MIDTERM- RENAL DISEASE

Question 1

disruption of the electrical membrane charges as occurs in the
____ syndrome.

Answer 1

nephrotic syndrome

Question 2

The term ___ refers to a sterile, inflammatory process that affects the glomerulus and
is associated with the finding of blood, protein, and
casts in the urine

Answer 2

glomerulonephritis

Question 3

what are the components we can found in the urine of a patient with glomerulonephritis?

Answer 3

protein, blood, and cast

Question 4

___is a
disease marked by the sudden onset of symptoms consistent
with damage to the glomerular membrane.

Answer 4

acute glomerulonephritis (AGN)

Question 5

signs and symptoms for acute poststreptococcal glomerulonephritis

Answer 5

These may include
fever, edema (most noticeably around the eyes), fatigue,
hypertension, oliguria, and hematuria.

Question 6

which bacteria or strains can be associated with acute poststreptococcal glomerulonephritis?

Answer 6

group a streptococcus with M protein

Question 7

what is the primary urinalyss findings for acute post-streptococcal glumeronephritis

Answer 7

Primary urinalysis findings include marked

hematuria,
proteinuria, and oliguria, accompanied by red blood cell (RBC)
casts, dysmorphic RBCs, hyaline and granular casts, and white
blood cells (WBCs).

Question 8

A more serious form of acute glomerular disease is called ___ and has a much
poorer prognosis, often terminating in renal failure.

Answer 8

rapid progressive (or crescentic) glomerulonephritis

Question 9

Symptoms
are initiated by deposition of immune complexes in the glomerulus, often as a complication of another form of glomerulonephritis or an immune systemic disorder such as systemic lupus
erythematosus (SLE).

Answer 9

Rapidly Progressive (Crescentic) Glomerulonephritis

Question 10

Damage by macrophages to the capillary
walls releases cells and plasma into Bowman’s space, and the
production of CRESCENTIC FORMATION containing macrophages, fibroblasts, and polymerized fibrin, causes permanent damage to
the capillary tufts.

Answer 10

Rapidly Progressive (Crescentic) Glomerulonephritis

Question 11

Morphologic changes to the glomeruli resembling those in rap
idly progressive glomerular nephritis are seen in conjunction
with the autoimmune disorder termed ___

Answer 11

Goodpasture syndrome

Question 12

A cytotoxic autoantibody can appear against the glomerular
and alveolar basement membranes after

Answer 12

viral respiratory infections.

Question 13

Attachment of autoantibody to the basement membrane, followed by complement activation, produces the
capillary destruction. Referred to as ___ , the autoantibody can be detected in
patient serum.

Answer 13

antiglomerular basement membrane antibody

Question 14

what are the initial pulmonary complains for Goodpasture syndrome

Answer 14

hemoptysis and dyspnea

Question 15

urinary results commonly for Goodpasture syndrom

Answer 15

results include proteinuria, hematuria, and the presence of
RBC casts.

Question 16

Wegener granulomatosis causes a ___of the small blood vessels primarily of the kidney
and respiratory system.

Answer 16

granuloma-producing INFLAMMATION

Question 17

Key to the diagnosis of Wegener
granulomatosis is the demonstration of ____in the patient’s serum.

Answer 17

antineutrophilic
cytoplasmic antibody (ANCA)

Question 18

In ANCAor anti-neutrophilic cytoplasmic antibody testing,

we fix the serum in either ethanol or formalin/formaldehyde ad examine it through immunofixation.

If the neutrophils are fixed in ethanol, the antibodies form a perinuclear pattern called ___

Answer 18

p-ANCA

Question 19

In ANCAor anti-neutrophilic cytoplasmic antibody testing,

we fix the serum in either ethanol or formalin/formaldehyde ad examine it through immunofixation.

When the neutrophils are
fixed with formalin/formaldehyde, the pattern is granular throughout the cytoplasm called ___

Answer 19

c-ANCA.

