Path Lab midterm Flashcards
(110 cards)
1
Q
Urinary System consists:
A
- 2 kidneys
2 ureters - 1 bladder
- 1 urethra
2
Q
Describe the term Urolithiasis
A
is a calculus formation at ANY level of the collecting urinary system, not only the kidneys but other areas as well
3
Q
T/F
Urolithiasis only occurs in the kidneys
A
False
4
Q
Calculus -
Lithon
Iasis
Osis
A
- stone
- greek for stone
- suffix for medical term describing the non- inflammatory nature of the disorder
5
Q
Common disease that affects 10% Americans mostly males , etiology is unknown
A
Urolithiasis
6
Q
T/F
osteroarthritis is not really an inflammatory disease
A
true
7
Q
What is the pathogenesis of Urolithiasis
A
associated with increases stone constituents in the urine so that it exceeds their solubility in this fluid
8
Q
What is the prevention of stones forming?
A
hyrdation - adequate fluid in the body the stones will most likely not form
9
Q
name the chemical components of stones
A
calcium oxaloate
calcium phosphate
magnesium monophosphate
10
Q
75% of all stones in urinary tract are made of ____ ____ of combination of ______ + ______
A
- calcium oxalate
- calcium oxalate + calcium phosphate
11
Q
10 - 15% of stones are made of ______ ____ ___
A
magnesium ammonium phsophate
12
Q
magnesium ammonium phosphate AKA
A
- triple stones or struvite stone
13
Q
what kind of environment of urine does magnesium monophosphate form?
A
Basic
14
Q
Mg monophosphate stones are commonly seen in ____
A
Vegans
15
Q
Describe how pressure atrophy occurs from stones
A
Stones steals tissue from the kidneys to make space .. this leads to pressure atrophy … results in obstruction of urinary tract waste … can obstruct uereter and results in loss of kidneys tissue forever ( irreversible)
16
Q
_____ ___ crystals in urine can be a sign of increased proclivity for stone formation
A
Calcium oxalate
17
Q
what bacteria is considered the #1 enemy of the urinary system
A
Gram negative bascilis
18
Q
Most powerful Gram - bacteria
A
Proteus Vulgaris
19
Q
what is a good environment for triple stones
A
pH > 7
20
Q
T/F
Triples stones are radiolucent when found on x-ray
A
false
they are radiopaque which is abnormal to be seen
21
Q
name some normal radiopaque tissue on x-ray
A
- vertebra
- pelvic bones
- sacrum
- ribs
22
Q
T/F
normal environment for urine is weak acid
A
true
23
Q
T/F
Triple stone are formed in acidic environment
A
false
they form in basic environment
24
Q
IF pt have triple stones then rule out ____
A
UTI
25
Majority of urinary tract stones are formed in _______ environments
acidic
26
Urine ranges from pH of __ - __
4-8
27
what is the most powerful converter of urea into alkalinic properties and can result in UTI
Proteus vulgaris
28
6-23% of all stones of urinary stones are made of _____
uric acid salts
29
T/F
| uric acid stones appears radiopaque on films
false
| radiolucent
30
describe Hyperuricemia
too much uric acid in the blood .. gout most common
31
what is an essential amino acid that can form large stones in the kidneys .5-4% of cases
Cysteine
32
slow water/fluid flow , this results in precipitation of salts, which get deposited into walls of the tubes
Urinary obstruction
33
2nd group of lobes ____ zone is located away fromm the urethra and if tumor develops the urethra is not compressed
peripheral zone
34
Benign tumor originating from glandular tissue .. thyroid, pituitary etc.
Prostatic Adenoma
35
Develops in lobes around urethra . the tumor is always looking for path of least resistance
Benign prostatic hypertrophy
36
what are the sings of Benign prostatic hypertrophy
- bladder fills to a point before it must emptied ( 100mL)
- Tumor taking up 30mL develops pt will use bathroom frequently
- tumor may obstruct urethra .. results in dribbling
- increased abdominal pressure will be used to help pee
- increased risk in herniation
37
Prostatic cancer develops in _____ lobe ___ -___ of the time
- peripheral lobe
| - 70 -80%
38
___- ___ of the time prostatic cancer develops closer to urthera which allows it to be detected earlier
20-30%
39
describe some factors that explains why pregnancy can result in many pathologies
- baby can compress ureter in womb ---> fluid will accumulate above point of compression and lead to distention of ureter
- increase hydrostatic pressure result in atrophy in the kidney which decreases function of the kidney
40
pouching of the wall of bladder
- rare in kidney
- usually seen in colon
- can compress ureter
Diverticuli
41
known when kidney drops and results in accumulation in kidney pelvis
Nephroptosis
42
Descending of the kidney can usually happen when _____
weight loss happens too rapidly
43
Acute Pyelonephritis ?
