Midterm Flashcards
(103 cards)
1
Q
What is characterized by a kidney pathology and what is the cause of this characteristic
A
- back pain
- it is the cause of the extension of the kidney capsule due to inflammation of the kidneys
2
Q
Kidneys are located at level ___ and are ___
A
- lower ribs around 12
- retroperitoneal
3
Q
name the structural compartments of kidney
A
- Glomeruli ( cortex)
- Tubules (medulla)
- Interstitial tissue
- Blood vessels
4
Q
T/F
when pathology occurs in one compartment it will stay localized in that area and eventually cause disease to that specific area only
A
false
eventually all 4 compartments will be involved - this is why it is difficult to determine location of kidney pathology
- the entree kidney is involved in the pathological process
5
Q
Name the functions of the kidney
A
- excretion of waste products
- regulation of the body’s concentration of water and salt
- Maintenance of appropriate acid balance of plasma
- Secretion of hormones:
- renin - BP regulator
- Erythropoietin- promotes formation RBC ( lack or this hormone causes anemia)
- Prostaglandins
6
Q
T/F
All diseases in the Kidneys are considered inflammatory
A
False
later discovered not all are … can be glomerular disease
7
Q
All glomerular diseases are ____ mediated
Diseases of tubules/ interstitial tissues usually from ___ or ___
A
- immunologic
- bacterial infection
- intoxication
8
Q
inside the glomerulus are arterioles … the arterioles enters the glomerulus is the ___ arteriole and the blood leaves via ___ arteriole
A
- afferent
- efferent
9
Q
the arterioles in the glomeruli is made up of what kind of cells and where are these cells located near
A
- Juxtoglomelur cells
- Afferent
10
Q
Juxtoglomelur cells help control what in the arterioles
A
Blood Pressure
11
Q
If BP drops below ___ml the juxtaglomelur cells release renin
A
50ml
12
Q
T/F
inside the Bowman’s Capsule the arterioles are made up of juxtoglomeluar cells
A
False
endothelial cells
13
Q
Endothelial cells have holes within them called ____ and what is the AKA
A
Pseudofenestrations
- Fenestriate cells
14
Q
The membrane is the ___________ and is on tope of the ____ and on top is _____ … Once in the Bowman’s capsule the cells that line them are called ____
A
- glomerular basement membrane
- endothelial cells
- visceral epithelial cells
- parietal epithelial cells
15
Q
Name the 3 layers of the Arterioles
A
- Basement membrane
- inside is covered by endothelial cells - has holes – pseudofenestrations
- Fenestrum
16
Q
the Glomerular Basement Membrane is covered by what type of cells
A
visceral epithelial cells (podocytes)
17
Q
between podocytes is a space called ____ and has a important role in filtration of blood and formation of urine
A
filtration slits
18
Q
When visceral epithelial cells go to the inner surface of Bowman’s capsule they are known as _____
A
Parietal epithelial cells
19
Q
T/F
Mesangial cells are in the inner layer of the arterioles
A
false
they are in the middle of the arterioles
20
Q
Name the function of the Mesangial cells
A
- contractile abilities (changes sizes of glomeruli)
- healing of glomeruli
- Monocytes can be found among these cells which carry info to immune system
- Proliferations
- Secretions of some hormones
- Produce chemicals used for glomeruli function
21
Q
Mesangial cells fill in the spaces between _____ in the ____
A
- bordering vessels
- glomeruli
22
Q
Mesangial cells can account for what
A
scar tissue
23
Q
Glomerulonephritis (GMN) is characterized by :
A
- Hematuria
- Oliguria
- Azotenia
- Hypertension
24
Q
Hematuria is caused by in GMN
A
dramatic change in permeability of the arterial wall in the glomerulus
- results in Blood and RBC casts in urine
25
Azotemia is caused by what in GMN
nitrogen in blood
| - waste products of metabolism are not able to go from the blood to urine due to oligura
26
Oliguria is caused by what in GMN
