NU545 PATHO STUDY GUIDE UNIT #1
EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
What are cytokines?
Or cytokinesis? (p.37) - Answer-• Cytokines are peptides that transmit signals
within/between cells to stimulate tissue growth & development.
Do all cells continue to replicate or divide? - Answer-• No, all types of cells undergo
mitosis during formation of the embryo, but adult cells including: nerve cells, lens cells,
& muscle cells, lose the ability to replicate.
• When a need arises for new cells, as in the repair of injured cells, previously non-
dividing cells must be rapidly triggered to reenter the cell cycle.
• Neurons are fixed at birth & are unable to be replaced.
When normal columnar ciliated epithelial cells of the bronchial lining are replaced by
stratified squamous cells, the process is called? - Answer-• Metaplasia: the reversible
replacement of one mature cell by another, sometimes less differentiated cell type.
• However, lose protective ability, because new cells don't secrete mucus or have cilia.
• Bronchial metaplasia can be reversed if inducing stimulus is removed, such as
cigarette smoking.
What is the relationship between ischemia and ATP? - Answer-• When a hypoxic injury
occurs to myocardium, which causes an abrupt lack of contraction (caused by quick
decline in mitochondrial phosphorylation), causing insufficient ATP production.
• Lack of ATP leads to increase in anaerobic metabolism, which generates ATP from
glycogen when there is insufficient oxygen.
• When glycogen stores are depleted, even anaerobic metabolism ceases.
When does sodium enter the cell and cause swelling? - Answer-• A reduction in ATP
levels cause the plasma membrane's Na-K pump & Na-Ca exchange to fail.
• Causes intracellular accumulation of Na & Ca & diffusion of K out of cell.
• Na & H2O enter cell freely, leading to cellular swelling.
What are free radicals in relation to cell damage? Progression of diseases? - Answer-
Membrane damage is initiated by injury induced by free radicals, primarily by excess
reactive oxygen species (ROS) called oxidated stress. Free radical is an electrically
uncharged atom or group of atoms having an unpaired electron; thus causing the
molecule to be unstable. To stabilize the molecule, it gives up an electron or steals one.
This process is capable of injuries through chemical bond formation with proteins, lipids,
& carbs. Free radicals aren't easily controlled & they initiate chain reactions. These
reactive species are important in regard to cell injury by lipid peroxidation, alterations of
proteins causing fragmentation of polypeptide chains, & alterations of DNA (breaking
,single strands). Diseases & disorders have been linked directly & indirectly to these
reactive species.
Know all about lead poisoning. How does it cause damage within the cell? - Answer-• A
heavy metal, primary hazard to children.
• Can cause learning disabilities, hyperactivity, & ADD
• Found in paint, soil, dust, debris from houses, baby formula mixed with lead
contaminated water, newsprint, water that flows through lead pipes, hair dyes, gasoline,
& tin cans or pottery made with lead based glaze.
• Nervous system, hematopoietic system, & kidneys are primarily affected
• Interferes with Ca. Can increase intracellular Ca concentrations & become a substitute
& some Ca-binding proteins are capable of binding with lead. PKC (protein kinase C)
mediated lead induced rise in intracellular free Ca causing cellular disruption.
• Inhibits enzymes involved in hemoglobin synthesis (ie anemia)
• Other s/s: convulsions, delirium, & peripheral nerve involvement to the wrist, fingers, &
feet, glycosuria, aminoaciduria, & hyperphosphaturia, n/v, loss of appetite, wt loss, &
abd cramps.
Know about the affects of fetal alcohol syndrome on infants. - Answer-• Can lead to
growth retardation, cognitive impairment, facial anomalies, & ocular disturbances.
How does alcohol affect the nervous system? - Answer-• Acts as a depressant affecting
the subcortical structures first (brainstem reticular formation). Motor and intellectual
activities then become distorted. At high levels, medullar centers become depressed,
affecting respirations.
Where do lipids accumulate? - Answer- • During chemical injury lipids accumulate within
the cytoplasm, starting within cisternae of the endoplasmic reticulum
• Lipids primarily accumulate in the cells of the spleen, liver, CNS
• The most common site of intracellular lipid accumulation also known as fatty change is
liver cells
• Heart, liver, & muscle in hyperlipidemia
What is hemosiderosis? - Answer-• Excess iron is stored as hemosiderin in the cells of
many organs & tissues. Common w/multiple blood transfusions or prolonged parenteral
administration of iron or excessive alcohol
What causes free calcium in the cytosol? - Answer-• Calcium is usually stored in the
mitochondria and endoplasmic reticulum and then pumped to extracellular space bound
to calcium-binding proteins.
• Free calcium in the cytosol is caused by abnormal permeability of calcium-ion
channels, direct damage to membranes, or depletion of ATP (i.e. hypoxic injury);
therefore, causing uncontrolled enzyme activation causing further damage.
