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Pathology > Path 2 - Midterm > Flashcards

Path 2 - Midterm Flashcards

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1
Q

T or f

The major function of the kidneys are to regulate the body’s concentration of water and salt.

A

FALSE

Excretion of waste products of metabolism is its major function.

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2
Q

List the 4 main functions of the Kidneys

A

Excretion of waste products of metabolism
Water and Salt concentration
Acid/Base balance of plasma
Secretion of hormones

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3
Q

All of the following are secreted from the Kidneys except:

  • Prostaglandins
  • Angiotensiongen
  • Erythropoietin
  • Renin
A

Angiotensiongen

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4
Q

What cells make renin?

A

Juxtaglomerular cells

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5
Q

What condition will result if there is a failure or defect in the production of erythropoietin?

A

Anemia

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6
Q

T or F

The renal pyramids are the major site of filtration of the blood and primary urine production

A

False

This is describing the Cortex. The pyramids collect urine.

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7
Q

T or F

Almost all diseases of the Glomerulus are caused by immune system pathologies

A

True

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8
Q

Which microscopic compartment of the kidneys are mainly affected by toxins and infections

A

Tubules

Interstitial Tissue

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9
Q

What microscopic compartment of the kidney is mainly affected by pulmonary pathologies?

A

NONE!! TRICK QUESTION

The kidney vessels are mainly affected by Cardiovascular pathologies not just pulmonary.

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10
Q

Where is the Glomerulus located?

A

Within the Bowman’s Capsule

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11
Q

Which layer of the capillaries within the Glomerulus have fenestrations?

A

Endothelial cells

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12
Q

What is the name of the outermost layer of the capillaries within the Glomerulus?

A

Visceral Epithelial cells

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13
Q

Aka for Visceral Epithelial Cells

A

Podocytes

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14
Q

Name the glycoprotein located between the podocyte slits that aids in selective filtration

A

Nephrin

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15
Q

These cells are similar to podocytes but they line the inner surface of the Bowman’s Capsule

A

Parietal Epithelial Cells

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16
Q

List all the functions of the Mesangial Cells

A 
Contractile components
Produce chemicals that help for glomeruli function
Proliferations
Secretion of some hormones
Network of arterioles
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17
Q

Which cells of the Glomerulus account for scar tissue in the healing process and contain many monocytes?

A

Mesangial Cells

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18
Q

Where in the Glomerulus are the Juxtaglomerular cells located?

A

In the area where the afferent arteriole enters the Glomerulus

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19
Q

Circulating immune complex deposition is what type of hypersensitivity rxn?

A

Type 3

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20
Q

Where in the glomerulus do the immune complex of circulating immune complex deposition hide?

A

Subintimal layer - space between glomerular basement membrane and endothelial cells

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21
Q

The circulating immune complex deposition glomerulonephritis can result in damage to what structures?

A

Glomerular basement membrane
Endothelial Cells
Podocytes

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22
Q

T or F

Azotemia is a clinical abnormality characterized by increased levels of creatine and blood urea nitrogen in the blood stream.

A

False

Biochemical abnormality

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23
Q

What is the difference between Azotemia and Uremia

A

Azotemia is elevated levels of creatine and BUN but there are no clinical symptoms. When the process becomes advanced it is referred to as Uremia. Essentially uremia has symptoms and clinical manifestations.

