Basic and Clinical Sciences (BCSE) Practice Exam

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What does the term 'hyperplasia' refer to in the context of PAH pathology?

  1. Decreased cell numbers in the vascular walls

  2. Increased cell proliferation in vascular walls

  3. Normal cellular function

  4. Cellular apoptosis in pulmonary vessels

The correct answer is: Increased cell proliferation in vascular walls

Hyperplasia refers to an increase in the number of cells in a tissue or organ, which can lead to an enlargement of that tissue or organ. In the context of pulmonary arterial hypertension (PAH) pathology, hyperplasia specifically denotes increased cell proliferation within the vascular walls. This phenomenon is often a response to chronic injury or stress, leading to changes in the structure and function of the pulmonary arteries. In PAH, the vascular remodeling involves various cellular components, notably smooth muscle cells and endothelial cells, which become hyperplastic as a maladaptive response to factors such as hypoxia, shear stress, or other stimuli. The resultant thickening of the vascular walls contributes to increased vascular resistance and elevated pressures within the pulmonary circulation, which are hallmarks of PAH. Understanding hyperplasia in this context is crucial for grasping the pathophysiological mechanisms of PAH, as it highlights the alterations in cellular dynamics that can lead to significant clinical consequences.