Question 20

fixating serum for testing anti-neutrophilic cytoplasmic antibody for the detection of wegener granulomatosis

ethanol vs formalin

Answer 20

ethanol: perinuclear pattern - p anca
formalin: granular patter - c anca

Question 21

___ disease occurs primarily in children after upper respiratory infections. As its name implies,
initial symptoms include the appearance of raised, red patches
on the skin

Answer 21

Henoch-Schönlein purpura

Question 22

In Henoch-Schonlein Purpura, what is the most serious complication of the disorder

Answer 22

Renal involvement, may range from mild to heavy proteinuria and hematuria
with RBC casts.

Question 23

few of the symptoms for this type of Glomerulonephritis

Respiratory and gastrointestinal symptoms, including blood in the sputum and stools, may be present

Answer 23

Henoch-Schönlein Purpura

Question 24

The predominant characteristic of ___ is a pronounced thickening of the glomerular
basement membrane resulting from the deposition of a specific immunoglobulin immune complexes

Answer 24

membranous glomerulonephritis

Question 25

membranous glomerulonephritis's distinct clinical manifestation is the thickening of the glomerular basement membrane resulting from the deposition of what immunoglobulin immune complexes?

Answer 25

immunoglobulin G immune complexes

Question 26

Disorders associated with membranous glomerulonephritis development include ____

Answer 26

Systemic lupus erythematosus, Sjögren syndrome secondary syphilis hepatitis B, gold and mercury treatments malignancy.

Question 27

a glomerulonephritis which has a rule of the disease progresses SLOWLY, with possible REMISSION; however, nephrotic syndrome symptoms frequently develop.

Answer 27

membranous glomerulonephritis

Question 28

a glomerulonephritis that is marked by two different alterations in the cellularity of the glomerulus and peripheral capillaries

Answer 28

Membranoproliferative glomerulonephritis (MPGN)

Question 29

what are the 2 different alterations in the cellularity of the glomerulus and peripheral capillaries

Answer 29

Type 1 displays increased cellularity in the subendothelial cells of the mesangium (interstitial area of Bowman’s capsule) type 2 displays extremely dense deposits in the glomerular basement membrane. M

Question 30

which type of membranoproliferative glomerulonephritis is has the possibility of developing a necrotic syndrome

Answer 30

Type 1

Question 31

which type of membranoproliferative glomerulonephritis can experience the symptoms of chronic glomerulonephritis

Answer 31

type 2

Question 32

laboratory findings for membranoproliferative glomerulonephritis

Answer 32

The laboratory findings vary, but hematuria, proteinuria, and decreased serum complement levels are usual findings.

Question 33

a type of glomerulonephritis that has tendency toward THROMBOSIS

Answer 33

Membranous Glomerulonephritis

Question 34

laboratory findings for chronic glomerulonephritis

Answer 34

Examination of the urine reveals hematuria, proteinuria, glucosuria as a result of tubular dysfunction, and many varieties of casts, including broad casts.

Question 35

Gradually worsening symptoms for chronic glomerulonephritis are

Answer 35

fatigue, anemia, hypertension, edema, and oliguria

Question 36

A markedly decreased glomerular filtration rate is present in conjunction with increased BUN and creatinine levels and electrolyte imbalance this significant changes is an indication of what renal disease?

Answer 36

Chronic Glomerulonephritis

Question 37

Also known as Berger disease

Answer 37

Immunoglobulin A Nephropathy

Question 38

IgA nephropathy, in which ___are deposited on the glomerular membrane, is the most common cause of glomerulonephritis

Answer 38

immune complexes containing IgA

Question 39

IgA nephropathy, Patients have increased serum levels of IgA, which may be a result of a ___infection

Answer 39

mucosal

Question 40

Immunoglobulin A Nephropathy disorders are frequently seen in what ages?

Answer 40

The disorder is most frequently seen in children and young adults.

