4-Reversible and Irreversible cell injury

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reversible

alteration of homeostasis, remove problem, cell returns to normal

irreversible

alteration of homeostasis to "point of no return" = cell death, necrosis, removal of stimuli: still no return to normal

2 main types of reversible

swelling/hydropic degeneration
fatty change

fatty change - definition

early stage: sub-lethal damage, intracytoplasmic vaculoation bc of vacuoles of fat

fatty change pathogenesis

impaired metabolism of fatty acids thus build up of triglycerides, thus intracytoplasmic fat vacuoles

stages of fatty change

1. lipids into hepatocytes as FFA
2. FFA turned into: cholesterol, phopholipids, ketones, triglycerides
3. Triglycerides + apoproteins to make lipoproteins
4. Lipoproteins: only form triglycerides can leave hepatocytes
abnormalities in any of this causes fatty change

decreased beta-oxidation of fatty acids to ketones because of _____ injury

mitochondrial

impaired synthesis of apoproteins

starvation, CCl4 toxicity, aflatoxicosis

impaired combination of triglycerides and proteins to form

lipoprotein

problem secreting lipoproteins from hepatocyte

build up of fat

3 main etiologies of fatty change

hypoxia
toxicity
metabolic disorders

which cells do you mainly find fatty change

cells dependant on fat metabolism (hepatocytes)
renal tubular epithelium
myocardium

fatty change is seen with abnormalities of 3 things

synthesis
utilization
mobilization

what sometimes comes with fatty change

swelling

gross appearance of fatty change

liver diffusely yellow, or reticular pattern if only a zone is affected

cut section of fatty change

bulge
rounded edges

describe fatty change tissue

soft
friable
cuts easy
greasy texture

what happens when you put fatty liver in water

float

where is the nucleus in a fatty cell

periphery

how do you tell diff between swollen cell, fat cell, glycogen cell

stain

whats stains detect fat

oil red O
Sudan III

5 necrosis

coagulation
liquefactive
caeous
fat
gangrene

coagulation definition

death by preservation of tissue architecture and cellular outline

which is the most common necrosis

coagulation

hypoxic/ischemic death of all cells except brain is

coagulation

necrosis where outline of cell persists for a few days

coagulation

gross of coagulative

architecture of necrotic looks like normal, except for color and texture could be diff
ligher (pale)
swollen/shrunken
area could be surrounded by inflammation

microscopic change in coagulative of cytoplasm

inc eosinophilia (light pink) (loss of ribosomes)
hyalinized (glassy) apperance bc loss of glycogen

three types of nuclear changes

pyknosis
karyorrhexis
karyolysis

pyknosis

shurnken
dense basophilic (blue)
irregular

karyorrhexis

nuclear membrane ruptures
nucleus fragmented

karyolysis

complete dissolution
fading/loss of chromatin

etiology of coagulative

bacterial toxins
viral replication
infarction

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