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ZGoljan High Yields > Goljan High Yield Cell Injury EC > Flashcards

Goljan High Yield Cell Injury EC Flashcards

1
Q

PO2

A

driving force for diffusion of O2 into tissue

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2
Q

SaO2

A

percent heme groups occupied by O2

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3
Q

Cyanosis

A

decreased O2 saturation (SaO2)

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4
Q

O2 content

A

1.34HbSaO2 + PaO2

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5
Q

Oxygen

A

electron acceptor in oxidative pathway

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6
Q

Hypoxia

A

inadequate O2 leads to ATP depletion

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7
Q

Ischemia

A

Decreased blood flow

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8
Q

Respiratory acidosis

A

retention of CO2 always decreases PaO2

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9
Q

Ventilation defect

A

impaired delivery of O2 to alveoli

Intrapulmonary shunting of blood (ie RDS)

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10
Q

Perfusion defect

A

absent blood flow to alveoli

Increased alveolar dead space (ie PE)

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11
Q

Methemoglobin

A

Decreased SaO2
Heme Fe +3
Oxidizing agents (sulfur/nitro drugs) cause
Treat with IV methylene blue

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12
Q

Clinical methemoglobinemia

A

Cyanosis not corrected by O2

Chocolate colored blood

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13
Q

Carbon monoxide

A

Decreased SaO2
Left-Shifted OBC
inhibits cytochrome oxidase

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14
Q

Causes carbon monoxide poisoning

A

Car exhaust
Space heaters
Smoke inhalation

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15
Q

S/S carbon monoxide poisoning

A

Headache (#1 sign)

Cherry red color of skin (masks cyanosis)

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16
Q

Cyanide

A

inhibits cytochrome oxidase

Systemic asphyxiant

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17
Q

Carbon monoxide + cyanide poisoning

A

House fire

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18
Q

Left shifted O2 curve

A

decreased 23-BPG, CO, alkalosis, HbF, methemoglobinemia, hypothermia

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19
Q

Right shifted O2 curve

A

increased 23-BPG, high altitude, acidosis, fever

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20
Q

High altitude

A

respiratory alkalosis enhances glycolysis

Increased synthesis of 23-BPG

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21
Q

Mitochondrial poisons

A

damages membrane and drains off protons

Alcohol and salicylates

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22
Q

Uncoupling agents in mitochondria

A

drain off protons

Dinitrophenol, thermogenin (brown fat)

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23
Q

Complication of mitochondrial poisons/uncoupling agents

A

Hyperthermia

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24
Q

Decreased ATP

A

Impaired Na/K ATPase pump (cellular swelling)

Reversible

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25
Q

Anaerobic glycolysis

A

ATP synthesis in hypoxia
Lactate decreases intracellular pH
Denatures proteins

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26
Q

Irreversible injury hypoxia

A

membrane/mitochondrial damage

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27
Q

Mitochondrial damage

A

release cytochrome c which activates apoptosis

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28
Q

Irreversible injury hypoxia

A

Increased cytosolic Ca activates phospholipase, proteases, endonuclease

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29
Q

Free radicals MOA

A

Unpaired electron in outer orbit

Damage cell membranes and DNA

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30
Q

What are some some free radicals

A

Superoxide
Hydroxyl
Peroxide
Acetaminophen

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31
Q

Superoxide dismutase

A

Neutralizes superoxide

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32
Q

Glutathione

A

Neutralizes peroxide and drug free radicals

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33
Q

Catalase

A

Neutralizes peroxide

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34
Q

Lipofuscin

A

Indigestible lipid of lipid peroxidation

Brown pigment increased in atrophy and FR damage

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35
Q

Reperfusion injury in heart

A

Superoxide FRs+Ca

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36
Q

Mitochondrial injury

A

cytochrome C in cytosol initiates apoptosis

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37
Q

SER hyperplasia

A

alcohol
barbiturates
phenytoin

38
Q

Complications of SER hyperplasia

A

increased drug metabolism (ie oral contraceptives)

Decreased vit. D

39
Q

Chediak-Higashi

A

AR
Giant lysosomes
Membrane protein defect in transferring lysosomal enzymes to phagocytic vacuoles

40
Q

I-cell disease

A 
Absent enzyme marker in Golgi apparatus (mannose-6-phosphate)
Empty lysosomes (enzymes spilled into blood)
41
Q

Rigor mortis

A

stiff muscles after death due to ATP depletion

42
Q

Fatty change in liver

A

MCC alcohol (increase in NADH)
DHAP–>G3P–>TG
Increased VLDL pushes nucleus to side

43
Q

Causes fatty change

A

Increased synthesis of TG/FAs

Decreased beta-oxidation of FAs/synthesis of apoproteins/release of VLDL

44
Q

Fatty change in kwashiorkor

A

Decreased synthesis of apoproteins

45
Q

Ferratin

A

Primary Fe storage protein
Soluble in blood
Serum level reflects marrow storage of Fe