inflammation of kidney pelvis and kidney parenchyma
44
list some causes of urinary obstruction
- enlarged prostate
- Tumor
- diverticulum
45
describe what happens with epithelial injury
- increase sloughing off of epithelial cells and accumulate in the lumen and forms a organic core and form nidus
- an infection of mucosa anywhere leads to sloughing of epithelial cells
- Vit. A and B6 deficiency leads to sloughing off cells
46
5 units per ____ mL is the maximal concentration of chemical that can be dissolved in urine
100 mL
47
T/F
| Hyperuria is decrease in fluid with normal amount of solutes
false
that is dehydration
hyperuria - normal amount of fluid with increase solutes
48
what is know as a star like structure
staghorn calculus
49
what is stag horn calculus predominately made of
magnesium and ammonium phosphate
| - sometimes have inclusions of phosphates and oxalates inside them
50
____ may be another component that stag horn calculi are made of
Cysteine
51
Long term problem of accumulation of too much urine, too much hydrostatic pressure and pressure atrophy of kidney parenchyma with dramatic loss of kidney function can lead to _______
Hydronephrosis
52
explain Hydronephrosis
- distention of the kidney pelvis with accompanying atrophy of kidney parenchyma due to obstruction of the urine outflow
- accumulation of the entrée kidney system with increase infrarenal pressure and intrepelvic pressure
- will refer as low back pain
- 3 weeks until the kidney is dead
-
53
List factors that can result in decreased urine flow or obstruction
1. stricture of the ureter
2. moving kidney stones
3. urethral colic (renal colic)
4. bladder stones
5. Acute cystitis
54
T/F
| Stricture of ureter is usually congenital but sometimes acquired
false
| opposite of statement
55
what is the common cause of a stricture
healing
| repair- fibrosis- development of CT --- results in shrinking
56
_____ is sever pain due to spasm of empty organ (contraction of smooth muscle)
Cholic
57
most common cause of urinary obstruction resulting in ________
hydronephrosis
58
what happens in urethral colic aka renal colic
- kidney stone moves from pelvis into ureter and gets stuck because the lumen is too small for it to fit through. dramatic compression of smooth muscle cell in ureter wall - spasm
- pain develops in kidney and spreads to flank area into ipsilateral genitals and inner surface of proximal thigh
- hematuria - stone can injure wall and blood will be in urine
59
what is the treatment of urethral colic
shot containing spasmolytic and narcotic after 20-40 min pt feels better
60
what also may be from hematouria and is usually rare
microhematuria
61
explain acute cystitis
inflammation of the urinary bladder . almost completely a female disease .
- gram negative rods- E. coli .
- when gram neg rods go outside from anus into urethra it can create complications known as UTI
62
name some causes of UTI
- staphylococcus maybe streptococcus
- STD
- yeast infection
63
what is an AKA for candida albicans
monila (moniliasis
64
withdrawal of what drug results in cystitis
cytostatics
65
name the predisposing factors to acute cystitis
- exposure of female pelvis organs to cold
- installation of catheter
- tumors , stones in bladder
- procrastination to urinate
- foreign bodies in bladder
66
symptoms of acute cystitis
- dysuria
- increased frequency of urination
- lower abdominal or suprapubic pain - level of belly button
- hematuria
- if one of these symptoms are not present its probably not acute cystitis
67
digestion in stomach by _____
pancreas
68
digestion in the duodenum by ___
trypsin
69
T/F trypsin is produced by the pancreas
false
| trypsinogen
70
t/f
| trypsin is produced by trypsinogen in the duodenum
true
71
T/F
| emulsification by bile is considered digestion
false
| its preparation for digestion
72
lipase is produced where
in the pancreas
73
carbohydrates are broken down in mouth by ____
amylase
| salivary glands produce amylase
74
once carbohydrates are broken down in mouth by amylase where is it continued
in the duodenum and small intestine
75
what is the function of the funds
accumulate gas
76
back flow of stomach irritates esophageal mucosa.