What happens to sodium and water during cell injury? - Answer-In hypoxia ATP
decreases, causing the Na/K pump & Na/Ca exchange to fail. Leading to increase of
, intracellular Na & Ca, & diffusion of K out of the cell; Na & water can then enter the cell
freely causing swelling & dilation of the endoplasmic reticulum
During cell injury caused by hypoxia, what happens to osmotic pressure? - Answer-•
Osmotic pressure is the amount of hydrostatic pressure required to oppose the osmotic
movement of water.
• In hypoxia you have an increase in Na in the cell and an out flow of K+ (P.56).
Resulting in a deficit of Na in the ECF which decreases the ECF osmotic pressure and
water is attracted to the ICF space
What causes mammary glands to enlarge in pregnancy? - Answer-• Hormonal
hyperplasia (stimulated by estrogen)
After ovulation what happens to uterine endometrial cells? - Answer-• Hormonal
hyperplasia occurs chiefly in estrogen dependent organs. After ovulation estrogen
stimulates the endometrium to grow and thicken.
• After ovulation, then begins the secretory phase where glands in the endometrium
secrete glycogen containing fluid, and if there is no ovum implantation, then we move to
the ischemic phase where the endometrium sloughs off monthly During menstruation
the functional layer of the endometrium falls apart and sloughs.
What happens to liver cells when a portion of the liver is removed? - Answer-
Compensatory hyperplasia is an adaptive mechanism that allows some organs to
regenerate in order to compensate for the loss. A protein, hepatocyte growth factor
(HGF) is thought to be a mediator in vitro of liver regeneration; however other growth
factors and cytokines are involved.
Understand necrosis in relation to pulmonary TB and gangrene. - Answer-• TB results
in Caseous necrosis; a combination of coagulative & liquefactive necrosis
-coagulative = results from protein denaturation, where protein albumin changes from
gelatinous, transparent to firm, opaque like cooked egg whites
-liquefactive = digestive juices eat their own hydrolases, & tissue liquefies, gets walled
off from healthy tissue, & forms cysts
• Dead cells disintegrate but debris is not digested completely by hydrolases. Tissues
appear soft & granular. A granulomatous inflammatory wall encloses areas of caseous
necrosis.
• Gangrene is a term usually used to refer to death of tissue & results from severe
hypoxic injury usually from arteriosclerosis. Hypoxia and bacterial invasion occurs.
• Dry gangrene is d/t coagulative necrosis & the skin is dry & shrinks w/color changes
(black).
• Wet gangrene occurs when neutrophils invade the site & cause liquifactive necrosis,
usually in internal organs, causes site to be swollen, cold, & black. Foul odor is present
produced by pus.
EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
What are cytokines?
Or cytokinesis? (p.37) - Answer-• Cytokines are peptides that transmit signals
within/between cells to stimulate tissue growth & development.
Do all cells continue to replicate or divide? - Answer-• No, all types of cells undergo
mitosis during formation of the embryo, but adult cells including: nerve cells, lens cells,
& muscle cells, lose the ability to replicate.
• When a need arises for new cells, as in the repair of injured cells, previously non-
dividing cells must be rapidly triggered to reenter the cell cycle.
• Neurons are fixed at birth & are unable to be replaced.
When normal columnar ciliated epithelial cells of the bronchial lining are replaced by
stratified squamous cells, the process is called? - Answer-• Metaplasia: the reversible
replacement of one mature cell by another, sometimes less differentiated cell type.
• However, lose protective ability, because new cells don't secrete mucus or have cilia.
• Bronchial metaplasia can be reversed if inducing stimulus is removed, such as
cigarette smoking.
What is the relationship between ischemia and ATP? - Answer-• When a hypoxic injury
occurs to myocardium, which causes an abrupt lack of contraction (caused by quick
decline in mitochondrial phosphorylation), causing insufficient ATP production.
• Lack of ATP leads to increase in anaerobic metabolism, which generates ATP from
glycogen when there is insufficient oxygen.
• When glycogen stores are depleted, even anaerobic metabolism ceases.
When does sodium enter the cell and cause swelling? - Answer-• A reduction in ATP
levels cause the plasma membrane's Na-K pump & Na-Ca exchange to fail.
• Causes intracellular accumulation of Na & Ca & diffusion of K out of cell.
• Na & H2O enter cell freely, leading to cellular swelling.
What are free radicals in relation to cell damage? Progression of diseases? - Answer-
Membrane damage is initiated by injury induced by free radicals, primarily by excess
reactive oxygen species (ROS) called oxidated stress. Free radical is an electrically
uncharged atom or group of atoms having an unpaired electron; thus causing the
molecule to be unstable. To stabilize the molecule, it gives up an electron or steals one.
This process is capable of injuries through chemical bond formation with proteins, lipids,
& carbs. Free radicals aren't easily controlled & they initiate chain reactions. These
reactive species are important in regard to cell injury by lipid peroxidation, alterations of
proteins causing fragmentation of polypeptide chains, & alterations of DNA (breaking
,single strands). Diseases & disorders have been linked directly & indirectly to these
reactive species.
