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Pathophysiology-Exam-2-Review

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Know the 4 types of injuries to tissues o Adaptation: Change in a cell structure or function in response to changes in the Environment, meaning the following changes are revertible: i. Physiological: Inc. in size & # of cells (Ex. Uterine changes during pregnancy) ii. Pathological: Temporary inc. in size of myocardial (heart) cells (Ex. High BP) o Cell Injury: Caused by any factor that alters cellular structures, like physical injury of the body, which leads to deprivation of O2 or nutrients:  Reversible injury (Sub-lethal) & Irreversible injury (Lethal)  Classifications: Chemical, Hypoxic (Lack of O2), Free Radical (Oxidative stress or ROS), Unintentional, Intentional, Infectious agents, Inflammatory o Ageing: Long-term effects on cells, where general processes, including those that help repair and maintain the cell, begin to slow down over time. o Cell Death: Injured cells must repair or die. The 3 forms of cell-death are: i. Apoptosis: Programmed cell-death (during development)  Cell-shrinkage, budding, Caspases, p53) a. Nuclear: Nuclear/Chromatin margination, non-random DNA cleavage b. Cellular: Shrinkage, apoptotic bodies, membrane-upkeep, budding c. Biochemical: Caspases/p53/Cyto-C release, ATP upkeep, no inflame  Cytochrome-C is a mitochondrial protein that activates Caspase in the presence of ATP (which is why Cyto-C is found in Apoptosis, not Necrosis). ii. Necrosis: Tissue-death (cell/organelle-swelling, loss of membrane integrity)  Once Mito function is lost & ATP-levels fall (>30%), the cell will auto-switch from Apoptosis  Necrosis (aka ‘Oncosis’).  Na+/K+ pumps will fail, thus causing an imbalance of concentration gradient so that H2O/Ca2+ will follow Na+ into the cell (cell-swelling).  Swelling of ER/Mito, Blebbing w/out budding, no caspases, high intracellular Ca2+ levels (activates proteases), and has inflammation. iii. Autophagy: Cellular self-eating (induced by metabolic stress/starvation)  Toxicant-dependent: Ca2+ changes, Oxidants, Cisplatin, Cyclosporine  Beclin-1: Facilitates formation of autosome by regulating P13K  Measurements: Morph (what it looks like) & Biochemical (how it’s activated): a. Morphological: Cell-size, Plasma-membrane integrity (wall-strength), and Organellemembrane (mitochondria & nucleus) integrity. b. Biochemical: Leakage of intracellular enzymes & activation of proteins (caspases, p53, proteases).

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