HCP 11

Question 1

IgA nephropathy

Answer 1

see notebook

Question 2

3 constrictions of ureter

Answer 2

1. pelvi-ureteric junction (PUJ) of the renal pelvis and the ureter 2. as the ureter crosses the brim of pelvic inlet 3. as the ureter obliquely enters the muscular wall of the bladder in inferomedial direction

Question 3

formation of dark colored urine

Answer 3

hematuria

Question 4

MOA trimethoprim

Answer 4

inhibits dihydrofolate reductase -> prevents conversion of dihydrofolate to tetrahydrofolate -> disrupted nucleic acid synthesis -> cell death

Question 5

MOA sulfamethoxazole

Answer 5

competes with PABA for dihydropteroate synthetase (combines PABA and pteridine) -> decreased synthesis of dihydropteroate -> decreased dihydrofolate -> decreased tetrahydrofolate - disrupted nucleic acid synthesis -> cell death

Question 6

VUR

Answer 6

see notebook

Question 7

streptococcus pyogenes

Answer 7

causes repository infection

Question 8

proteus mirabilis

Answer 8

urease -> hydrolytic cleavage of urea -> ammonia and CO2 -> increased pH (alkaline) in urine -> precipitation of magnesium, ammonium phosphate salts -> struvite stones -> could lead to blockage

Question 9

c5 convertase produces

Answer 9

c5a and C5b, c5b needed to provide binding surface for membrane attack complex

Question 10

anaphylatoxin mechanism

Answer 10

triggers basophil and mast cell degranulation -> releases histamine -> vasodilation and increased vascular permeability chemotactic agent for neutrophils, monocytes, eosinophils, and basophils -> leukocyte adhesion Activates lipoxygenase pathway of arachidonic acid in neutrophils and monocytes -> increased leukotrienes -> increased inflammatory mediators induce smooth muscle contraction and increased vascular permeability -> influx of fluid to bring antibody and phagocytic cells to site of antigen entry

Question 11

c3 convertase produces

Answer 11

cleaves c3a and c3b, c3b coats immune complexes and particulate antigens (opsonization) and also combines with c4b2a (c3 convertase)