Chapter 2 Cellular Pathology: Injury, Inflammation, and

Repair
Oh No! Not Another Learning Experience
Learning Objective 1
Exercise 2-1
1. ectoderm
2. Totipotent
3. Pluripotent
4. Multipotent
Exercise 2-2
1. Cell Cycle
2. Mitosis
3. Stem Cell
4. Asymmetric Division
Learning Objective 2
Exercise 2-3
1. Labile
2. Stable
3. Permanent
4. brain
Exercise 2-4
1. stimulation
2. No
3. Short
4. Lifetime
5. Epithelium

Learning Objective 3
Exercise 2-5
1. most common
2. ischemia
3. ionizing radiation
Exercise 2-6
1. True
2. False, anoxia
3. True
4. False, frostbite
5. True
Learning Objective 4
Exercise 2-7
1. hydropic change
2. fat
3. lipofuscin
4. atrophy
5. hypertrophy
6. hyperplasia
7. metaplasia
8. dysplasia
9. apoptosis
10. necrosis
Exercise 2-8
1. Decrease size of cells
2. Hypertrophy
3. Increase number of cells
4. Chronic injury/stress
5. Barretts esophagus

Exercise 2-9
1. Apoptosis
2. Pathologic
3. fat necrosis
4. coagulative necrosis
5. liquefactive necrosis
6. caseous necrosis
7. No inflammatory reaction
Exercise 2-10
1. Coagulative
2. Liquefactive
3. Caseous
4. Fat
Exercise 2-11
1. True
2. True
Learning Objective 5
Exercise 2-12
1. leukocytes
2. lymphocytes
3. plasma cells
4. Neutrophils
5. Eosinophils
6. Basophils
7. autocrine
8. paracrine
9. hormones
10. vasodilation
11. Cytokines
12. complement system

Exercise 2-13
1. Mast Cells
2. Leukocytes
3. Macrophages
4. Platelets
5. Granulocytes
6. T Lymphocyte
7. B Lymphocyte
8. Monocytes
9. Cytokines
10. Chemokines
11. Chemotaxis
12. Clotting System
Learning Objective 6
Exercise 2-14
1. Acute inflammation
2. tumor
3. rubor
4. calor
5. dolor
6. chronic inflammation
7. chronic inflammation
8. lymphocytes
9. granulomatous inflammation
Exercise 2-15
1. Persistent injury
2. a few hrs/weeks
3. Resolution
4. Scar

Exercise 2-16
1. Serious Inflammation
2. Supparative (pyogenic) Inflammation
3. Fibrin
4. No Inflammatory cells
5. Inc. protein
Exercise 2-17
1. True
2. False, hyperemia
3. False, edema
4. True
Learning Objective 7
Exercise 2-18
1. reactive hyperplasia
2. fibrinogen
3. appetite
Exercise 2-19
1. Fibrinogen
2. Reactive Hyperplasia
3. Lymphangitis
4. Inflammatory markers
5. Lymphadenitis
6. Lymphadenopathy
7. Erythrocyte Sedimentation Rate
Learning Objective 8
Exercise 2-20
1. Parenchymal repair
2. scar
3. permanent cells

4. angiogenesis
5. mixture
Exercise 2-21
1. False, repair
2. True
3. True
4. False, parenchyma
5. False, stroma
6. True
Learning Objective 9
Exercise 2-22
1. first intention
2. second intention
3. widely
4. granulation tissue
5. longer
Exercise 2-23
1. Second intention
2. Closely
3. Surgical incision
4. scarring
Learning Objective 10
Exercise 2-24
1. dehiscence
2. infection
3. steroids
4. keloids
5. pyogenic granulomas

Exercise 2-25
Test Yourself
Multiple Choice
1. The answer is C. During a heart attack, an artery becomes blocked. This blockage
deprives part of the heart of blood (and therefore oxygen). With deprivation of blood
comes coagulative necrosis. The exception to this rule is liquefactive necrosis, but this
only occurs in CNS blood deprivation.
2. The answer is C. Dysplasia is characterized by a disordered growth and large darkened,
irregular nuclei. It is a premalignant change and may lead to cancer.
3. The answer is A. A surgical incision typically heals by first intention due to closely
approximated edges. Second intention is typical of wounds with wide margins.
Regeneration/restoration is replacement of the tissue good as new can be
accomplished.
4. The answer is C. The replacement of one differentiated tissue with another is
metaplasia.
5. The answer is B. During apoptosis DNA ladders on an agarose gel. The other statements
are false. Apoptotic cells are smaller and have a more intense color, and apoptosis is not
accompanied by inflammation. Finally, condensation of nuclear proteins occurs during
necrosis.
6. The answer is D. An increase in the size of an organ could be either hyperplasia or
hypertrophy. As heart cells are unable to divide (they are a permanent cell), the heart
must have therefore undergone hypertrophy (or an increase in cell size).
7. The answer is B. Serous inflammatory exudate is characterized by a thin watery fluid,
and is common to burns. Edema is a general increase in fluid in the tissue. Supparative
inflammatory exudates are characterized by pus. Fibrinous inflammatory exudate is
typified by high levels of fibrin, as seen in heart attack patients suffering from
pericarditis.
8. The answer is D. Vasodilation is the first response to acute inflammation; it serves to
bring more blood to the site of injury. Prior to the occurrence of the injury, blood flow is
smooth. After injury, the vasculature dilates and endothelial gaps widen causing edema.

