Complete Review (2026) | 100%
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• Atrophy -✓✓E. Cells decrease in size
P. Still functional; imbalance between protein synthesis and degradation. Essentially
there is an increase in the catabolism of intracellular organelles, reducing structural
components of cell
Physiologic: thymus gland in early childhood
Pathological: disuse (muscle atrophy d/ decrease workload, pressure, use, blood
supply, nutrition, hormonal stimulation, or nervous stimulation)
• Hyperplasia -✓✓E: cells increase in number, mitosis (cell division) must occur, size of
cell does not change
Phys: increased rate of division, increase in tissue mass after damage or partial
resection; may be compensatory, hormonal, or pathologic
Patho: abnormal proliferation of normal cells usually caused by increased hormonal
stimulation (endometrial). increase of production of local growth factors
Ex: removal of part of the liver lead to hyperplasia of hepatocytes. uterine or mammary
gland enlargement during pregnancy
• Dysplasia -✓✓E. Not true adaptation; Cells abnormal change in size, shape,
organization (classified as mild, moderate, severe)
P. caused by cell injury/irritation, characterized by disordered cell growth. aka atypical
hyperplasia or pre-cancer, a disorderly proliferation
Physiologic: N/A
Pathologic: squamous dysplasia of cervix from HPV shows up on pap smear, breast
cancer development; pap smears often show dysplastic cells of the cervix that must
undergo laser/surgical tx
• Metaplasia -✓✓E: reversible change, one type of cell changes to another type for
survival
P: reversible; results from exposure of the cells to chronic stressors, injury, or irritation;
Cancer can arise from this area, stimulus induces a reprogramming of stem cells under
the influence of cytokines and growth factors
Ex: Patho: Columnar cells change to squamous cells in lungs of smoker or normal
ciliated epithelial cells of the bronchial linings are replaced by stratified squamous
epithelial cells.; Phys: Barrett Esophagus- normal squamous cells change to columnar
epithelial cells in response to reflux, aka intestinal metaplasia
• Hypoxia injury -✓✓E. inadequate oxygenation of tissues
,P. decrease in mitochondrial function, decreased production of ATP increases
anaerobic metabolism. eventual cell death.
C.M. hypoxia, cyanosis, cognitive impairment, lethargy
• Free radical and ROS -✓✓E. normal byproduct of ATP production, will overwhelm the
mitochondria- exhaust intracellular antioxidants
P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease, Amyotrophic
Lateral Sclerosis
• Ethanol -✓✓E. mood altering drug, long term effects on liver and nutritional status
P. metabolized by liver, generates free radicals
C.M. CNS depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation
and fatty infiltration of liver, hepatomegaly, leads to liver failure irreversible
• Oncosis -✓✓Na and H2O enter cell and cause swelling. Organ increases in weight,
becomes distended and pale. Associated with high fever, hypocalcemia, certain
infections
• Fatty Infiltration -✓✓intracellular accumulation of lipids in the liver
liver fails to metabolize lipids. usually from ETOH or high fat diet. can lead to cirrhosis
• dystrophic calcification -✓✓accumulation of Ca in dead or dying tissues
calcium salt clump and harden- interfere with cellular structure and function
r/t pulmonary TB, atherosclerosis, injured heart valves, chronic pancreatitis
• metastatic calcification -✓✓accumulation of Ca in normal tissue
result of hypercalcemia r/t hyperparathyroidism, hyperthyroidism, toxic levels of Vit D.
Can also r/t hyperphosphatemia in renal failure
• urate accumulation -✓✓sodium urate crystals are deposited in tissues- group of
disorders collectively called gout- acute arthritis, chronic gouty arthritis, tophus, nephritis
• Coagulative Necrosis -✓✓kidneys, heart, adrenals- secondary to hypoxia
• Liquefactive Necrosis -✓✓nerve cells- brain- accumulation of pus
• Caseous Necrosis -✓✓lung disease- usually TB- tissue looks like clumped cheese
• Fat Necrosis -✓✓breast, pancreas, abdominal structures- creates soaps
• Gangrenous Necrosis -✓✓Dry- dark shriveled skin
Wet- internal organs- can lead to death
Gas- from clostridium- antitoxins and hyperbaric therapy
,• Gout -✓✓E. disturbances in serum urate levels. uncommon for < 30 years old.
