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Biology Of Disease > Unit 4 > Flashcards

Unit 4 Flashcards

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1
Q

First Stop of Breathed Air

A

Nasopharynx

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2
Q

Second Stop of Breathed Air

A

Larynx

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3
Q

Lobes of the Right Lung

A

3

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4
Q

Lobes of the Left Lung

A

2

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5
Q

Two Layers of the Pleura

A

Visceral
Parietal

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6
Q

Pleura Against Lung

A

Visceral

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7
Q

Pleura Against Chest Wall

A

Parietal

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8
Q

Features of Bronchi

A

Large airways with cartilage and submucosal glands

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9
Q

Features of Bronchioles

A

Smaller with NO cartilage or submucosal gland

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10
Q

Acinus of Lung

A

Sight of gas exchange supplied by a single bronchiole

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11
Q

Type I Pneumocyte Function

A

Flat cells that do gas exchange

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12
Q

Type II Pneumocyte Function

A

Secretes surfactant and helps repair the lung

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13
Q

Other Cells of the Lung

A

Macrophage
Eosinophils

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14
Q

These cells secrete mucous

A

Goblet cells
Submucosal Gland Cells

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15
Q

These cells propel mucous out of the airways

A

Ciliated columnar epithelial cells

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16
Q

Macrophage Function

A

Move in and out of the alveolar space to ingest foreign particles

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17
Q

Three Categories of Pulmonary Disease

A

Interstitial
Vascular
Airway

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18
Q

Atelectasis

A

Lung collapse due to inadequate expansion

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19
Q

Three Types of Atelectasis

A

Resorption
Compression
Contraction

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20
Q

Resorption Atelectasis Cause

A

Blockage of airway

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21
Q

Compression Atelectasis Cause

A

Something pushes on the lung from the outside

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22
Q

Contraction Atelectasis Cause

A

Tumor or infection

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23
Q

Diffuse Alveolar Damage Other Name

A

Also called Acute Respirator Distress Syndrome in clinical practice

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24
Q

Diffuse Alveolar Damage Definition

A

Ratio of partial pressure of oxygen to fraction of inspired oxygen 200 or less

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25
Diffuse Alveolar Damage Causes
Pneumonia Aspiration of Gastric Contents Sepsis Trauma with Shock
26
Diffuse Alveolar Damage General Pathology
Leakage of cellular contents and fluid into the airway
27
Phases of Diffuse Alveolar Damage
1. Edema 2. Hyaline Membrane Appearance 3. Interstitial Inflammation and Fibrosis
28
ARDS Clinical Definition
Rapid onset dyspnea with low blood oxygen levels Diffuse bilateral lightly colored infiltrates on chest xray
29
ARDS must be differentiated from this pathology
Left side heart failure
30
Three Types of Obstructive Diffuse Pulmonary Diseases
Asthma COPD Bronchiectasis
31
Restrictive Lung Disease Definition
Reduced expansion and decreased total lung capacity
32
Obstructive Lung Disease Definition
Limitation of airflow on expiration
33
General Components of COPD
Emphysema Chronic Bronchitis
34
Pathological Components of COPD
Alveolar wall Destruction Overinflation Productive Cough Airway Inflammation
35
General Components of Asthma
Muscle Spasm of the airway
36
Most Common Type of Asthma
Extrinsic
37
Antibody of Extrinsic Asthma
IgE
38
More Rare Type of Asthma
