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Path 2 Lab > Midterm > Flashcards

Midterm Flashcards

1
Q

Urolithiasis refers to __ formation at ___ level of the collecting urine system

A

calculus

any

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2
Q

Urolithiasis develops mostly in ___. __% of the population has this. Pathogenesis is associated with ___ of the urine.

A

Males
10
supersaturation

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3
Q

What are most kidney stones made up of?

A

Pure Calcium Oxalate or combination with calcium phosphate (75% are made up of these)

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4
Q

If urine stone blocks __ __, it causes accumulation of fluid because fluid cannot ___. This increases ___ pressure leading to __ __ of the tissue.

A

major calyx
compress
hydrostatic
pressure atrophy

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5
Q

10-15% of stones in the urinary tract are made up of __ and __. What is the official name?

A

magnesium
monophosphate
Triple Stones or Struvites

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6
Q

Alkaline urine is more susceptible to bacteria like __ __ and other __ __ __, which are a normal part of gut flora and may cause a ___ and can convert urea into substance that create alkaline environment. Urine sometimes becomes alkaline with ___.

A

Proteus Vulgaris
Gram - Rods
UTI
vegetarians

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7
Q

6-23% of stones are __ __ salts. These stones are radio___ and will sometimes have inclusion of __ within the stones and appear __ on the xray

A

Uric Acid
lucent
calcium
patchy

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8
Q

0.5-4% of stones are ___, an amino acid. The stones are radio___

A

Cystine

opaque

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9
Q

What are some predisposing factors to stone formation?

A

Urinary Obstruction
Epithelial Injury
Changes in urine
Quick weight loss

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10
Q

What are possible causes of urinary obstruction?

A

Enlarged prostate
Pregnancy
Diverticuli

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11
Q

Enlarged Prostate: There are __ lobes to the prostate. Central lobe can compress the __ and cause obstruction. Peripheral lobe has low access to the urethra, __ must grow here to be symptomatic.

A

2
urethra
tumors

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12
Q

Enlarged Prostate: Benign Prostatic Hypertrophy/ Hyperplasia: Located in the __ lobes. A smaller amount of fluid causes urination, so there is __ urination. Because the urethra is narrowed, there may be ___, increased __ pressure, and inguinal ___. There is also difficulty __ urination.

A 
central
frequent
dribbling
abdominal
hernias
initiating (hesitancy)
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13
Q

Enlarged Prostate: 70-80% of __ __ begins in the peripheral lobes, and is usually caught __.

A

Prostatic Carcinoma

late

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14
Q

Pregnancy: The fetus can be in a position that compresses the __. This increases __ pressure as the fluid builds up in the __ and may lead to atrophy of the ___. The capsule around the kidney is very sensitive to pain from the __ of the kidneys.

A

ureter
hydrostatic
kidney
parenchyme

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15
Q

Pregnancy: Fetus may also compress veins leading to ___ veins or may compress the __ __ causing __ __.

A

varicose
bile duct
gall stones

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16
Q

DIvertuculi can also cause ___

A

compression/ obstruction

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17
Q

Epithelial Injury: Epithelial cells can slough off and form a ___. Vit __ and Vit __ deficency cause a reduction in the life span of epithelial cells so they slough off more often.

A

nidus
A
B6

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18
Q

Changes in urine: What may cause changes in urine that lead to predisposition to stone formation?

A

Dehydration
Hypercalcuria
Hyperphosphoturia
Oxaluria

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19
Q

Quick Weight loss: __ usually surrounds and cushions the kidney. With weight loss, the kidneys ___ which can causes compression of the ___ and lead to ___

A

Fat
distend
ureters
pyelonephritis

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20
Q

What are some complications of kidney stones?

A

Staghorn Calculus
Hydronephrosis
Ureteral Colic (Renal Colic)

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21
Q

Staghorn Calculus: 99% are made up of __ __ __. and 1% are made from __. These are large stones formed in a __ environment. Leads to dramatic loss of kidney __ and __ __.

A 
Magnesium Ammonium Phosphate (triple stones)
Cystine
Alkaline
function
urine flow
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22
Q

Staghorn Calculus: Urine will accumulate in the kidney causing (3). Parenchyme becomes __ due to increased __ __.

