AP6: R

Question 1

Flashcard 1 Type: MCQ Question: Which term refers specifically to the restoration of tissue architecture and function after an injury? Options: A. Inflammation B. Repair C. Pathogenesis D. Homeostasis Answer: B. Repair

Question 2

Flashcard 2 Type: Fill in the blank Question: While “repair” is used for parenchymal and connective tissues, the term ______ is often used specifically for surface epithelia. Answer: Healing

Question 3

Flashcard 3 Type: MRQ Question: What are the two primary processes by which damaged tissues are repaired? Options:A. Regeneration B. Apoptosis C. Scar formation D. Necrosis Answer: A, C

Question 4

Flashcard 4 Type: FFQ Question: Define Regeneration and explain what determines whether a tissue can undergo this process. Answer: Regeneration is the replacement of damaged components to return the tissue to its normal state. It depends on the tissue’s intrinsic proliferative capacity (labile vs. stable vs. permanent) and the presence of tissue stem cells or progenitors.

Question 5

Flashcard 5 Type: MCQ Question: Which of the following is an example of a Labile (continuously dividing) tissue?Options: A. Liver parenchyma B. Neurons C. Skin epidermis D. Smooth muscle Answer: C. Skin epidermis

Question 6

Flashcard 6 Type: Fill in the blank Question: Cells that are normally quiescent (in the G0 stage) but can divide in response to injury are classified as ______ tissues. Answer: Stable

Question 7

Flashcard 7 Type: MRQ Question: Which of the following cell types are considered part of Stable tissues? Options: A. Hepatocytes B. Endothelial cells C. Fibroblasts D. Cardiomyocytes Answer: A, B, C

Question 8

Flashcard 8 Type: FFQ Question: Why is repair in Permanent tissues like the heart and brain typically dominated by scar formation? Answer: These tissues are composed of terminally differentiated, non-proliferative cells. Because they lack the capacity for significant cell division, any loss of tissue mass cannot be replaced by regeneration and must be filled with connective tissue (scarring).

Question 9

Flashcard 9 Type: MCQ Question: Cell proliferation in regeneration is primarily driven by growth factors produced by which cell type? Options: A. Neutrophils B. Activated macrophages C. Platelets D. Stem cells Answer: B. Activated macrophages

Question 10

Flashcard 10 Type: Fill in the blank Question: For regeneration to be successful, the integrity of the ______ must be preserved to provide a scaffold for the new cells. Answer: Extracellular Matrix (ECM)

Question 11

Flashcard 11 Type: MCQ Question: In the liver, where do progenitor cells typically reside when hepatocyte proliferation is impaired? Options: A. Kupffer cells B. Space of Disse C. Canals of Hering D. Sinusoids Answer: C. Canals of Hering

Question 12

Flashcard 12 Type: MRQ Question: Which factors are involved in the Priming Phase of hepatocyte proliferation?Options: A. IL-6 B. Kupffer cells C. HGF D. TGF-β Answer: A, B

Question 13

Flashcard 13 Type: FFQ Question: Describe the Termination Phase of liver regeneration. Answer: Once the liver mass has been restored, hepatocytes must return to a state of quiescence (G0). This process is mediated by antiproliferative cytokines, specifically those belonging to the TGF-β family.

Question 14

Flashcard 14 Type: Fill in the blank Question: During the Growth Phase of liver repair, ______ acts on primed hepatocytes to stimulate their entry into the cell cycle. Answer: Hepatocyte Growth Factor (HGF) or TGF-α

Question 15

Flashcard 15 Type: MCQ Question: Resection of up to what percentage of the human liver can be corrected by hepatocyte proliferation? Options: A. 25% B. 50% C. 75% D. 90% Answer: D. 90%

Question 16

Flashcard 16 Type: FFQ Question: Explain the role of Integrins in tissue regeneration. Answer: Cells bind to ECM proteins via integrins. These connections are not just structural; signals from integrins can stimulate cell proliferation, working alongside growth factors to drive repair.

Question 17

Flashcard 17 Type: MCQ Question: What is the primary aim of Scar Formation? Options: A. Restoration of original tissue function B. To provide structural stability C. Elimination of the basement membrane D. Activation of permanent cells Answer: B. To provide structural stability

Question 18

Flashcard 18 Type: Fill in the blank Question: When fibrosis occurs in a tissue space occupied by an inflammatory exudate (e.g., in the lung), the process is known as ______. Answer: Organization

Question 19

Flashcard 19 Type: MRQ Question: Which components make up Granulation Tissue? Options: A. Loose connective tissue B. New thin-walled capillaries C. Large collagen bundles D. Inflammatory cells Answer: A, B, D

Question 20

Flashcard 20 Type: FFQ Question: Why are M2 Macrophages considered central to the repair process? Answer: M2 (alternatively activated) macrophages clear dead tissue and debris, but also secrete growth factors for cellular proliferation and cytokines (like TGF-β) that stimulate fibroblast proliferation and connective tissue synthesis.