Non atopic
39
Drug of Drug Induced Asthma
Aspirin
40
Biochemistry of Drug Induced Asthma
Inhibition of COX without inhibition of LOX, which shifts the balance towards bronchoconstriction
41
Role of Leukotrienes in Asthma
Brochoconstriction and increased vascular permeability
42
Role of Prostaglandins in Asthma
Bronchoconstriction and vasodilation
43
Role of Histamines in Asthma
Bronchospasm and increased vascular permeability
44
Eosinophils in Asthma
Tissue damage and recruitment of additional inflammatory cells
45
Gross Pathology of Asthma
Lung Hyperinflation Mucous Plugging Edema
46
Histopathology of Asthma
Smooth muscle and mucous gland hypertrophy Thickened collagen beneath basement membrane
47
Clinical Features of Asthma
Attacks of dyspnea, wheezing, cough, and chest tightness
48
COPD Pulmonary Function Test
Decreased FEV1/FVC
49
Emphysema Definition
Abnormal permanent enlargement of air spaces distal to the terminal bronchioles accompanied by distruiction of their walls
50
Centriacinar Emphysena
Upper lung respiratory bronchiole involvement
51
Panacinar Emphysema
Destruction of the entire acinus found in the lower lung
52
Distal Acinar Emphysema
Usually involves the upper lung in spontaneous pneumothorax patients
53
Irregular Emphysema
Irregular acinus involvement associated with previous scaring and NOT with smoking
54
Emphysema Pathology
Reactive oxygen species in tobacco attracts neutrophils that break down lung tissue
55
Chronic Bronchitis Definition
Persistent productive cough for most day for 3 consecutive months of the year for at least two years
56
Chronic Bronchitis Pathology
Oversecretion of mucous from proliferation of mucous glands
57
Pure Emphysema Clinical Picture
Prominent dyspnea and hyperventilation Adequate oxygenation of hemoglobin Barrel chest hunched over
58
COPD Clinical Picture
Persistent cough with sputum Recurrent Infections
59
Causes of Bronchiectasis
60% Idiopathic Cystic Fibrosis Bacterial Pneumonia Foreign Body Ingestion Immunodeficiency
60
Bronchiectasis Clinical Picture
Productive cough with mucopurulent sputum
61
Bronchiectasis Pathology
Permanent dilation of the bronchioles caused by destruction of the walls and supporting tissue
62
Pure Emphysema Oxygenation
Normal hemoglobin oxygenation
63
Chronic Bronchitis With Emphysema Oxygenation
Low, which causes cyanosis
64
Diffuse Interstitial Restrictive Lung Disease General Pathology
Fibrosis of interalveolar walls which yields reduced compliance
65
Diffuse Interstitial Restrictive Lung Disease Etiologies
Idiopathic Occupational Drugs Radiation Autoimmune
66
Major Categories of Diffuse Interstitial Restrictive Lung Disease
Fibrosing Granulomatous Eosinophilic Smoking Related
67
Diffuse Interstitial Restrictive Lung Disease Pathological Definition
Idiopathic pulmonary fibrosis
68
Diffuse Interstitial Restrictive Lung Disease Histological Definition
Usual interstitial pneumonia
69
Usual Interstitial Pneumonia Histological Pattern
Fibroblastic Foci Older areas with dense collagen
70
Usual Interstitial Pneumonia Gross Pathological Finding
Honeycomb lung
71
Usual Interstitial Pneumonia Clinical Progression
Gradually progressive dyspnea Poor prognosis
72
Usual Interstitial Pneumonia Gender and Age
Males 40 to 70 years
73
Nonspecific Interstitial Pneumonia Gross Pathology
Uniform fibrosis
74
Nonspecific Interstitial Pneumonia Clincial Features
Nonsmoking women Cellular and fibrotic pattern
75
Cryptogenic Organizing Pneumonia Pathology
Plugs and loose organizing connective tissue in bronchioles and alveolar ducts
76
Pneumoconioses General Cause
Lung reacts to inhaled particles
77
Pneumoconioses Specific Causes
Coal Dust Silica Asbestose
78
Pneumoconioses Cellular Pathology
Damage caused by macrophages
79
Silicosis makes you more susceptible to this infection
TB
80
Asbestos makes you more susceptible to these two pathologies
Mesothelioma Lung Cancer
81
These drugs increases risk for pulmonary fibrosis
Bleomycin Ameodarone Radiation
82
Sarcoidosis general definition
Idiopathic multisystem granulomatous disease
83
Sarcoidosis Classic Presentation
Enlarged hilar lymph nodes
84
Sarcoidosis Population
Young black Americans
85
Sarcoidosis Histopathology
Non necrotizing granulomas around lymph space