Question 41

The ___ is marked by massive proteinuria (greater than 3.5 g/day), low levels of serum albumin, high levels of serum lipids, and pronounced edema.

Answer 41

nephrotic syndrome

Question 42

in order to be classified as a nephrotic syndrome, a patient must have proteinuria of around ____ g/day

Answer 42

3.5 g per day

Question 43

Acute onset of the disorder can occur in instances of circulatory disruption producing SYSTEMIC SHOCK that decrease the pressure and flow of blood to the kidney.

Answer 43

chronic glomerulonephritis

Question 44

___is the primary protein depleted from the circulation

Answer 44

Albumin

Question 45

In chronic glomerulonephritis Urinalysis observations include marked

Answer 45

proteinuria; urinary fat droplets; oval fat bodies; renal tubular epithelial (RTE) cells; epithelial, fatty, and waxy casts; and microscopic hematuria

Question 46

minimal change disease (also known as ____)

Answer 46

lipid nephrosis

Question 47

Although the etiology is unknown at this time, allergic reactions, recent immunization, and possession of the human leukocyte antigen-B12 (HLA-B12) antigen have been associated with this disease

Answer 47

Minimal Change Disease

Question 48

Minimal Change Disease responds well to ____, and prognosis is generally good, with frequent complete remissions.

Answer 48

corticosteroids

Question 49

this glomerulonephritis___ affects only certain numbers and areas of glomeruli, and the others remain normal. S

Answer 49

focal segmental glomerulosclerosis (FSGS)

Question 50

Symptoms may be similar to the nephrotic syndrome and minimal change disease owing to damaged podocytes

Answer 50

focal segmental glomerulosclerosis (FSGS)

Question 51

In focal segmental glomerulosclerosis, Immune deposits, primarily ___, are a frequent finding and can be seen in undamaged glomeruli

Answer 51

immunoglobulin M and C3

Question 52

focal segmental glomerulonephritis is often seen in association with abuse of _

Answer 52

heroin and analgesics and with AIDS.

Question 53

glomerulonephritis disorders

Answer 53

1. Acute Poststreptococcal Glomerulonephritis 2. Rapidly Progressive (Crescentic) Glomerulonephritis 3. Goodpasture Syndrome 4. Wegener Granulomatosis 5. Henoch-Schönlein Purpura 6. Membranous Glomerulonephritis 7. Membranoproliferative Glomerulonephritis 8. Chronic Glomerulonephritis 9. Immunoglobulin A Nephropathy

Question 54

disorders under nephrotic syndrome

Answer 54

1. Minimal change disease 2. focal segmental glomerulosclerosis

Question 55

The primary disorder associated with damage to the renal tubules is ___

Answer 55

acute tubular necrosis (ATN).

Question 56

Damage to the RTE cells may be produced by decreased blood flow that causes a lack of oxygen presentation to the tubules (______) or the presence of toxic substances in the urinary filtrate.

Answer 56

ischemia

Question 57

“____” is a general term indicating a severe condition that decreases the flow of blood throughout the body

Answer 57

Shock

Question 58

Examples of conditions that may cause shock are ___

Answer 58

cardiac failures, sepsis involving toxigenic bacteria, anaphylaxis, massive hemorrhage, and contact with high-voltage electricity.

Question 59

aside from ischemia what is the other reason for having a damage RTE cells

Answer 59

Exposure to a variety of nephrotoxic agents

Question 60

what are the example of nephrotoxic agents that can damage the RTE cells

Answer 60

Substances include aminoglycoside antibiotics, the antifungal agent amphotericin B, cyclosporine, radiographic dye, organic solvents such as ethylene glycol, heavy metals, and toxic mushrooms.

Question 61

aside from the chemicals and substances, what are the example of a naturally occuring component in the body that is as well nephrotoxic

Answer 61

filtration of large amounts of hemoglobin and myoglobin is also nephrotoxic.