A 
distention
hydronephrosis
atrophy
thin
hydrostatic pressure
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23
Q

Hydronephrosis- distention of the kidney __ with accompanying __ of the kidney __ due to __ of urine outflow.

A

pelvis
atrophy
peranchyma
obstruction

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24
Q

Hydronephrosis: Once complete obstruction occurs, complete __ of the kidney will occur and death occurs within __ weeks. What is the MCC of hydronephrosis?

A

atrophy
3
Kidney Stones

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25
Q

Renal Colic: Full __ of the ureter by a stone. __ of the __ muscle walls of the ureter lodge. Extremely painful. Where does pain radiate to?

A

obstruction
Spasm
smooth
-Pain from kidney will radiate down the flank to the groin, ending in the ipsilateral genitalia.

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26
Q

Renal Colic: Stone injures the wall causing __. There would be a very positive __ __. What does treatment include?

A

hematuria
murphy’s punch
-Tx includes pain relievers and muscle relaxers to allow stone movement. If too large, may need to remove surgically

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27
Q

Bladder stones are more common in __ over __ years old. How are they removed?

A

males
60
-Instrument is inserted into the urethra to remove the stones. Ouch.
-No anesthesia is used bc Dr. could tear urethra near the __.

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28
Q

Acute Cystitis: What are some causes?

A 
E. Coli- #1 cause
Other Gram - Bacteria
STDs- Gonorrhea and Chlamydia
Yeast Infection
Some Cytostatics used to Tx cancer and Autoimmune disorders may cause hemorrhagic cystitis
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29
Q

Yeast Infection: Candida Albicans AKA ___. Common condition in USA because of overuse of ___.

A

Molina

antibiotics

30
Q

What are some predisposing factors to Acute Cystitis?

A 
Exposure of female pelvis to cold temperatures
Catheter
Stones
Pouches in bladder
Obstruction
Foreign bodies in bladder
31
Q

Acute Cystitis is inflammation of the __ __. Usually occurs in __. Usually caused by an infection from the __ __ __

A

urinary bladder
females
normal gut flora

32
Q

Exposure of female pelvis to cold: Ovaries are very sensitive to the cold. __ decreases blood flow and there is a decrease in the function of ___, and an increase in ___. The healing process forms __ __ that will __ and __ the lumen of fallopian tubes leading to tubal pregnancy or infection.

A 
Vsoconstriction
enzymes
infection
connective tissues
shorten 
narrow
33
Q

What are the 3 major symptoms of Acute Cystitis?

A

Dysuria
Increased Frequency
Lower abdominal or subrapubic pain

  • Must have all 3 to be acute cystitis. If one is missing, may be pelvic subluxation.
  • Hematuria may or may not be present with AC
34
Q

Acute cystitis is treated with __. Improvement should occur within __ day(s). If there is no improvement within __ days, it is not cystitis. If antibiotics are not take for at least 7 days, this could lead to __ __, which reduces bladder __ and is incurable.

A 
Antibiotics
1
3
chronic cystitis
capacity
35
Q

What are the 4 types of prostate inflammation pathologies?

A

Acute Bacterial Prostatitis
Chronic Bacterial Prostatitis
Chronic Abacterial Prostatitis
Granulomatous Prostatitis

36
Q

Acute bacterial prostatitis is caused by ___, usually (3), or other gram - rod bacteria. This is due to intraprostatic __ of urine and may follow __ manipulation of the uerthra of prostate.

A 
UTI
Staphylococcus
E Coli
Enterococcus
reflux
surgical
  • Catherization, cytoscopy, etc. may cause
  • Extremely boggy prostate
37
Q

Chronic Bacterial Prostatitis: Difficult to diagnose. Diagnosis is dependent on ___ and Hx of infections. What are some symptoms?

A 
Cultures
Insidious LBP
Dysuria
Perineal/ suprapubic discomfort
*Antibiotic not effective
38
Q

Chronic Abacterial Prostatitis: MCC of Prostatitis. No history of recurrent ___. __ are present in the urine, but __ are not.