Know all about lead poisoning. How does it cause damage within the cell? - Answer-• A
heavy metal, primary hazard to children.
• Can cause learning disabilities, hyperactivity, & ADD
• Found in paint, soil, dust, debris from houses, baby formula mixed with lead
contaminated water, newsprint, water that flows through lead pipes, hair dyes, gasoline,
& tin cans or pottery made with lead based glaze.
• Nervous system, hematopoietic system, & kidneys are primarily affected
• Interferes with Ca. Can increase intracellular Ca concentrations & become a substitute
& some Ca-binding proteins are capable of binding with lead. PKC (protein kinase C)
mediated lead induced rise in intracellular free Ca causing cellular disruption.
• Inhibits enzymes involved in hemoglobin synthesis (ie anemia)
• Other s/s: convulsions, delirium, & peripheral nerve involvement to the wrist, fingers, &
feet, glycosuria, aminoaciduria, & hyperphosphaturia, n/v, loss of appetite, wt loss, &
abd cramps.
Know about the affects of fetal alcohol syndrome on infants. - Answer-• Can lead to
growth retardation, cognitive impairment, facial anomalies, & ocular disturbances.
How does alcohol affect the nervous system? - Answer-• Acts as a depressant affecting
the subcortical structures first (brainstem reticular formation). Motor and intellectual
activities then become distorted. At high levels, medullar centers become depressed,
affecting respirations.
Where do lipids accumulate? - Answer- • During chemical injury lipids accumulate within
the cytoplasm, starting within cisternae of the endoplasmic reticulum
• Lipids primarily accumulate in the cells of the spleen, liver, CNS
• The most common site of intracellular lipid accumulation also known as fatty change is
liver cells
• Heart, liver, & muscle in hyperlipidemia
What is hemosiderosis? - Answer-• Excess iron is stored as hemosiderin in the cells of
many organs & tissues. Common w/multiple blood transfusions or prolonged parenteral
administration of iron or excessive alcohol
What causes free calcium in the cytosol? - Answer-• Calcium is usually stored in the
mitochondria and endoplasmic reticulum and then pumped to extracellular space bound
to calcium-binding proteins.
• Free calcium in the cytosol is caused by abnormal permeability of calcium-ion
channels, direct damage to membranes, or depletion of ATP (i.e. hypoxic injury);
therefore, causing uncontrolled enzyme activation causing further damage.
What happens to sodium and water during cell injury? - Answer-In hypoxia ATP
decreases, causing the Na/K pump & Na/Ca exchange to fail. Leading to increase of
, intracellular Na & Ca, & diffusion of K out of the cell; Na & water can then enter the cell
freely causing swelling & dilation of the endoplasmic reticulum
During cell injury caused by hypoxia, what happens to osmotic pressure? - Answer-•
Osmotic pressure is the amount of hydrostatic pressure required to oppose the osmotic
movement of water.
• In hypoxia you have an increase in Na in the cell and an out flow of K+ (P.56).
Resulting in a deficit of Na in the ECF which decreases the ECF osmotic pressure and
water is attracted to the ICF space
What causes mammary glands to enlarge in pregnancy? - Answer-• Hormonal
hyperplasia (stimulated by estrogen)
After ovulation what happens to uterine endometrial cells? - Answer-• Hormonal
hyperplasia occurs chiefly in estrogen dependent organs. After ovulation estrogen
stimulates the endometrium to grow and thicken.
• After ovulation, then begins the secretory phase where glands in the endometrium
secrete glycogen containing fluid, and if there is no ovum implantation, then we move to
the ischemic phase where the endometrium sloughs off monthly During menstruation
the functional layer of the endometrium falls apart and sloughs.
What happens to liver cells when a portion of the liver is removed? - Answer-
Compensatory hyperplasia is an adaptive mechanism that allows some organs to
regenerate in order to compensate for the loss. A protein, hepatocyte growth factor
(HGF) is thought to be a mediator in vitro of liver regeneration; however other growth
factors and cytokines are involved.
Understand necrosis in relation to pulmonary TB and gangrene. - Answer-• TB results
in Caseous necrosis; a combination of coagulative & liquefactive necrosis
-coagulative = results from protein denaturation, where protein albumin changes from
gelatinous, transparent to firm, opaque like cooked egg whites
-liquefactive = digestive juices eat their own hydrolases, & tissue liquefies, gets walled
off from healthy tissue, & forms cysts
• Dead cells disintegrate but debris is not digested completely by hydrolases. Tissues
appear soft & granular. A granulomatous inflammatory wall encloses areas of caseous
necrosis.
• Gangrene is a term usually used to refer to death of tissue & results from severe
hypoxic injury usually from arteriosclerosis. Hypoxia and bacterial invasion occurs.
• Dry gangrene is d/t coagulative necrosis & the skin is dry & shrinks w/color changes
(black).
• Wet gangrene occurs when neutrophils invade the site & cause liquifactive necrosis,
usually in internal organs, causes site to be swollen, cold, & black. Foul odor is present
produced by pus.