Question 62

list down the Hereditary and Metabolic Tubular Disorders

Answer 62

Fanconi Syndrome Alport Syndrome Uromodulin-Associated Kidney Disease Diabetic Nephropathy Nephrogenic Diabetes Insipidus Renal Glycosuria

Question 63

The disorder most frequently associated with tubular dysfunction is

Answer 63

Fanconi syndrome

Question 64

The syndrome consists of a generalized failure of tubular reabsorption in the PROXIMAL CONVOLUTED TUBE

Answer 64

Fanconi Syndrome

Question 65

In fanconi syndrome, since the one affected is the proximal convoluted tube, the substances that are most noticeably affected includes the

Answer 65

glucose, amino acids, phosphorous, sodium, potassium, bicarbonate, and water

Question 66

Tubular reabsorption may be affected by the 3, what are they?

Answer 66

dysfunction of the transport of filtered substances across the tubular membranes, disruption of cellular energy needed for transport, changes in the tubular membrane permeability.

Question 67

Fanconi syndrome may be inherited in association with ___ disease, acquired through exposure to toxic agents, including heavy metals and outdated tetracycline, or seen as a complication of multiple myeloma and renal transplant

Answer 67

cystinosis and Hartnup disease

Question 68

hereditary and metabolic tubular disorder is an inherited disorder of collagen production affecting the glomerular basement membrane.

Answer 68

Alport syndrome

Question 69

The syndrome can be inherited as a ___ and ___

Answer 69

sex-linked or autosomal genetic disorder.

Question 70

in alport syndrome, During respiratory infections, males younger than age ___ years may exhibit macroscopic hematuria and continue to exhibit microscopic hematuria. Abnormalities in hearing and vision may also develop

Answer 70

6 yrs old

Question 71

The glomerular basement membrane has a lamellated appearance with areas of thinning

Answer 71

Alport Syndrome

Question 72

__is a glycoprotein and is the only protein produced by the kidney. I

Answer 72

Uromodulin

Question 73

is primarily an inherited disorder caused by an autosomal mutation in the GENE that produces uromodulin

Answer 73

Uromodulin-associated kidney disease

Question 74

a hereditary tubular disorder that is about The mutation which causes a decrease in the production of normal uromodulin that is replaced by the abnormal form

Answer 74

Uromodulin-associated kidney disease

Question 75

in uromodulin-associated kidney disease. The mutation also causes an increase in serum uric acid, resulting in persons developing ___as early as the teenage years before the onset of detectable renal disease.

Answer 75

gout

Question 76

is currently the most common cause of end-stage renal disease.

Answer 76

Diabetic nephropathy

Question 77

diabetic nephropathy, Damage to the glomerular membrane occurs not only as a result of glomerular membrane thickening but also because of the increased proliferation of ___ and increased deposition of cellular and noncellular material within the glomerular matrix, resulting in accumulation of solid substances around the capillary tufts.

Answer 77

mesangial cells

Question 78

Diabetic Nephropathy This glomerular damage is believed to be associated with deposition of ____ resulting from poorly controlled blood glucose levels.

Answer 78

glycosylated proteins

Question 79

Diabetic Nephropathy The vascular structure of the glomerulus also develops __

Answer 79

sclerosis

Question 80

early monitoring of persons diagnosed with diabetes mellitus for the presence of ___ is important to detect the onset of diabetic nephropathy.

Answer 80

microalbuminuria

Question 81

___can be inherited as a sex-linked recessive gene or acquired from medications, including lithium and am photericin B

Answer 81

Nephrogenic DI

Question 82

the disorder related to the action of ADH which is disrupted either by the inability of the renal tubules to respond to ADH or failure of the hypothalamus to produce ADH

Answer 82

Nephrogenic Diabetes Insipidus

Question 83

a disorder that affects only the reabsorption of glucose

Answer 83

Renal Glycosuria

Question 84

renal glucosuria, The disorder is inherited as an __

Answer 84

autosomal recessive trait.