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24
Q

T or F

Anti-GBM is a type 3 hypersensitivity

A

False

Type 2 - complement dependent

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25
T or F Heymann's Glomerulonephritis is a Type 3 Hypersensitivity rxn
False Not associated with a specific hypersensitivity reaction.
26
What is the pathogenesis of Heymann's Glomerulonephritis?
Development of autoantibodies against Podocytes as well as some antigens within podocytes.
27
Describe what Nephritis Syndromes are
Basically when damage of glomerular walls leads to dramatic increased permeability for red blood cells = Hematuria
28
What is Oligouria?
Decrease in the amount of urine excreted per day. Results from a decrease in permeability of water in the glomerulus.
29
If there is a decrease of BP to less than ____ mmHG juxtaglomerular cells will increase pressure
50
30
What are the signs and symptoms of acute glomerulonephritis?
``` A little proteinuria Azotemia Hematuria Casts Hypertension Oliguria Swelling under the eyes. ```
31
What tonsils are more susceptible for infection?
Palantine
32
What disease associated with Nephritis syndromes is described as having molecular mimicry?
Acute Proliferative (post-streptococcal, post-infectious) Glomerulonephritis
33
What specific type of Strep is involved with Acute Proliferative (post-strep) Glomerulonephritis.
Beta hemolytic Strep A
34
Pathogenesis of Post Strep Glomerulonephritis
Immune system makes antibodies that bind to the antigen of strep. This antigen is very similar to that of Glomerular Tissue. Immune system is not able to tell which is which and will destroy both causing kidney damage!
35
T or F Post-strep Glomerulonephritis is considered to be an infectious condition.
False! Disease of immune system. Infection is the catalyst for the immune system to destroy healthy glomeruli tissue.
36
What are the recovery rates of Post-Strep Glomerulonephritis?
Children = 99% Adults = 50% * tx = corticosteroids
37
What type of Glomerulonephritis is clinically characterized by rapid & progressive loss of renal function associated with severe Oliguria & (if untreated) death from renal failure within weeks to months
Rapidly Progressive (Crescentric) Glomerulonephritis
38
T or F Good Pasture's Syndrome falls under Type 2 of Rapidly Progressive Glomerulonephritis
False Type 1
39
Describe the pathogenesis of Crescentric Glomerulonephritis
Hyperplasia of Parietal Epithelial cells - epithelial cells eventually will close the exit to proximal tubules resulting in an accumulation of primary urine in Bowman's Capsule. This increase in pressure = atrophy of capillary network within the capsule.
40
Type 1 Rapidly Progressive Glomerulonephritis is what type of Hypersensitivity rxn?
Type II
41
What is Good Pasture's Syndrome?
Characterized by autoimmune aggression against antigens of two types of basement membranes - Alveolar & Glomerular
42
What is a typical manifestation of Goodpasture's Syndrome in the lungs?
Hemoptysis - damage of alveolar wall leads to hemorrhage and blood within the alveoli. Patient will literally drown in their own blood.
43
How is Goodpasture's Syndrome Treated?
Plasmapheresis - blood is taken from patient and spun in a centrifuge, the plasma is thrown again and blood cells given back in glucose solution. Mechanical cleaning of blood to get rid of the antibodies.
44
T or F Type II Rapidly Progressive Glomerulonephritis is a Type I hypersensitivity reaction.
False Type III
45
This condition is characterized by the formation of autoantibodies against antigens of cell nuclei and cytoplasm **antinuclear antibodies
Systemic Lupus Erythematosus
46
List some symptoms of SLE
Butterfly rash on face Allopecia Joint involvement * Lupus Arthritis Hypertension
47
List some factors contributing to SLE
Genetic predisposition | Provocative factors = Exposure to UV light *MC, Certain drugs (sulfa drugs), rxn to vaccination.
48
T or F The kidneys are the only system affected by SLE
False Potentially any system in the body but kidneys are the most involved organ.
49
List the 4 clinical symptoms of Henoch-Schonlein Purpura
Cutaneous - purpura Abnormal - pn in stomach and duodenum Articular Syndrome - arthralgia Kidney Syndrome - Type II RPGN
50
T or F Type III Rapidly Progressive Glomerulonephritis is not associated with a hypersensitivity
True
51
What type of antibodies are made in Pauci-immune RPGN
Antineutrophils
52
List the 3 important components of Wegener's Granulomatosis
1. Necrotizing vasculitis of middle and small arteries of URT 2. Necrotizing vasculitis of middle of small arteries of LRT 3. RPGN Type III
53
Virtually all organs are affected when a person suffers from Polyarteritis Nodosa except...
Lungs | Arch of aorta
54
What is the pathogenesis of Polyarteritis Nodosa
Vasculitis of small and middle arteries of the body causes weakening and softening of vascular wall which leads to pouching of the wall. Weakening also leads to rupture under pressure.
55
IgA Nephropathy aka ?
Berger's Disease
56
What is the most common glomerular disease worldwide and the most common cause of hematuria?
IgA Nephropathy
57
How does Berger's disease begin?
With/after an acute urinary, GI or respiratory infection. Sudden development of gross hematuria within 1-2 days of acute infection. Will urinate blood for a few days than disappears.
58
Where does IgA and IgA complexes get deposited in Berger's disease?
Mesangium - the space between capillaries in the glomerulus.
59
Berger's Disease aka?
Thromboangitis Obliterans
60
T or F Berger's Disease is a kidney related pathology
False Cardiovascular
61
What are some manifestations caused by Berger's Disease?
Raynaud's Syndrome Instep Calaudication Gangrene Thrombophlebitis
62
What is the most common hereditary RPGN?