decreased urine production resulting from decreased glomerulrar filtration
27
Hypertension is caused by what in GMN
juxtaglomerular cells release renin due to a decreased glomerular filtration rate
28
Describe the biochemical cascade due to low BP
REnin---> angiotensionge---> angiotensin I -----> angriotensin II (vasoconstricot)----> Increased BP
29
List the 3 Pathogenic mechanisms of GMN
1. Circulating Immune Complex Deposition Glomerulonephritis
2. Anti- Glomerllur Basement Membrane
3. Heymann's Glomerulonephritis
30
What type of Hypersensitivity reaction is typical for Circulating Immune Complex Deposition Glomerulonephritis
Type III Hypersensitivity
31
Describe the immune complex formation for the circulating immune complex deposition glomerulonephritis
Both antigen and antibody flow in the blood ---__> binding takes place in circulating blood to form an immune complex
- later attach to walls of the blood vessels ----> phagocytic cells try to engulf the immune complex that is attached to the vessels ----> the cell releases an enzyme that destroys the vessel's wall
32
In Circulating Immune Complex Deposition Glomerulonephritis .... immune complex lodges itself in the ____ and this results in ___ and ___
sub- intimal layer
vascularitis
nephritis
33
where is the sub- intimal layer located
- a space between the glomerular basement membrane and the endothelial cells
34
Anti- Glomerulrar Basement Membrane is typical for which type of hypersensitivity reaction
Type II ( reaction- complement dependent reactions)
35
T/F
| Anti - Glomerular Basement Membrane is considered and Auto- immune Pathology
True
36
Describe the process of Anti- Glomerular Basement Membrane pathology
- Formation of autoantibodies against the glomerular basement membrane ----> antibodies flow with blood circulation and meet in the glomeruli ----. pahgocytic attraction occurs ---> releases enzymes into surrounding area that digests tissue the area of immune complex that has formed in the GBM
- Damage of arterial walls
37
T/F
| Heymann's Glomerulonephritis has a typical Hypersensitivity reaction of type III
False
| There is no association with Hypersensitivity
38
Heymman's Glomerulonephritis is from production of autoantibodies against ____ as well as some antigens
podocytes
39
what is the result of damage from Heymann's Glomerulonephritis
causes damage to structure of arterioles, damaging function
40
What are the Two types of syndromes in Glomerulonephritis
1. nephrotic
| 2. nephritic
41
Explain the significance of Nephritic syndrome
when damage of the glomerular wall leads to increase permeability for RBCs - usually called Hematuria
42
What causes Hematuria
water cannot move easily through the wall , but the walls of capillary comes permeable to RBCs
43
what causes Oliguria
decrease in the amount of urine excreted per day (300-400) mL
- Permeability to water is dramatically diminished
44
Describe Azotemia
it is a biochemical abnormality that refers to an elevation of blood urea nitrogen (BUN) and creatinine levels and is largely related to a decreased glomerular filtration
- waste products of metabolism contain high amounts of nitrogen
45
What does it mean when azotemia is considered a biochemical abnormality instead of clinical
- not clinical because the patient feels ok ---> no signs or symptoms
46
What is Uremia
Azotemia + clinical signs and symptoms
47
T/F
Acute Proliferative Glomerulonephritis is clinically characterized by rapid and progressive loss of renal function associated with severe oliguria and death from renal failure if untreated
False
| that was explaining rapidly progressive glomerulonephritis
48
In acute proliferative Glomerulonephritis , where is the most vulnerable area to infection
Tonsils ( palatine tonsils)
49
what happens in acute proliferative glomerulonephritis with strep throat
the body produces antibodies against streptococcal wall ---> antibodies find strep bodies and kill them