- irritates distal 2 cm of esophagus
- inflammation and irritation of distal esophagus . chronic acid reflux
- could lead to metaplasia of mucosa, replacement of squamous epithelial cells of esophageal mucosa, replaced with columnar eli cells from the stomach
- predisposes to esphageal cancer
Barrett esophagus
77
where do stomach cancer and ulcers develop
body of the stomach
| - lesser curvature
78
which disorder is permanent or frequent reflux of acid to esophagus
- can lead to development of aspiration pneumonia
Gastro-esophageal reflux diseas GERD
79
antrum means
cave
80
where is stomach acid most vulnerable
proximal portion of duodenum ( duodenal bulb)
| - right next to pyloric canal
81
in pyloric reflex , the more ___ the environment of stomach , the ___ the lumen of the pyloric canal
- acidic
| - narrower
82
T/F
| Ruga is a portion of the stomach that is part of the outer surface
false
| inner surface
83
foldings within stomach wall . increases stomach capacity due to distention. increase of surface area results in more contact with food
Rugae
84
presence of goblet cells in the stomach means the stomach is _______
sick and cancer will develop
| - goblet cells belong in duodenal wall, intestinal mucosa, tracheal brachial tree -
85
mucuos barrier protects stomach wall from ____ environment
acidic
86
which cells produce HCL
- activates pepsinogen to pepsin
- keeps pepsin active
- antibacterial action
parietal cells
87
what is the neural stimulator
endocrine stimulator
local stimulator for parietal cell
- parasympathetic - vagus nerve
- made by gastrin - stimulation of parietal cells for HCL production
- histamine - resides in masts cells
88
describe the parietal cells and intrinsic factor
- binds vit B12 and carries it to ileum
- no receptors for B12 just intrinsic factor
- death of parietal cells leads to no intrinsic factor a
89
Chief cells aka
zymogen cells
90
chief cells produce ____
pepsinogen
91
where are G cells located
antro- pyloric area to stomach
| - produce endocrine stimulator for HCL production
92
what is this condition called when it can reulst from mucosal atrophy and decreases function and leads to intestinal metaplasia
Chronic gastritis
93
this condition leads to formation of autoantibodies selectively against parietal cells of the stomach
auto - immune chronic gastritis
94
auto - immune chronic gastritis leads to :
- pernicious anemia
- hypo-avidity - malnutrition
- mechanical irritation of the entire GI tract
- Bacterial infection
- Nervous system pathologies - atrophy of stomach mucosa
- stomach bleeding
95
T/F
| bleeding below the duodenum will result in melena
false
| located above the proximal duodenum will result in melena below is none cause no HCL
96
what type of stomach cancer has a projectile tumor that projects into the lumen of the stomach . the location is usually in the lesser curvature close to the antropyloric area
intestinal type adenocarcinoma
97
this type of stomach cancer occurs more often . a flat tumor finding it is more difficult . H. Pylori and chronic gastritis often absent ... Gastroscopy will determine this issuer
diffuse carcinoma
98
diffuse stomach carcinoma is also a ____ cancer aka leather bottle stomach aka Linitis plastic
Scirrhous cancer
99
this type of cancer are made primarily of stroma and metastasize primarily through lymph
Scirrhous cancer
100
describe the Latent period of stomach cancer
- time between onset of tumor and beginning of metals
- Latent period for ITA is long- at least one year
- latent period for diffuse carcinomas is very short
101
T/F
| latent period for intestinal type adenocarcnimoa is very short
false very long , diffuse carcinoma is very short
102
what is a pedunculated tumor
has a long leg made of stroma but characteristic is in the head
103
describe a leomyoma
- smooth muscle cell origin
- very rare
CT capsule surrounds the tumor
-
104
what is the most common leomyoma in the uterine
fibroid
105
Rhabdomyoma is a smooth muscle tumore benighn
false
benign skelatal muscle tumor
- rhabdomyosarcoma - malignant
106
Laenmyoma may lead to _______
pyloric stenosis
107
Stomach cancer will metastasize to the ___ first fir the _________
- stomach
| - hepatic portal system
108
spread of stomach cancer into left supraclavicular lymphatic node is considered to be___
Virchow's nodes
109
spread of stomach cancer via cavity into the ovaries
Krukenberg tumors
110
Carcinoma metastizes in _____
| Sacoma metastizes in _____
- lymphatic system
| - blood