Question 21

Flashcard 21 Type: MCQ Question: What is the very first step in scar formation following tissue injury? Options: A. Angiogenesis B. Hemostatic plug formation C. Collagen deposition D. Granulation tissue peak Answer: B. Hemostatic plug formation

Question 22

Flashcard 22 Type: Fill in the blank Question: The hemostatic plug is composed of ______ and provides a scaffold for fibrin deposition. Answer: Platelets

Question 23

Flashcard 23 Type: MCQ Question: Which growth factor is primarily responsible for inducing vasodilation and increased permeability during angiogenesis? Options: A. FGF B. VEGF C. PDGF D. TGF-β Answer: B. VEGF

Question 24

Flashcard 24 Type: MRQ Question: Which of the following molecules are responsible for separating pericytes and breaking down the basement membrane to allow for a vessel “sprout”? Options: A. Angiopoietin 1 B. Angiopoietin 2 C. Nitric Oxide D. Matrix Metalloproteinases (MMPs) Answer: A, B, D

Question 25

Flashcard 25 Type: FFQ Question: Describe the role of PDGF in the maturation of new blood vessels. Answer: PDGF (Platelet-derived growth factor) is responsible for the recruitment of periendothelial cells, such as pericytes and smooth muscle cells. This stabilizes the vessel sprout and turns it into a mature, functional vessel.

Question 26

Flashcard 26 Type: Fill in the blank Question: The proliferation of endothelial cells behind the leading front of a migrating vessel is mainly stimulated by ______ growth factors. Answer: Fibroblast (FGF)

Question 27

Flashcard 27 Type: MCQ Question: Which signaling pathway helps to suppress endothelial proliferation to ensure proper remodeling into capillary tubules? Options: A. IL-6 B. Notch C. HGF D. TNF Answer: B. Notch

Question 28

Flashcard 28 Type: Fill in the blank Question: During angiogenesis, ______ ______ is released to promote vasodilation.Answer: Nitric Oxide

Question 29

Flashcard 29 Type: MRQ Question: Where is angiogenesis commonly seen? Options: A. Healing wounds B. Tumor growth C. Ischemic tissue (collateral supply) D. Permanent tissue necrosis Answer: A, B, C

Question 30

Flashcard 30 Type: FFQ Question: How does the Extracellular Matrix (ECM) contribute to angiogenesis? Answer:ECM proteins interact with integrin receptors on migrating cells and provide the necessary physical scaffolding for the growth and organization of new vessels.

Question 31

Flashcard 31 Type: MCQ Question: Which cytokine is the most important for stimulating the synthesis and deposition of connective tissue proteins by fibroblasts? Options: A. IL-6 B. TNF C. TGF-β D. VEGF Answer: C. TGF-β

Question 32

Flashcard 32 Type: Fill in the blank Question: Fibroblasts that acquire features of smooth muscle cells to help with scar contraction are called ______. Answer: Myofibroblasts

Question 33

Flashcard 33 Type: FFQ Question: Explain the balance required for the Remodeling of connective tissue. Answer:Remodeling depends on the balance between the synthesis of ECM proteins and their degradation by Matrix Metalloproteinases (MMPs). This ensures the scar is refined and strengthened over time.

Question 34

Flashcard 34 Type: MCQ Question: MMPs are produced as inactive precursors known as: Options: A. TIMPs B. Integrins C. Zymogens D. Pericytes Answer: C. Zymogens

Question 35

Flashcard 35 Type: Fill in the blank Question: Matrix metalloproteinases are inhibited by specific tissue inhibitors known as ______. Answer: TIMPs

Question 36

Flashcard 36 Type: MRQ Question: Which cell types produce MMPs? Options: A. Fibroblasts B. Macrophages C. Neutrophils D. Red blood cells Answer: A, B, C

Question 37

Flashcard 37 Type: MCQ Question: Clinically, what is one of the most important causes of delayed wound healing?Options: A. Age B. Foreign bodies C. Infection D. Steroid use Answer: C. Infection

Question 38

Flashcard 38 Type: Fill in the blank Question: Protein and ______ deficiency significantly inhibit collagen synthesis and retard healing. Answer: Vitamin C

Question 39

Flashcard 39 Type: FFQ Question: How does Diabetes impair tissue healing? Answer: It is a metabolic disease that causes impaired healing through various mechanisms, including macro- and microangiopathy (vascular issues) and a higher susceptibility to infections.

Question 40

Flashcard 40 Type: MCQ Question: Why do Glucocorticoids (steroids) sometimes result in scar weakness? Options: A. They stimulate too much collagen B. They inhibit TGF-β C. They increase inflammation D. They prevent hemostasisAnswer: B. They inhibit TGF-β

Question 41

Flashcard 41 Type: Fill in the blank Question: Mechanical factors, such as torsion or increased pressure, can lead to wound ______, where the wound reopens. Answer: Dehiscence

Question 42

Flashcard 42 Type: MRQ Question: Which of the following are local factors that influence tissue repair? Options: A. Poor vascular perfusion B. Nutritional status C. Foreign bodies D. Type and location of injury Answer: A, C, D

Question 43

Flashcard 43 Type: FFQ Question: Why do Varicose Veins lead to chronic venous leg ulcers? Answer: Varicose veins lead to obstructed venous drainage and venous congestion. This causes poor oxygenation of local tissues, resulting in chronic wounds that are difficult to heal.