Question 85

In inherited renal glucosuria either the number of glucose transporters in the tubules is decreased or the affinity of the transporters for glucose is decreased. true or false

Answer 85

true

Question 86

Considering the close proximity between the renal tubules and the renal interstitium, disorders affecting the interstitium also affect the tubules, resulting in the condition commonly called ___ disease

Answer 86

tubulointerstitial

Question 87

The most common renal disease for tubulointerstitial disease

Answer 87

urinary tract infection or UTI

Question 88

for interstitial disease, Most frequently encountered is infection of the bladder (____), which can progress to a more serious upper UTI if left untreated.

Answer 88

cystitis

Question 89

Infection of the upper urinary tract, including both the tubules and interstitium, is termed __and can occur in both acute and chronic forms

Answer 89

pyelonephritis

Question 90

___ most frequently occurs as a result of ascending movement of bacteria from a lower UTI into the renal tubules and interstitium.

Answer 90

Acute pyelonephritis

Question 91

reflux of urine from the bladder back into the ureters (___).

Answer 91

vesicoureteral reflux

Question 92

____ producing reflux nephropathy are the most frequent cause of chronic pyelonephritis

Answer 92

Congenital urinary structural defects

Question 93

The presence of WBC casts is significant for differentiating between ___ and ___

Answer 93

cystitis and pyelonephritis

Question 94

is marked by inflammation of the renal interstitium followed by inflammation of the renal tubules.

Answer 94

Acute interstitial nephritis (AIN)

Question 95

Patients present with a rapid onset of symptoms relating to renal dys function, including oliguria, edema, decreased renal concen trating ability, and a possible decrease in the glomerular filtration rate.

Answer 95

Acute Interstitial Nephritis

Question 96

__ is primarily associated with an allergic reaction to medications that occurs within the renal interstitium, possibly caused by the medication binding to the interstitial protein

Answer 96

AIN Acute interstitial nephritis

Question 97

Medications commonly associated with AIN include ___

Answer 97

penicillin, methicillin, ampicillin, cephalosporins, sulfon amides, NSAIDs, and thiazide diuretics.

Question 98

The progression to _____ is characterized by a marked decrease in the glomerular filtration rate (less than 25 mL/min); steadily rising serum BUN and cre atinine values (azotemia); electrolyte imbalance; lack of renal concentrating ability producing an isosthenuric urine; protein uria; renal glycosuria; and an abundance of granular, waxy, and broad casts, often referred to as a telescoped urine sediment

Answer 98

end-stage renal disease

Question 99

___, in contrast to chronic renal failure, exhibits a sudden loss of renal function and is frequently REVERSIBLE

Answer 99

Acute renal failure (ARF)

Question 100

renal calculi or kidney stones will form in what part of the kidney?

Answer 100

calyces and pelvis of the kidney, ureters, and bladder.

Question 101

a procedure using high-energy shock waves, can be used to break stones located in the upper urinary tract into pieces that can then be passed in the urine.

Answer 101

Lithotripsy

Question 102

Conditions favoring the formation of renal calculi are similar to those favoring formation of urinary crystals, including __, __, ___

Answer 102

pH, chemical concentration, and urinary stasis

Question 103

Approximately 75% of the renal calculi are composed of what crystal?

Answer 103

calcium oxalate or calcium phosphate

Question 104

__, __, and ___ are the other primary calculi constituents.

Answer 104

Magnesium ammonium phosphate (struvite), uric acid, and cystine

Question 105

which calculi are are frequently associated with metabolic calcium and phosphate disorders and occasionally diet.

Answer 105

Calcium calculi

Question 106

which calculi are frequently accompanied by urinary infections involving urea-splitting bacteria

Answer 106

Magnesium ammonium phosphate calculi

Question 107

which calculi may be associated with increased intake of foods with high purine content and with uromodulin-associated kidney disease.

Answer 107

Uric acid calculi

Question 108

which calculi are seen in conjunction with hereditary disorders of cystine metabolism

Answer 108

cystine calculi