86
Sarcoidosis Gross Pathology
Granulomas around lymph spaces
87
Hypersensitivity Pneumonitis Hypersensitivity Type
Type III and Type IV
88
Hypersensitivity Pneumonitis General Cause
Immune reaction from inhaled particles like from a horse barn or bird ownership
89
Hypersensitivity Pneumonitis Acute Clinical Presentation
Fever, cough, and dyspnea about 4 to 8 hours after exposure to insult
90
Hypersensitivity Pneumonitis Chronic Clinical Presentation
Cough, dyspnea, weight loss, with an insidious course
91
Hypersensitivity Pneumonitis Gross Pathology
Progression from normal to nodules to fibrosis with honeycombing
92
Hypersensitivity Pneumonitis Histopathology
Progresses from necrotizing alveolitis to poorly formed granulomas to fibrosis with honeycomb change
93
Two Smoking Related Interstitial Diseases
Desquamative Interstitial Pneumonia Respiratory Bronchiolitis
94
Smoking Related Interstitial Disease Histopathology
Brown macrophages
95
Pulmonary Eosinophilia Treatment
Steroids
96
Pulmonary Eosinophilia Diagnosis
Bronchoalveolar Lavage
97
Pulmonary Thromboembolism Deaths
Over 50,000 US Deaths per Year
98
Pulmonary Thromboembolism Origin
95% clots from the legs
99
Pulmonary Thromboembolism Risk Factors
Prolonged Immobilization Trauma Congestive Heart Failure Pregnancy Oral Contraceptives Cancer Genetic Hypercoagulability
100
Pulmonary Thromboembolism Outcomes
Death Lysis Reorganization Rare Infarction
101
Pulmonary Hypertension Primary Cause
Blood Clots
102
Pulmonary Hypertension Definition
Pulmonary blood pressure 1/4 that of systemic
103
Primary Pulmonary Hypertension Population
Young people
104
Secondary Pulmonary Hypertension Causes
Pulmonary emboli Emphysema Left to right shunt Mitral Stenosis Left Heart Failure
105
Diffuse Alveolar Hemorrhage Syndromes
Goodpasture Syndrome Granulomatosis with Polyangiitis Idiopathic
106
Diffuse Alveolar Hemorrhage Syndrome Histopathology
Lungs with excessive hemosederin
107
Types of Infective Pneumonia
Community Acquired Hospital Acquired Aspiration
108
Community Acquired Pneumonia Most Common Organism
Strep after flu or COVID
109
Bacterial Pneumonia Anatomic Types
Lobar Bronchopneumonia
110
Atypical Community Acquired Pneumonia Causative Organisms
Mycoplasma Chlamydia
111
Bacterial Pneumonia Histopathology
Excessive neutrophils in the alveoli
112
Complications of Pneumonia
Abscess Sepsis
113
Lung Abscess Causes
Tumor Trauma Infection seeding thru Blood
114
Tuberculosis Deaths Worldwide
3 million
115
Tuberculosis Causative Organism
Mycobacterium tuberculosis
116
Tuberculosis Spread
Respiratory dropletts
117
Primary TB Characteristics
Mid to lower lung Ghon Complex 90 to 95% asymptomatic
118
Secondary TB Characteristics
Apical Lung Caseation Fibrosis Cavitation
119
Primary TB Population
Those with NO previous exposure to TB
120
Secondary TB Population
Those with previous exposure to TB
121
Miliary TB Organ System Involvement
Vascular Spread
122
Common Non TB Mycobacterial Disease
M. avium M. kansasii
123
Non TB Mycobacterial Disease Population
HIV Patients
124
Non TB Mycobacterial Disease Presentation
Apical lung disease that look like TB
125
Candida albicans Organ System
Mucous membranes
126
Cryptococcus neoformans Population
HIV patients
127
Cryptococcus neoformans Organ System
CNS
128
Aspergillosis Organ System
Often in the lungs Sometimes invasive cavitary mass
129
Most Common Fungal Infection In Nebraska
Histoplasmosis
130
Histoplasmosis Organ System Presentation
Granulomas in the lungs
131
Blastomycosis Organ Systems
Pulmonary Skin
132
Coccidioides Microscopic Presentation
Large spherules containing endospors
133
Pneomocystis jiroveci Microscopic Presentation
Ping Pong Ball Shape
134
Pneomocystis jiroveci Population
Almost exclusively HIV patients
135
Bronchogenic Carcinoma Definition
Malignancy from bronchial epithelium
136
Bronchogenic Carcinoma Population
2 to 1
137
Bronchogenic Carcinoma Genetic Mutations
TP53 and KRAS
138
Other Bronchogenic Carinoma Associations
Air Pollution Asbestose Radon Uranium Nickel
139
Two Type of Lung Cancer
Small Cell Non Small Cell
140
Three Types of Non Small Cell Cancer
Squamous Cell 25 to 30% Adenocarcinoma 30 to 35% Large Cell Carcinoma 10 to 15%
141
First Morphological Change in Lung Cancer
