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Big Picture: USMLE Step 1 Web Prep - Cellular Injury and Adaptation

This document discusses the causes and types of cellular injury and death. The major causes of cellular injury include hypoxia, infections, chemicals, physical trauma, and nutritional imbalances. Cells undergo adaptation, reversible injury, or irreversible injury and death. The types of cell death include necrosis, apoptosis, and autophagy. Cells may also show adaptations like atrophy, hypertrophy, hyperplasia, metaplasia, and dysplasia in response to injury.

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22 views9 pages

Big Picture: USMLE Step 1 Web Prep - Cellular Injury and Adaptation

This document discusses the causes and types of cellular injury and death. The major causes of cellular injury include hypoxia, infections, chemicals, physical trauma, and nutritional imbalances. Cells undergo adaptation, reversible injury, or irreversible injury and death. The types of cell death include necrosis, apoptosis, and autophagy. Cells may also show adaptations like atrophy, hypertrophy, hyperplasia, metaplasia, and dysplasia in response to injury.

Uploaded by

frabzi
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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USMLE Step 1 Web Prep Cellular Injury and Adaptation

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BIG PICTURE
Cellular injury o Reversible injury o Adaptation o Irreversible injury + cell deat
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CAUSES OF CELLULAR INJURY


Hypoxia "ost co##on cause o$ injury %e$inition o &ac' o$ o(y)en inability to synt esi*e A+, by anaerobic o(idation

&oss o$ A+, o -ailure o$ sodiu#.potassiu# pu#p o Increased )lycolysis o -ailure to produce proteins "ajor causes o Isc e#ia o Cardiopul#onary $ailure o %ecreased o(y)en carryin) capacity
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CAUSES OF CELLULAR INJURY CON T


In$ections 0acteria1 viruses1 $un)i I##unolo)ic reactions 2ypersensitivity reactions Autoi##une diseases Con)enital disorders Inborn errors o$ #etabolis#
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CAUSES OF CELLULAR INJURY CON T


C e#ical injury %ru)s

,oisons 3ccupational e(posure &i$estyle c oices

, ysical $or#s o$ injury +rau#a 0urns Radiation


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CAUSES OF CELLULAR INJURY CON T


5utritional or vita#in i#balance Inade6uate calorie7 protein inta'e o 89as ior'or. selective protein de$iciency o "aras#us. total calorie de$iciency :ita#in de$iciency o :it % ric'ets + osteo#alacia o :it 8 coa)ulopat y o :it 012 #e)aloblastic ane#ia o -olate #e)aloblastic ane#ia + neural tube de$ects
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CELLULAR CHANGES DURING INJURY


;eneral Adaptation Reversible injury Irreversible injury + cell deat Cellular response dependent on +ype %uration <everity +ype o$ cell "etabolic state
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CELLULAR CHANGES DURING INJURY CON T


Critical intracellular susceptible syste#s %5A ,roduction o$ A+, Cell #e#branes ,rotein synt esis "ec anis#s o$ cell injury 3(y)en.derived $ree radicals o <upero(ide1 ydro(yl + ydro)en pero(ide A+, depletion

Increased cell #e#brane per#eability In$lu( o$ calciu# "itoc ondrial dys$unction


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RE&ERSIBLE AND IRRE&ERSIBLE CELL INJURY

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IRRE&ERSIBLE CELL INJURY


<evere #e#brane da#a)e "yocardial injury troponin 1 C8."0 + &%2 2epatitis transa#inases ,ancreatitis a#ylase + lipase 0iliary +ract obstruction al'aline p osp atase "ar'ed #itoc ondrial dys$unction <9ellin) %ensities in #atri( ",+ Inability to produce A+,
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IRRE&ERSIBLE CELL INJURY CON T


Rupture o$ lysoso#es Autolysis 5uclear c an)es ,y'nosis 8aryorr e(is

8aryolysis
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CELL DEATH
(o)p*o+o,i- .yp/0 of 1/-)o0i0 Coa)ulative necrosis "ost co##on %enaturin) + coa)ulation o$ proteins > <lide i#a)e o$ eart ?cross section@ ,ale1 yello9 in$arction
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C/++ D/a.*
Coa)ulative necrosis > <lide i#a)e o$ eart ?#icro@ &ac' o$ nuclei &i6ue$action necrosis %estruction by ydrolytic en*y#es 0rain1 pancreas +abscess
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(ORPHOLOGIC TYPES OF NECROSIS CON T