P. uric acid is deposited in the tissues of kidney, heart, earlobes, and joints.
C.M. inflammation, painful joints. result of diuretic use or diet high in cream sauces, red
wine, or red meat
• Rhabdomyolysis -✓✓E. cell hypoxia caused by severe muscle trauma, hyperthermia,
crush injuries, or severe dehydration
P. hypoxia to cell causes failure of the Na-K pump, causing accumulation of intracellular
sodium, oncosis, and eventual cell death. Cell death releases enzymes such as CK, uric
acid, LDH, AST, etc.
C.M. Causes: trauma, hyperthermia, crush injuries, severe dehydration; s/s: CK is 5x
upper normal limit, muscle pain, weakness, dark, reddish-brown urine, hypercalcemia,
renal failure
• Alpha Fetoprotein Origin -✓✓Liver and germ cell tumors
• Carcinoembryonic Antigen -✓✓GI, pancreas, lung, breast tumors
• Prostate Specific Antigen -✓✓prostate tumors
• Carcino- -✓✓from epithelial tissue- renal cell carcinoma
• Sarco- -✓✓from connective tissue- chondrosarcoma
• Carcinoma in situ -✓✓preinvasive epithelial malignant tumors of glandular or
squamous cells- cervix
• Lung ca metastasis -✓✓Multiple organs including brain
• Colorectal ca metastasis -✓✓Liver, lungs
• Testicular ca metastasis -✓✓Liver, lungs, brain
• Prostate ca metastasis -✓✓Bones (especially lumbar spine), liver
• Head and neck ca metastasis -✓✓Liver, bones, lymphatics
• Ovarian ca metastasis -✓✓Peritoneal surfaces, diaphragm, omentum, liver
• Sarcoma metastasis -✓✓Lungs
• Melanoma metastasis -✓✓In transit lymphatics, lung, liver, brain, GI tract
, • Mechanisms of ca metastasis -✓✓Local invasion, followed by invasion of surrounding
tissues. Cells then may invade blood and lymphatic vessels. They must survive in
circulation, then enter and survive in a new location. Then the cells can multiply and
form a new tumor.
• TNM staging system -✓✓T= tumor size >/= correlates with metastatic ability
N= whether lymph nodes are involved
M= extra nodal involvement (liver, lungs)
• Intravascular fluid compartment -✓✓In venous system- 20%
• Osmolality -✓✓The measure of solute concentration in a fluid.
280-295 mOsm
• Interstitial fluid compartment -✓✓Surrounds the cells and bathes them in nutrients-
20%
• Intracellular fluid compartment -✓✓Within the cells- 40% uk
• Osmosis -✓✓Passive- the movement of water from an area of low concentration of
solute to one of higher concentration
• Osmotic pressure -✓✓Pulling- the amount of pressure or force that is exerted by
solute molecules of a given compartment
• Hydrostatic pressure -✓✓Blood pressure- pushes fluid outside of the vessels, the
force of fluid against the walls of a compartment- venous obstruction, Na and water
retention
• Oncotic pressure -✓✓Colloid pressure keeps water inside the compartment, attracts
water from interstitial space back into the capillary- losses or diminished albumin
• Effective arterial blood volume -✓✓The amount of blood within the arterial space- ECF
changes will cause changes in the EABV in the same direction
• Renin Angiotensin Aldosterone System -✓✓Activated by low blood volume, triggers
release of renin which converts angiotensinogen to angiotensin 1. ACE converts
angiotensin 1 to angiotensin which causes arterial vasoconstriction and stimulates
release of aldosterone. Aldosterone stimulates renal Na reabsorption and K+ excretion.
Water is retained, less urine is produced, blood volume increases.
• Natriuretic hormones -✓✓ANP and BNP- released by heart- works opposite RAAS to
decrease blood volume, promotes urinary excretion of Na and water