Squamous metaplasia
142
5 Year Survival of Squamous Cell Carcinoma
10 to 20%
143
5 Year Survival of Adenocarcinoma Lung Cancer
10%
144
Large Cell Lung Cancer General Microscopic Morphology
Nonspecific and undifferentiated
145
Small Cell Lung Cancer Morphology
Small round blue cells
146
Small Cell Lung Cancer 5 Year Survival
1 to 3%
147
Do small cell lung cancers get surgery?
NO
148
Carcinoid Tumor of Lung
Low grade malignancy of the lung
149
Lung Hamartoma Definition
A noncancerous abnormal collection of cartilage, fat, and epithelium in the lung
150
Three Types of Pleural Effusion
Hemothorax Transudate Exudate
151
Hemothorax Fluid
Blood
152
Transudate Fluid
Noninflammatory fluid
153
Exudate Fluid
Inflammatory, often pus
154
Most Common Pleural Tumor
Mesothelioma
155
Most pleural tumors are this type
Metastasis
156
Common Causative Organism
Rhinoviruses Coronavirus
157
Acute Pharyngitis Common Name
Sore throat
158
It is important to recognize this diagnosis in acute pharyngitis
Strep
159
Bacterial Epiglotisis Population
Children
160
Bacterial Epiglotisis Clinical Presentation
Fevor Stridor Lethargy Bending Over Drooling
161
Bacterial Epiglotisis Causative Organism
HIB
162
Acute Laryngitis Etiology
Virus Occasionally diphtheria
163
Diptheria Laryngitis Anatomical Feature
Dirt gray pseudomembrane from necrosis
164
Croup Classic Symptoms
Stridor Barking Cough
165
Croup Causative Organisms
Parainfluenza Virus Respiratory Syncytial Virus
166
Nasopharyngeal Carcinoma Causative Organism
EBV
167
Multiple Squamous Papilloma Causative Organism
HPV
168
Solitary Squamous Papilloma Population
Adults
169
Multiple Squamous Papilloma Population
Children
170
Laryngeal Carcinoma Population
Over 40 Men Smokers
171
Laryngeal Carcinoma Microscopic Morphology
Squamous cell carcinoma
172
Main Acid Base Buffer
HCO3-
173
The body regulates pH through controlling these two things
Partial pressure of CO2 HCO3 Concentration in Blood
174
Acid Base Body Inputs
Diet Metabolic Products
175
Two Systems That Regulate Acid Base
Lungs Kidneys
176
Carbonic Anhydrase Function
Converts CO2 to H2CO3
177
CO2 is Regulated by This System
Lungs
178
HCO3- is Regulated by This System
Kidneys
179
This System QUICKLY Changes Body pH
Lungs
180
This System SLOWLY Changes Body pH
Kidneys
181
Arterial Blood Gas must be tested this quickly after a blood draw
Within 30 minutes
182
Is the HCO3- measured directly in an ABG
NO, it is CALCULATED
183
Normal pH
7.35 to 7.45
184
Normal PaCO2
35 to 45 mmHg
185
Normal HCO3-
18 to 26 meq/L
186
Acidosis Definition
A process that increases H+ and decreases pH
187
Acidemia Definition
A net acidic state in the blood
188
Alkalosis Definition
A process that decreases H+ and increases pH
189
Alkalemia Definition
A net alkali state in the blood
190
Lethal Acidemia Effects
Coma Decreased Consciousness Cardiac Rhythm Changes
191
Lethal Alkalemia Effects
Mental Excitability Tetany and Seizures Cardiac Rhythm Changes
192
Respiratory Acidosis General Cause
Issue with the lungs
193
Metabolic Acidosis General Cause
Issue with the kidneys
194
The body stays on this side of an acid base issue
The body always stays on the side of the primary issue
195
Relationship Between pH and the GI Tract
Patients vomit acid and poop bicarb
196
Steps for Acid Base Interpretation
1. Describe pH 2. Describe Respiratory Status 3. Describe Metabolic Status 4. How many processes? 5. Primary process vs. compensation 6. Interpret acid base status
197
Normal pH in an acid base disorder indicates what?
TWO primary processes
198
Anion gap only works in this type of acidosis
Metabolic
199
Large anion gap indicates this general pathology
An extra source of acid
200
H+ is physiologically linked to this cation
K+
201
Common Sources of Anion Gap Acidosis
CATMUDPILES
202
Main Hormones Produced by Kidneys
Erythropoietin Vitamin D
203
Components of the Kidney
Glomeruli Tubules Blood Vessels
204
Glomerular Filtration Fraction
About 20% of blood volume filtered
205
Amount of water and electrolyte resorption in the kidneys
99%
206
Azotemia General Definition
Increase in nitrogen containing substances in the blood, specifically BUN and creatinine
207
Prerenal Azotemia General Mechanism
Inadequate blood flow to kindey