50
what is the antibody that bind to glomerular wall and kill normal glomerular tissue with a patient that has strep throat
- Beta hemolytic streptococcus group A
51
Beta hemolytic streptococcus group A ... AKA
nephrogenic strain of streptococcus
52
T/F
| Acute Proliferative Glomerulonephritis is primarily affected by men > age 50
False primarily affects young children
53
in some people the tissue has antigenic determinant (epitope) in ___ and ___ that is similar to that of specific strain of strep bacteria
- kidney
| - heart
54
what is considered a molecular mimicry
Epitopes of kidney and heart are similar to epitopes on the wall of specific type of streptococcus ---> Beta hemolytic streptococcus A
55
T/F
| Acute Proliferative Glomerulonephritis is caused from a streptococcal infection
False
| it is associated with streptococcal infection but not caused
56
Clinical signs of Acute Glomerulonephritis
- some proteinuria
- Azotemia
- Hematuria
- Casts
- Hypertension
- Oliguria
- Swelling under eyes
57
what is the treatment for acute glomerulonephritis
Predenezone
58
T/F
| Adults have a full 90% recovery from acute glomerulonephritis
False
can be 90% recovered with children
- only 50% with adults
59
What is different with Rapidly Progressive (Crescentic) Glomerulonephritis that is different from the other Nephritic diseases
it is not just one disease, it is grouped of systemic diseases with kidney involvement as well as other organ systems
60
What is the common result with Cresentic Glomerulonephritis
results from hyperplasia of Parietal epithelial cells
61
Hyperplasia in the bowman's capsule can lead to what
dramatic borrowing of the lumen , which eventually results in obstruction of the convoluted tubules .. urine cannot pass through and it accumulates in the capsule
-- results in increase of hydrostatic pressure --. leads to pressure atrophy
62
Name the 3 types of Rapidly progressive (crescentic) Glomerulonephritis
1. anti - GBM
2. Immune Complex- mediated disease
3. Pauci- immune
63
Describe the significance of rapidly progressive glomerulonephritis ( Crescentic)
rapid and progressive loss of renal function associated with severe oliguria and death due to renal failure if left untreated
64
Autoantibodies against antigens of basement membrane of either the alveolar or glomelular ..... what type of crescentic disease is this?
Anti- GBM
65
which disease may result from hemoptysis
anti- GBM
66
in goodpasture's syndrome what is the treatment for patients?
plasmapheresis
- blood taken from patient - spun in centrifuge
- plasma thrown away
- blood cells given back in glucose solution
67
Which type of hypersensitivity is corresponded with Type 1 crescentic glomerulonephritis
(anti- GBM)
| - Type II
68
which hypersensitivity is associated with immune complex- mediated disease ?
- Type III hypersensitivity
| Type 2 crescentic glomerulonephritis
69
Production of autoantibodies against antigens of cell nuclei and cytoplasm ( antinuclear antibodies) ... which disease is this?
- Systemic Lupus Erythematosus (SLE)
| falls under Type 2 Crescentic glomerulonephritis
70
Name some provoking factors for SLE
- UV
- reaction to vaccination
- sulfa drug (antibiotic)
- post- infectious strep
71
List the signs of SLE
- butterfly rash
- allopecia
- lupus nephritis
72
rare autoimmune disease development of 4 clinical syndromes . develop together or independently . usually in young to middle - aged males
- IgA deposition in the mesangium
Henoch- Schonlein purpura
73
explain the term mesangium
space between the glomeruli- cells with contractile components and have the ability to produce connective tissue.
- contains monocytes and macrophages
74
which type of disease is Henoch - Scholein purpura associated with in Rapidly Progessive Glomerulonephritis ?
Type II - immune complex - mediated
75
what are the four clinical syndromes of Henoch - Schonlein Purpura ?