Caseous necrosis Coa)ulative + li6ue$action necrosis ;ross. Acotta)e. c eese.li'eB o ;iant cells o Cpit eliod cells o &y#p ocytes +0 -at necrosis Action o$ lipases on $atty tissues

0reast1 abdo#en + pancreas


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(ORPHOLOGIC TYPES OF NECROSIS CON T


-ibrinoid necrosis > <lide i#a)e o$ 'idney ;lo#erulus. a$$erent arteriole. pin'. $ibrinoid necrosis Arteridities %ead tissue

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(ORPHOLOGIC TYPES OF NECROSIS CON2T


;an)renous necrosis %ead tissue %ry )an)rene . blac' toes . coa)ulative necrosis Det )an)rene . yello9 areas . li6ue$active necrosis

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APOPTOSIS
%e$inition ,ro)ra##ed cell deat Active process "orp olo)ic appearance Cell s rin's 5uclear c ro#atin condenses Cytoplas#ic blebs Apoptotic bodies , a)ocytosis &ac' o$ in$la##atory response
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APOPTOSIS CON T
<ti#ulus $or apoptosis Cell injury + da#a)e &ac' o$ or#ones1 cyto'ines + )ro9t $actors Receptor. li)and si)nals -as li)and +5-

Apoptosis is re)ulated by )enes bcl.2 o In ibits apoptosis o ,revents release o$ cytoc ro#e c o 0inds Apa$.1 p.53 o <ti#ulates apoptosis
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APOPTOSIS CON T
, ysiolo)ic e(a#ples o$ apoptosis C#bryo)enesis 2or#one dependent + y#us ,at olo)ical e(a#ples :iral diseases E epatitis ?Council#an body@ ;ra$t vsF ost Cystic $ibrosis
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ADAPTATION
;eneral Result o$ persistent injury ,otentially irreversible "ay neoplasia
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ADAPTATION CON T A.)op*y


%e$inition %ecrease cell si*e Causes %ecreased 9or'load Isc e#ia &ac' o$ or#onal or neural sti#ulation "alnutrition A)in) "icro

<#all s run'en cells %ecreased intracellular co#ponents +

C"

autop a)oso#es
o
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Atrop ic 'idney due to arterial occlusion


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HYPERTROPHY
%e$inition Increase in cell si*e + $unction Causes Increased de#and o , ysiolo)ic o ,at olo)ic

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&e$t ventricular concentric ypertrop y. ypertension


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HYPERPLASIA
%e$inition Increase G o$ cells , ysiolo)ic causes Co#pensatory ,at olo)ic causes Cndo#etrial yperplasia ,rostatic yperplasia o$ a)in)
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(ETAPLASIA
%e$inition C an)e o$ cell type to anot er C(a#ple 0ronc ial epit eliu# . colu#nar epit eliu#
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s6ua#ous #etaplasia
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DYSPLASIA
%e$inition Abnor#al proli$eration o$ cells Increased 5:C ratio &oss o$ polarity C(a#ple Cervical dysplasia
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cancer
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OTHER CELLULAR ALTERATIONS DURING INJURY


Intracellular accu#ulations &ipids ,roteins ;lyco)en stora)e diseases Cndo)enous pi)#ents o &ipo$uscin.i#a)e "elanin
o
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2e#osiderin
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OTHER CELLULAR ALTERATIONS DURING INJURY CON T


2yaline c an)es %e$inition o ,in' o#o)enous appearance Intracellular yaline o "ultiple #yelo#a o Russell bodies C(tracellular yaline o Absence o$ linin) cells
o
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,in' yaline #e#branes. 2yaline #e#brane disease o$ ne9born


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PATHOLOGIC FOR(S OF CALCIFICATION


%ystrop ic calci$ication vsF "etastatic calci$ication %ystrop ic calci$ications Calci$ication in dyin) 7necrotic tissue "etastatic Calci$ications Calci$ication in ypercalce#ia
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PATHOLOGIC FOR(S OF CALCIFICATION CON T


%ystrop ic calci$ication C(a#ples o -at necrosis o +u#ors. ,sa##o#a bodies
o
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At erosclerotic pla6ues. i#a)e


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PATHOLOGIC FOR(S OF CALCIFICATION CON T


"etastatic calci$ication %e$inition o 2ypercalce#ia C(a#ples o 2yperparat yroidis# o ,arat yroid adeno#as o Renal $ailure o :it % into( o "il'.al'ali syndro#e o "etastatic cancer to bone

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