208
Renal Azotemia General Mechanism
Kidney damage
209
Postrenal Azotemia General Mechanism
Obstruction of urine flow
210
Acute Renal Failure General Definition
Marked decrease or cessation of urinary output
211
Acute Renal Failure Common Causes
Acute Tubular Necrosis Rapid Glomerulonephritis ADD
212
Chronic Renal Failure General Definition
The final common pathway of most renal disease
213
Chronic Renal Failure Clinical Presentation
Uremia Hypertension
214
Chronic Renal Failure Microscopic Pathology
Scarred down kidneys
215
Uremia General Definition
Constellation of clinical, metabolic, and endocrine effects of chronic renal failure
216
Uremia Components
Azotemia Uremic Gastroenteritis Uremic Neuropathy Uremic Pericarditis
217
Proteinuria Definition
Protein in the urine
218
Gross Hematuria Defintion
Frank blood in the urine
219
Microscopic Hematuria Definition
RBCs seen microscopically in urine
220
Nephrolithiasis Definition
Kidney stones
221
Nephrotic Syndrome Presentation
Massive Proteinuria Hypoprotenemia Edema Hyperlipidemia
222
Nephritic Syndrome Presentation
Mild to moderate proteinuria Hematuria with. RBC Casts in Urine Oliguria and Azotemia Hypertension Acute Onset
223
This implies glomerular disease
Hematuria and or proteinuria
224
Messangial Cells
Cells at the center of glomerulus that hold things together
225
Special Feature of Glomerular Capillaries
Fenestration
226
Podocytes
Line urinary space of glomerulus
227
Special Feature of Podocytes
Negative charge on surface that repels proteins
228
Most common cause of renal disease and failure
Glomerular disease
229
Most glomerular disease are this type of disease
Type III Immune Hypersensitivity
230
Laboratory Diagnosis of Glomerular Disease
Autoantibodies Complement Levels
231
Pathological Diagnosis of Glomerular Disease
Light Microscopy Immunofluorescence Electron Microscopy
232
Minimal Change Disease Pathological Presentation
Normal Light Microscopy Normal Immunofluorescence DIFFUSE FOOT PROCESS EFFACEMENT on electron microscopy
233
Minimal Change Disease General Category
Nephrotic Disease
234
Minimal Change Disease Population
Kids
235
FSGS Pathological Presentation
Same as minimal change disease with SCARRING OF THE GLOMERULUS
235
FGSG Causes
Idiopathic HIV Drugs
236
FSGS General Category
Nephrotic Syndrome
237
Membranous Nephropathy Cause
Type III Hypersensitivity
238
Membranous Nephropathy Pathological Presentation
Diffuse thickening of loops Antibody deposits Positive IgG and complement deposits
239
Membranous Nephropathy General Category
Nephrotic Syndrome
240
Membranous Nephropathy Population
Adults
241
Other Causes of Nonnephrotic Proteinuria
Diabetic Glomerulosclerosis Amyloidosis Light Chain Nephropathy
242
Diabetic Glomerulosclerosis Buzzword
Kimmelstiel Wilson Nodules
243
Amyloidosis Buzzword
Congo Red Positive
244
Light Chain Nephropathy
Bence Jones Protein
245
Most Common Cause of Postinfectious Glomerulonephritis
Group A Strep
246
Postinfectious Glomerulonephritis Pathological Presentation
Immune complex humps in glomerular capillaries
247
Postinfectious Glomerulonephritis General Category
Nephritic
248
Rapidly Progressive Glomerulonephritis Pathological Presentation
Crescents of cells in the glomerular space
249
Rapidly Progressive Glomerulonephritis General Category
Nephritic
250
Rapidly Progressive Glomerulonephritis Causes
Anti GBM Disease Pauci immune disease that activate neutrophils and DO NOT DEPOSIT ANTIBODIES
251
Anti GBM Disease Etiology
Antibody formation to type 4 collagen
252
Asymptomatic Hematuria Causes
IgA Nephropathy Hereditary Nephritis
253
IgA Nephropathy Pathological Presentation
Increased cells in the mesangium
254
IgA Nephropathy Population
Asian and Native American
255
Hereditary Nephritis Genetics
X linked mutation in type 4 collagen
256
Hereditary Nephritis Key Associations
Sensorineural Hearing Loss Vision Issues
257
SLE Pathological Presentation
Positive ANA in 90% of patients Full house immunofluorescence
258
Two important classes of SLE
Class IV Diffuse Proliferative Class V Membranous
259
Two Categories of Tubulointerstitial Disease
Inflammation and Infection Drugs
260
Causative Organism in Pyelonephritis
Gram Negative Rods like E coli
261