1. Cutaneous syndrome
2. Abdominal syndrome
3. Articular syndrome
4. kidney syndrome
76
explain cutaneous syndrome
- development of purport rash
- cutaneous hemorrhage less than 2 cm in diameter
- legs, buttocks and abdomen are most common area
77
Abdominal syndrome
- gastritis or gastroduodenitis
| - associated with bad pina in area of stomach and may cause bleeding - ulcers rare
78
Articular syndrome
Joint pain
79
Kidney syndrome
addition to this syndrome drops survival rate to 70%
| - in form of rapidly progressing glomerulonephritis type II - crescent shaped cells
80
T/F
| Type III of crescentic glomerulurnephritis is associated with Type II hypersensitivity
False
| does not have any relations with hypersensitivity reactions
81
what is the name of the disease for Type 3 in crescentic glomerulornephritis
pauci- immune
82
In pauci- immune disease what are the findings in the antibodies
anti- neutrophil cytoplasmic autoantibodies - the finding of these autoantibodies means the patient has vasculitis
83
Wegner's granulomatosis is characterized by what 3 problems ?
1. necrotising vasculitis of upper respiratory tract - decay of tissue in facial
2. Necrotising vasculitis of lower respiratory tract - formation of cavities in the lungs
3. rapidly progressing glomerulonephritis - decaying while alive
84
development of middle sized and small sized arteries with development of vasculitis . formation of nodes and involves every organ in the body
Polyarteritis nodosa
85
what are the two consequences of polyarteritis nodosa
- dramatic swelling of the wall, narrowing the lumen - weakening vascular wall = high BP leads to pouching of blood vessels = pressure atrophy
- kidney size decreases and takes on a contracted appearance - develops fibrosis/ scar tissue
86
T/F
| polyarteritis nodosa involves the lungs and arch aorta
False
| involves everywhere in the body EXCEPT the lungs and arch of aorta
87
Which nephritic syndrome is considered the most common kidney disease worldwide?
- IgA neuropathy ( Berger's disease)
88
most common cause of hematuria due to upper acute respiratory tract infection . also can be from acute gastroenteritis and acute ureter inflammation
- characterized by pain on the loin area
IgA neuropathy ( Berger's disease)
89
what is the cause of IgA neuropathy
caused by a buildup of the IgA protein in the kidneys. IgA proteins help the body fight infections. There are more of these proteins when you have an infection like the cold or flu.
- 10% of patients can show typical nephritic syndrome
90
which is not considered a kidney pathology
Buerger's disease
91
Thrombosing vascularitis of middle and small arteries that involves the veins and nerves (inflammation of vessels that supply nervous fibers) prominent in male smokers
Thromboangitis obliterans AKA Buerger's disease
92
name the symptoms of Buerger's disease
- instep calaudication
- raynauds
- thrombophlebtis
- can develop gangrene
93
Explain the significance of Nephrotic syndrome
increased permeability to protein as opposed to in nephritic there is an increase permeability to RBC
94
when the amount of albumin in the vessels is less than amount of albumin in tissue what will occur?
fluid will escape causing generalized edema
95
T/F
| Muehrke's lines aka meuhrkes nails or leuokonychia stria.... is a sign of hyperlipidemia
False
| it is a sign of hypoalbuminemia
96
what is it called when there is a decrease concentration of albumin in blood circulation
hypoalbuminemia
97
when more globulins than albumins = _____
generalized edema
98
T/F
| albumin : globulin
false
| inversion
99
Explain what secondary hyper- aldosterism is
escape of fluid into tissue... decrease of blood volume adrenal cortex releases aldosterone to increase salt retention to increase blood pressure
100
Explain what secondary hyper- aldosterism is
escape of fluid into tissue... decrease of blood volume adrenal cortex releases aldosterone to increase salt retention to increase blood pressure
101
what is an accumulation of transuate fluid in peritoneal cavity
ascites
102
What are the results of hyperlipiidemia and lipiduria
- increase cholesterol
- increase triglycerides
- increase lipids
- goe in blood and urine to form casts
103
how does hyperlipidemia occur
due to loss of albumins, the liver makes an effort to increase production of albumins, but can't produce proteins by themselves