46
Q

Hemosiderin

A

Insoluble ferritin degradation product visible with Prussian blue stain

47
Q

Atrophy

A

Reduction in cell/tissue mass by either loss or cell shrinkage

48
Q

Brain atrophy

A

Ischemia

Alzheimer’s

49
Q

Exocrine gland atrophy in CF

A

Pancreatic duct obstruction by thick secretions

50
Q

Labile cells

A

Stem cells (skin, marrow, GI)

51
Q

Stabile cells

A

in G0 phase (SM, hepatocytes)

Can enter cell cycle (growth factors, hormones stimulate)

52
Q

Permanent cells

A

Cannot replicate
Cardiac/striated muscle
Neurons

53
Q

Hypertrophy

A

Increase in cell size (structural components, DNA)

54
Q

LVH

A 
Increased preload (valve regurg)
Increased afterload (hypertension, aortic stenosis)
55
Q

RVH

A

Pulmonary hypertension

56
Q

Bladder smooth muscle hypertrophy

A

Prostate hyperplasia constricts urethra

57
Q

Removal of kidey

A

Hypertrophy of remaining kidney

58
Q

Hyperplasia

A

Increase in number of cells

59
Q

Endometrial hyperplasia

A

Unopposed estrogen (obesity, taking estrogens)

60
Q

RBC hyperplasia

A

Increased EPO (blood loss, ectopic secretion, high altitude)

61
Q

Prostate hyperplasia

A

Increased DHT

62
Q

Gynecomastia

A

Hyperplasia in male breast tissue

Normal in newborn, adolescent, elderly

63
Q

Squamous metaplasia in broncus

A

smoking

64
Q

Intestinal metaplasia in stomach

A

Paneth cells, goblet cells

H. pylori chronic atrophic gastritis

65
Q

Squamous metaplasia of the bladder

A

Schistosoma haematobium infection

66
Q

Barrett’s esophagus

A

glandular metaplasia of distal esophagus due to GERD

67
Q

Dysplasia

A

Atypical hyperplasia or metaplasia are precursors for cancer

68
Q

Squamous dysplasia in cervix

A

HPV

69
Q

Squamous dysplasia in broncus

A

Smoking

70
Q

Necrosis

A

Death of groups of cells

71
Q

Coagulation necrosis

A

Preservation of structural outlines (due to increased lactic acid)

72
Q

Infarction

A

Pale (heart, kidney)
Hemorrhagic (lung, small bowel)
Dry gangrene

73
Q

Liquefactive necrosis

A

Brain infarct
Bacterial infections
Wet gangrene

74
Q

Caseous necrosis

A

Variant of coagulation necrosis

Granulomas due to TB/systemic fungi

75
Q

Granulomas

A 
Activated macrophages (epithelioid cells) join to form multinucleated giant cells
Th1 CD4 cells
76
Q

Epithelioid cells

A

Gamma interferon released by CD4 T cells activates macrophages to become

77
Q

Multinucleated giant cells

A

fusion of epithelioid cells

78
Q

Granulomas

A

Type IV hypersensitivity

79
Q

Enzymatic fat necrosis

A 
Associated with pancreatitis
Soap formation (Ca+FAs) aka saponification
80
Q

Fibrinoid necrosis

A

Necrosis of immune reactions (immune vasculitis/endocarditis)

81
Q

Postmortem necrosis

A

autolysis

no inflammatory reaction

82
Q

Dystrophic calcification

A

calcification of damaged tissue

Normal serum calcium

83
Q

Metastatic calcification

A

Calcification of normal tissue

Increased serum calcium or phosphorus

84
Q

Nephrocalcinosis

A

Metastatic calcification of collecting tubule basement membranes

85
Q

S/S nephrocalcinosis

A

Polyuria due to nephrogenic diabetes insipidus

Renal failure

86
Q

Apoptosis

A

gene regulated individual cell death (little to no inflammation)

87
Q

Signals activating apoptosis

A

Mullerian inhibitory factor
Tumor necrosis factor
Hormone withdrawal

88
Q

Signal modulators of apoptosis

A

p53 suppressor gene

BCL-2

89
Q

BCL-2 genes

A

Anti-apoptosis gene

Prevents cytochrome c from leaving mitochondria

90
Q

Caspases

A

responsible for enzymatic cell death in apoptosis

Proteases and endonucleases

91
Q

Markers of apoptosis

A

Eosinophilic cytoplasm

Pyknotic (ink dot) nucleus

92
Q

Apoptosis examples

A

Loss of Mullerian epithelium in male fetus
Thymus involution
Killing cancer cells

ZGoljan High Yields (5 decks)

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