Pyelonephritis Pathological Presentation
Neutrophils in tubules
262
Pyelonephritis Clinical Presentation
Fever and flank pain
263
Drug Induced Tubulointerstitial Nephritis Causes
Antibiotics Synthetic Penicillins Rifampin Diuretics NSAIDS Lithium
264
Drug Induced Tubulointerstitial Nephritis Timecourse
Two weeks after drugs started
265
Drug Induced Tubulointerstitial Nephritis Pathological Presentation
Eosinophils
266
Most Common Cause of Acute Renal Failure
Acute Tubular Necrosis
267
Acute Tubular Necrosis Pathologic Presentation
Destruction of tubular epithelial cells
268
Acute Tubular Necrosis Ischemic Causes
General Ischemia Massive Hemolysis Sepsis
269
Acute Tubular Necrosis Toxic Causes
Hg Organic Solvents Gentamicin Xray Contrast
270
Nephrolithiasis Causes
Calcium Oxalate MOST COMMON Magnesium Phosphate Uric Acid
271
Magnesium Phosphate Stones are associated with this pathology
Proteus UTI
272
Uric Acid Stones are associated with this pathology
Gout Chemotherapy
273
Most common vascular kidney disease
Hypertensive Nephrosclerosis
274
Hypertensive Nephrosclerosis Pathological Presentation
Intimal thickening of large arteries Hyaline thickening of small renal arteries
275
Malignant Nephrosclerosis Etiology
Very high blood pressure precipitates acute renal failure
276
Malignant Nephrosclerosis Pathological Presentation
Fibrinoid necrosis of kidney vessels
277
Paraprotein Related Disorders Buzzwords
Positive Congo Red Bence Jones Protein
278
Renal Agenesis Etiology
No kidney development Bilateral kidney loss is incompatible with life
279
Horseshoe Kidney Occurrence
1 in 500 to 1 in 1000
280
Renal Displasia Cause
Kidney forms incorrectly and causes nonfunctional tissues in the kidney
281
Adult Polycystic Kidney Disease Genetics
Autosomal Dominant
282
Adult Polycystic Kidney Disease Occurrence
1 in 1000
283
Most Common Type of Kidney Tumor
Renal Cell Carcinoma
284
Renal Cell Carcinoma Associations
Smoking Polycythemia
285
Renal Cell Carcinoma spreads this way
Invades blood vessels
286
Most Common Type of Renal Cell Carcinoma
Clear Cell
287
How much of the fluid filtered by the glomerulus reenters the blood?
About 60%
288
General Function of the Loop of Henle
Concentration
289
Markers of Nephron Function
Glomerular Filteration Rate GFR
290
GFR Measures This
The amount of blood filtered by the glomeruli per unit time
291
Normal GFR
100 to 120 mL/min
292
Stage 1 GFR
90 or higher
293
Stage 2 GFR
60 to 89
294
Stage 3a GFR
45 to 59
295
Stage 3b GFR
30 to 44
296
Stage 4 GFR
15 to 29
297
Stage 5 GFR
Less than 15
298
This chemical is used to measure GFR
Creatinine
299
Blood Urea Nitrogen BUN Measures This Function
Tubular Function
300
Azotemia Clinical Defintion
Elevated BUN and Creatinine
301
Normal Creatinine
0.6 to 1.3 mg/dL
302
Creatinine Levels in Renal Failure
Over 10
303
General Causes of Acute Renal Failure
Prerenal Renal Postrenal
304
General Definition of Acute Renal Failure
When the patient suddenly stops producing urine
305
Prerenal Renal Failure Mechanism
Inadequate blood flow to kidney
306
Intrinsic Renal Failure Mechanism
Disease of the kidney itself
307
Postrenal Renal Failure Mechanism
Obstruction of both ureters
308
Pre renal BUN:Cr
Over 20:1
309
Postrenal BUN:Cr
10 to 20:1
310
Intrinsic BUN:Cr
Less than 10:1
311
Methods of Urine Protein Measurement
Dipstick 24 Hour Urine Measurement
312
Effective Substitute for 24 Hour Urine
Spot Urine Protein to Creatinine Ratio
313
Microalbuminuria indicated what?
Early diabetic nephropathy
314
Other Findings in Chronic Renal Failure
Anemia Metabolic Acidosis Decreased Na+ Increased K+ Decreased Ca2+ Increased PTH Increased phosphorus
315
Best Urine Test for Cytology
Spot Urine
316
Best Urine Test for Culture
Clean Catch
317
Best Urine for Testing Substances in Low Concentration
First Void Morning Urine
318
Visual Urinalysis Components
Color Turbidity Specific Gravity
319
Dipstick Urinalysis Components
Glucose Bilirubin Ketones pH Protein Nitrite Leukocytes
320
Red Urine Causes
Blood Porphyria Beets Drugs
321
Orange Urine Causes
Bile Drugs
322
Brown Urine Causes
Hemoglobin Acid Urine Melanin Alcaptonuria Drugs
323
Blood Glucose Renal Threshold
180 to 200 mg/dL
324
Urine Sugar Tests
Dipstick for Glucose Clinitest tablets for other sugars
