years. He is currently complaining of wheezing during exercise. Chest palpitation reveals displacement of the point of maximal impact of the heart. Echocardiogram confirms enlargement of the heart.

pathological hypertrophy In this scenario, the echocardiogram reveals enlargement of the heart, which indicates hypertrophy. This increase in heart size, though, is due to a disease process, Miles' hypertension, which is causing the heart to grow in order to pump against the higher pressure. Because it is a response to a disease process, the hypertrophy is considered pathological. The increase in heart size is not met with an equal increase in support structures.

Brian, age 28, began an aerobic exercise program 2 years ago. Brian now competes in long-distance cycling events and considers himself to be an endurance athlete who is in the "best shape of his life." An echocardiogram reveals a slightly enlarged left ventricle.

physiological hypertrophy