Question 44

Flashcard 44 Type: MCQ Question: Healing by First Intention is best exemplified by: Options: A. A large burn B. An uninfected surgical incision C. A pressure sore D. A deep laceration with gaping edges Answer: B. An uninfected surgical incision

Question 45

Flashcard 45 Type: Fill in the blank Question: Within ______ hours of a first-intention wound, neutrophils are seen migrating toward the fibrin clot. Answer: 24

Question 46

Flashcard 46 Type: MCQ Question: By which day does granulation tissue peak in first-intention healing? Options: A. Day 1 B. Day 3 C. Day 5 D. Day 14 Answer: C. Day 5

Question 47

Flashcard 47 Type: MRQ Question: Which of the following occur during the second week of first-intention healing?Options: A. Proliferation of neutrophils B. Conversion of granulation tissue to a collagenous scar C. Continued collagen accumulation D. Proliferation of fibroblasts Answer: B, C, D

Question 48

Flashcard 48 Type: FFQ Question: How does Second Intention healing differ from First Intention regarding the inflammatory reaction? Answer: In second intention, the inflammation is much more intense because there is more necrotic debris, exudate, and fibrin that must be removed. This results in a greater risk of inflammation-mediated injury.

Question 49

Flashcard 49 Type: Fill in the blank Question: The tensile strength of a wound increases over the first two months due to the ______ of collagen fibers. Answer: Crosslinking

Question 50

Flashcard 50 Type: MCQ Question: In Second Intention healing, what happens to destroyed dermal appendages (hair follicles, glands)? Options: A. They regenerate from stem cells B. They are permanently lost C. They are replaced by granulation tissue that later differentiates D. They are only lost if an infection is present Answer: B. They are permanently lost

Question 51

Flashcard 51 Type: MRQ Question: Which of the following are characteristic of Second Intention healing compared to Primary Intention? Options: A. Larger scar B. Wound contraction C. Faster healing time D. More granulation tissueAnswer: A, B, D

Question 52

Flashcard 52 Type: FFQ Question: Explain the importance of Wound Contraction in second-intention healing.Answer: Wound contraction is driven by myofibroblasts and is essential for closing large, gaping wounds. It can reduce the wound surface area by 5% to 10% within 6 weeks, helping to bridge the gap between unapposed edges.

Question 53

Flashcard 53 Type: MCQ Question: By the end of the first month in a primary union wound, what does the scar consist of? Options: A. Active neutrophils and macrophages B. Cellular granulation tissue C. A cellular connective tissue scar devoid of inflammatory cells D. Fibrin and platelets Answer: C. A cellular connective tissue scar devoid of inflammatory cells

Question 54

Flashcard 54 Type: MCQ Question: An excessive accumulation of collagen that stays within the boundaries of the original wound is a: Options: A. Keloid B. Hypertrophic scar C. Granuloma D. Ulcer Answer: B. Hypertrophic scar

Question 55

Flashcard 55 Type: Fill in the blank Question: A scar that grows beyond the boundaries of the original wound and does not regress is called a ______. Answer: Keloid

Question 56

Flashcard 56 Type: FFQ Question: What is a Contracture, and where is it most commonly seen? Answer: A contracture is an abnormality where excessive wound contraction results in deformities and impairment of joint movement. It is a common complication following serious, large-scale burns.

Question 57

Flashcard 57 Type: MRQ Question: Which factors contribute to the formation of a Chronic Wound? Options: A. Venous congestion B. Adequate vascularization C. Prolonged mechanical compression D. Peripheral vascular diseaseAnswer: A, C, D

Question 58

Flashcard 58 Type: MCQ Question: Excessive granulation tissue that protrudes above the skin and prevents re-epithelialization is colloquially known as: Options: A. Proud flesh (implied by cautery/surgical removal need) B. Keloid C. Dehiscence D. Organizing exudate Answer: A. Proud flesh

Question 59

Flashcard 59 Type: Fill in the blank Question: Wound dehiscence is particularly common after ______ surgery due to increased internal pressure. Answer: Abdominal

Question 60

Flashcard 60 Type: FFQ Question: Differentiate between Fibrosis in a repair context and Fibrosis in a parenchymal organ. Answer: While both involve excessive collagen deposition, repair-related fibrosis (scarring) is a necessary step to provide stability. In parenchymal organs (e.g., liver cirrhosis, pulmonary fibrosis), fibrosis is a pathologic process responsible for substantial organ dysfunction and failure.