325
Urine Ketones Indicate This
DKA
326
Urine Conjugated Bilirubin Indicates This
Biliary Obstruction Liver Disease
327
Urine Unconjugated Bilirubin Indicates This
Hemolysis Hepatic Disease
328
Chemical evidence of Urinary Disease
Protein Nitrite Leukocyte Esterase Blood
329
Urine Microscopic Analysis Checks for These General Things
Crystals and cells
330
Urinary Sediment RBCs Indicate These Things
Some Are Normal Bladder Tumor Kidney Stones
331
Urinary Sediment WBCs Indicate These Things
Some are Normal UTI
332
Urinary Sediment Eosinophils Indicate This
Drug Induced Nephritis
333
Urinary Sediment Granular Casts Indicate These Things
Glomerular and tubular diseases
334
Urinary Sediment Red Blood Cell Casts Indicate These Things
Specific Glomerular Disease Nephritic Syndrome
335
Urinary Sediment White Blood Cell Casts Indicate These Things
Acute Pyelonephritis
336
Renal Imaging Assesses These Things
Collecting System Size of Kidneys Perfusion
337
Zone 1 Hepatocyte Location
Closest to Portal Triad
338
Zone 3 Hepatocyte Location
Closest to Hepatic Vein
339
Zone 1 Hepatocyte Primary Function
Synthesis
340
Zone 3 Hepatocyte Primary Function
Detoxification
341
Stellate Cell Location
Space of Disse between hepatocytes and sinusoid endothelial cell
342
Stellate Cell Noninflammatory Function
Vitamine A Storage
343
End stage of liver fibrosis
Cirrhosis
344
Acute Liver Disease Presentation
Pain Some evidence of liver failure Jaundice
345
Chronic Liver Disease Presentation
Portal hypertension
346
Clinical Features of Liver Failure
Jaundice Hypoalbuminemia Hyperammonemia Hyperestrogenism Coagulopathies Encephalopathy
347
Three Morphologic Features of Cirrhosis
Regenerative Nodules Fibrosis Surrounding the Nodules Whole Organ Damage
348
Main Mechanism of Cirrhosis
Alteration of sinusoidal blood flow
349
Cellular Mechanism of Cirrhosis
Stellate cells lay down collagen when exposed to inflammatory cytokines
350
Prehepatic Portal Hypertension Causes
Portal vein thrombosis or narrowing
351
Posthepatic Portal Hypertension Causes
Right side heart failure or hepatic outflow obstruction
352
Intrahepatic Portal Hypertension Causes
Cirrhosis
353
What organ enlarges with portal hypertension
Spleen
354
Timeframe for Chronic Hepatitis
Longer than 6 months
355
Serum Markers of Hepatitis
ALT and AST
356
Acute Hepatitis Biopsy Pattern
Scattered lobular inflammation
357
Chronic Hepatitis Biopsy Pattern
Portal and periportal inflammation
358
Acute Hepatitis General Causes
Non hepatotropic infection Drugs Toxins
359
Nisan trichrome stain colors collagen this color
Blue
360
Chronic Hepatitis General Causes
Hepatitis B and D Hepatitis C Autoimmune Wilson Drugs PBC and PSC Graft vs. Host Acute Rejection
361
Hepatotrophic Viruses
Hepatitis A thru E
362
Hepatitis A Transmission Route
Fecal Oral
363
Hepatitis that will most likely cause chronic liver failure without treatment
Hepatitis C
364
Hepatitis that occurs with hepatitis B coinfection
Hepatitis D
365
Viral Hepatitis Histology Buzzword
Ground glass inclusions in the liver
366
Autoimmune Chronic Hepatitis Key Features
70% Female Negative Viral Serology Elevated Serum IgG High Autoantibody Titers Another Autoimmune Disease Plasma cells on biopsy
367
Antibodies of Type 1 Autoimmune Hepatitis
Antinuclear Anti smooth muscle
368
Antibodies of Type 2 Autoimmune Hepatitis
Liver and kidney microsomal type 1 antibodies
369
Antibodies of Type 3 Autoimmune Hepatitis
Antibodies to soluble hepatocyte antigen
370
Main Mechanism of Toxic Liver Injury
Conversion of the chemical by the liver to a toxic substance
371
Most Common Toxic Liver Injury Pattern
Idiosyncratic, where response varies person to person
372
This is the leading cause of liver disease worldwide
Alcohol
373
Alcohol use deaths per year
200,000
374
Three Forms of Alcohol Related Liver Disease
Steatosis Steatohepatitis Cirrhosis
375
How many moderate to heavy drinkers will experience liver steatosis
80%
376
How many of those who experience steatosis will develop steatohepatisis
About 1/3
377
Cellular Etiology of Steatosis
Lipid retention by hepatocytes
378
Steatosis Starts Here
Hepatic zone 3
379
Histological Features of Steatohepatitis