Alport Syndrome
63
Increased selective permeability of albumin sized proteins is characteristic of what class of Kidney pathologies?
Nephrotic Syndrome
64
List the major groups of blood proteins and their relative percentages in the blood
Albumin 55% Globulins 45% Fibrinogen 5%
65
What blood protein is responsible for maintaining oncontic pressure?
Albumins
66
Why is there generalized edema with Nephrotic conditions?
From a decreased oncotic pressure in the blood and a higher pressure in the tissues causes an escape of the fluid portion of the blood into the tissues.
67
Massive proteinuria is how many grams?
Greater than 3.5 g/dl
68
T or F The ratio of albumin to globulins normally should be less than 1
False Normally ratio is 55/45 so greater than 1. When you have the loss of albumin the ratio will drop to below one and essentially reverse. This is a major sign or a Nephrotic syndrome.
69
T or F Ascites is characterized by accumulation of exudate in the abdomen
False Transudate! Exudate is in the glomeruli
70
What are the name of the white lines on the nails that can disappear upon pressure commonly seen with Nephrotic conditions.
Muehrcke's Lines
71
What are the primary Glomerular diseases?
Minimal change disease (lipid nephrosis) Membranous Glomerulonephritis Focal Glomerulosclerosis Membranoproliferative Glomerulonephritis
72
What kidney pathology is the most common contributor to Chronic Glomerulonephritis? Least common?
RPGN = MC | Post Strep = LC
73
What happens to the appearance of the kidney with Chronic Glomerulonephritis?
Has a granular appearance due to healing by repair at different rates.
74
This condition will develop suddenly and is characterized by pain in the back, a higher fever with chills
Acute Pyelonephritis
75
What bacteria is the most common cause of Acute Cystitis?
E.Coli others = Staphylococcus, Gram - bacillus, Candida Albans
76
T or F Bacteremia and Lymphogenic is the most common cause of Acute Pyelonephritis
False Rare
77
What is the #1 cause of chronic renal failure in the USA
Chronic Pyelonephritis
78
T or F Healing of erosions takes weeks to months
False Ulcers are weeks to months Erosions are short 2-5 days
79
Breech in the mucosa of the wall of the alimentary tract organ that extends through muscularis mucosa into the submucousa or deeper is describing...
Ulcers
80
T or F Erosions tend to be multiple
True
81
T or F Erosions are superficial damage to the GI wall
True
82
80% of stomach ulcers occur where?
Dudodenum (duodenal bulb)
83
What is the Z line?
Boundary between esophagus and stomach
84
Name the aggressive forces contributing the ulcers
Stomach acidity Peptic activity H.Pylori Infection
85
T or F Approximately 20% of ulcers occur in the esophagus
False Stomach - usually the lesser curvature
86
Where do the H.Pylori bacteria like to hang out in the stomach?
Anteropyloric acrea
87
What are the components of the Mucous barrier?
``` Surface mucousal secretion Bicarbonate Secretion into the mucosa Mucosal blood flowApical surface membrane transport Epithelial regenerative Capacity Elaboration of prostaglandins ```
88
Why do smokers have a hard time healing peptic ulcers?
Smokers have an impaired mucosal defensiveness due to the vasoconstriction of the wall of the stomach.
89
How do NSAIDs and corticosteroids contribute to peptic ulcers?
They prevent prostaglandins and other mediators of inflammation.
90
T or F With a decrease in gastrin secretion you get an alternative increase in HCL production
False Decrease gastrin = decrease HCL
91
T or F The duodenal bulb is the most distal portion
False Most proximal
92
Name the 5 complications of peptic ulcers
1. Hemorrhage 2. Perforation 3. Penetration 4. Hypertrophic Pyloric Stenosis 5. Transformation of the peptic ulcer to cancer
93
T or F | Perforation is the most common complication of peptic ulcers
Fales Hemorrhage
94
T or F A major concern with duodenal peptic ulcer is its transformation into cancer
False This will occur in a stomach peptic ulcer but doesn't occur in the duodenal peptic ulcers.
95
What complication of peptic ulcers would indicate the need for surgery?
Perforation - gas can accumulate just under the diaphragm in the liver, due to perforation of the alimentary tract. These gases can get caught between the liver and the diaphragm and this requires immediate attention.
96
Why is Pyloric stenosis a complication?
Due to healing of ulcer by connective tissue causing a narrowing of the lumen of the pyloric canal it does not allow the passage for food to enter the duodenum.
97
T or F Hypertrophic pyloric stricture is a complication of peptic ulcers
False This is a congenital disorder not a complication of ulcers
98
T or F Rheumatic Fever causes cardiomyopathy
False Valvular problem not muscular problem
99
Rhematic conditions associated with the heart primarily caused by what microbe?
Beta Hemolytic Strep A (Pyogens)
100
What layer of the heart makes the valves?
Endocardium
101
What is the fibrous layer of the heart called?
Pericardium
102
Rhematic arthritis is characterized by...
Migrating arthritis Erythmia Annulare Subcutaneous nodules Sydenham Chorea
103
Where do you see the subcutaneous nodules develop with Rheumatic arthritis?
knuckles
104
T or F Sydenham Chorea is curable
True
105
Syndenham's Chorea usually affects what part of the body?
Jerky movements of extremities and facial muscles
106
Aschoff's Nodes affect what layer of the heart?
Myocardium | - Rheumatic Myocarditis
107
Aschoff's nodes are what type of necrosis?
Fibrinoid Necrosis
108
T or F Involvement of the pericardium occurs in 100% of cases of Rheumatic fever
False MUSCLE layer ALWAYS involved
109
What is the pathopneumonic sign of rheumatic myocarditis?
Aschoff's Nodes

Pathology (6 decks)

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