After injury, during the healing process, angioneogenesis (or the formation of new
blood vessels) to restore blood flow.
9. The answer is C. Keloids are hyperplastic scars containing excess collagen. They are
commonly found in people of African American descent.
10. The answer is A. Chemokines do cause these systemic manifestations.
11. The answer is D. All of the above are potential vasodilators. Histamine and serotonin
are cell-derived vasoactive amines, and nitrous oxide is a reactive oxygen species. Kinin
also serves as a vasodilator (but it is one that is plasma derived).
12. The answer is B. Mesoderm differentiates into the deep layer of skin (dermis), bone,
skeletal muscle, blood vessels, smooth muscle, pleura, peritoneum, pericardium, and
the kidneys and gonads. Ectoderm differentiates into hair, nails, and epidermis;
endoderm differentiates into mucosa of the intestinal and respiratory tracts and into
the liver.
True or False
13. True
14. False. Apoptosis is orderly programmed cell death. Necrosis occurs when a cell has
been irreversibly injured.
15. True. Dystrophic calcification occurs with all types of necrosis: free fatty acids (from
broken down triglycerides) precipitate with calcium. Metastatic calcification is seen when
serum calcium is at high levels.
16. False. Mitosis is a process of organizing and dividing the nucleus into two daughter
nuclei.
17. False. Hypoxia is the deprivation of oxygen, while ischemia is the deprivation of blood
flow. This lack of blood flow prevents cells from obtaining nutrients, and also increases the
buildup of wastes such as lactic acid.
Matching
18. A. <ii> Caseous necrosis is commonly found in TB patients and is characterized by
soft-white, clumpy tissue.

B. <iii> Liquefactive necrosis is found in patients suffering from a stroke in the CNS and at
sites of infection.
C. <iv> Fat necrosis is seen in organs high in fat content: either damage or trauma to
tissue high in fat content, or upon enzymatic digestion.
D. <i> Coagulative necrosis is caused by blood deprivation such as a heart attack or
hypoxia of the kidney.
19. A. <i> Permanent cells are those that dont divide, for example, the heart and the CNS.
B. <iii> Stabile cells divide upon stimulation, for example, the kidney and the liver.
C. <ii> Labile cells are continuously dividing, for example, those found in the epidermis or
the epithelial lining of the gut.
D. <iii> See explanation for B above.
E. <i> See explanation for A above.
20. A. <ii> Neutrophils generally respond to bacteria.
B. <iii> Parasites instigate an eosinophilic response.
C. <i> Syphilis is the bacterial exception to neutrophils, as lymphocytes respond.
D. <iii> Allergens incite an eosinophilic response.
E. <i> Lymphocytes respond to viruses.
Short Answer
21. A stem cell is an undifferentiated cell capable of reproducing itself and a specialized cell.
They are classified according to their potency to develop into specialized cells. The most
potent (totipotent) have the broadest powers and can give rise to any particular type of cell
in the body or even to an entire organism. Subsequent stem cell generations become more
specialized and less broadly potent. The pluripotent stem cell can produce any type of
tissueheart, brain, liver, skin, etc.but cannot form an entire new human being. With
further division, pluripotent stem cells become multipotent stem cells, which can produce a
limited range of cell types.
22. The potential outcomes of acute inflammation include resolution (the restoration of
normal tissue), scarring (destroyed support cells render the tissue unable to regenerate),
abscess formation (fibrous walled-off area containing necrotic debris and dead white cells),
and chronic inflammation due to persistent injury.

23. Acute inflammation is of short term, lasts days to weeks, is accompanied by

vasodilation and neutrophils, and heals with complete resolution. Chronic inflammation is
of long term, lasts weeks to years, is characterized by monocytes, and heals with scarring.