Hepatocyte swelling and necrosis Mallory Bodies Neutrophils in lobules Fibrosis
380
Nonalcohol related fatty liver disease causes
Obesity Type 2 Diabetes Hyperlipidemia
381
Diseases of Hepatic Veinous Outflow
Heart Failure Veno occlusive Disease Budd Chiari Syndrome
382
Mechanism of Liver Injury In Heart Failure
Enlarged heart blocks the inferior vena cava and outflow
383
Budd Chiari Syndrome Involves These Vessels
Hepatic Veins
384
Budd Chiari Syndrome Involves This General Pathology
Hypercoagulability
385
Veno occlusive Disease Involves These Vessels
Microscopic terminal hepatic veins
386
Veno occlusive Disease Involves This General Pathology
Toxin injury of the liver
387
This side heart failure can cause liver disease
Right heart failure
388
Right heart failure damages this hepatic zone first
Zone 3
389
Inborn Errors of Metabolism That Can Cause Liver Injury
Hemochromatosis Wilson's Disease Alpha 1 Antitrypsin Deficiency
390
Hemochromatosis Genetic Cause
Autosomal recessive
391
Hemochromatosis Pathophysiology
Too much iron absorbed from the gut which is then deposited in the liver, pancreas, and heart
392
Hemochromatosis becomes symptomatic during this time
5th to 6th decade of life
393
Hemochromatosis Specific Genetics
HFE Gene on 6p near MHC
394
Hemochromatosis Population Occurence
1 in 220
395
Laboratory Features of Hemochromatosis
Elevated serum iron and ferritin
396
Wilson Disease Genetics
Autosomal Recessive
397
Wilson Disease Specific Genetics
ATP7B on Chromosome 13
398
Wilson Disease usually effects these organs
Liver Eyes CNS
399
Wilson Disease Clinical Features
Liver disease Parkinson like symptoms Psychosis
399
Alpha 1 Antitrypsin Deficiency Specific Genetics
Autosomal recessive mutations on SERPINA1
400
Alpha 1 Antitrypsin Deficiency Pathophysiology
Low levels of protease inhibitor causes increased neutrophil activity
401
Clinical Manifestation of Excess Bilirubin
Jaundice Icterus Itching
402
Most Common Causes of Excess Bilirubin
Overproduction Liver Injury Outflow Obstruction
403
Cholestasis Definition
Lack of bile flow where bilirubin becomes visible in tissue
404
Unconjugated Bilirubin Solubility
Lipid soluble, so it generally circulates bound to albumin Indirect Fraction
405
Conjugated Bilirubin Solubility
Water soluble Direct Fraction
406
Liver processes bilirubin this way
Conjugates it, then excretes it in bile
407
Energy intensive portion of bilirubin processing
Excretion in bile
408
Unconjugated bilirubin can do this
Cross the blood brain barrier
409
Major Causes of Hyperbilirubinemia
Increased Production Liver Damage Damaged Outflow
410
Neonatal Jaundice Etiology
Conjugation enzymes do not fully develop until the 2nd week of newborn life
411
Ocurence of Neonatal Jaundice
60% of term babies 80% of premature babies
412
Gilbert Syndrome Presentation
Transient unconjugated hyperbilirubinemia under stress
413
Bile Duct Injury Serum Markers
Alkaline Phosphatase GGT Direct Hyperbilirubinemia
414
Two Main Immune Mediated Bile Duct Injuries
Primary Biliary Cholangitis Primary Sclerosing Cholangitis
415
Primary Biliary Cholangitis Pathological Presentation
Autoimmune attack of microscopic bile ducts Granulomas
416
Primary Biliary Cholangitis Population
10 to 1 Female to Male Ages 40 to 50
417
Primary Biliary Cholangitis Lab Findings
Antimitochondrial Antibodies Elevated Cholesterol
418
Primary Sclerosing Cholangitis Etiology
Inflammation and obliterative fibrosis of large bile ducts
419
Primary Sclerosing Cholangitis Imaging Finding
Beaded appearance on ERCP
420
Primary Sclerosing Cholangitis is strongly associated with this other disease
Ulcerative colitis
421
Primary Sclerosing Cholangitis increases the risk for this disease
Adenocarcinoma of bile ducts
422
Primary Sclerosing Cholangitis Pathological Finding
Periductal fibrosis
423
Most liver malignancies are this type
Metastasis from somewhere else
424
Most Common Primary Malignancies of Liver
Hepatocellular Carcinoma Cholangiocarcinoma Angiosarcoma Hepatoblastoma
425
Three major etiologies of hepatocellular carcinoma
HBV Chronic Alcohol Use Aflatoxins Cirrhosis of any cause
426
Hepatocellular Carcinoma Main Lab Finding
Elevated AFP in adults

Biology Of Disease (5 decks)

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