A

infection
Leukocytes
Bacteria

39
Q

Granulomatous Prostatitis is a __ procedure in the US, instill __ for superficial bladder cancer. There is also a __ type which occurs in immunocompromised patients. The relatively common non specific type is a reaction to secretions form a ruptured __ __

A

common
bacillus
fungal
prostatic duct

40
Q

What is benign Nodular Enlargement AKA?

A

Nodular Hyperplasia

41
Q

Nodular Hyperplasia: Extremely common in men over __. __% of men by the age of 40. __% of men by the age of 60. __% of the men by the age of 70. __% of men with hyperplasia have symptoms.

A 
50
20
70
90
50
42
Q

Nodular Hyperplasia: Involves hyperplasia of the __ and __ cells forming a large and discrete nodule that compresses the ___ zone which narrows or obstructs the urethral canal.

A

stroma
epithelial
periurethral

43
Q

Nodular Hyperplasia: Etoliology?

A

Prostate synthesizes dihydrotestosterone from circulating testosterone which controls the prostate’s growth

44
Q

What are the symptoms of Nodular Hyperplasia?

A 
Difficulty urinating
Retention of urine (Bladder hypertrophy, distention, cystitis, renal infection)
Frequency
Nocturia
Dribbling
Dysuria
45
Q

Nodular Hyperplasia: Treatment?

A

Surgically by transurethral resection, alpha blockers, reduced fluid at bedtime, reduced alcohol and caffeine, and phytochemicals.

46
Q

Adenocarcinoma of prostate: Most common form of cancer in men, 2nd leading cause of cancer deaths. Typically affects men over 50, uncommon in __ men, more common in US __ males. Etiology is unknown. A common genetic alteration is hypermethylation of ____.

A

Asian
Black
Glutathione S-transferase gene promoter (GSTP1)

47
Q

Adenocarcinoma of the prostate is __ during rectal exam. due to typical __ location on the __ zone. Will feel gritty and firm. Spreads locally or through __ or __. May involve __ __ and the base of the __.

A 
palpable
posterior
peripheral
bloodstream
lymph
seminal vesicle
bladder
48
Q

How does gleason grading of prostate cancer work?

A

5 grades based on glandular differentiation and pattern
Grade 1- well defined tumor
Grade 5- No glandular differentiation
Primary and secondary patterns added together
5-7 is treatable
8-10 is not treatable

49
Q

What is PSA and what is it used for?

A

Prostetic Specimen antigen

Product of epithelium and is organ specific, not cancer specific. Useful fro Tx response.

50
Q

What is treatment of Adenosarcoma of prostate?

A

Radical Prostatectomy

51
Q

What are the neural, endocrine, and local stimulators of HCl?

A

Pernicious Anemia means ___Neural- Vagus N. (Parasympathetic)
Endocrine- Gastrin8ik
Local- Histamine

*Histamine is found in mast cells, eating spicy food will cause degranulation of mast cells.

52
Q

Pernicious Anemia: Blood cells are ___ and have a __ membrane that prevents them from bending to get out of the ___. Neutrophils and other WBCs are ___ with more than __ nuclei. There is CNS damage of the __ columns of the spinal cord. With __ __ deficient anemia the CNS is spared.

A 
large 
rigid
capillaries
hypersegmented
5
Posterior
Folic Acid
53
Q

Zygomen cells AKA

A

Chief Cells

54
Q

Chief Cells produce ___ which is inactive. This is activated by __ to __. The zygomen cells would be damaged if they produced activated pepsin.

A

pepsinogen
HCL
Pepsin

55
Q

G Cells are located in the __ area and produce __, the __ stimulator.

A

antropyloric
gastrin
endocrine

56
Q

Ghronic Gastritis: Chronic __ inflammatory changes of the stomach wall that eventually result in mucosal __ and __.

A

mucosa
atrophy
metaplasia

57
Q

Chronic Gastritis: Caused by __ __. __% of americans have this in their stomach and __% of russians and puerto ricans do. This produces __ that are toxins or enzymes that are harmful, causing atrophy of the mucosa. The stomach epithelial cells may transform into ___ epithelial cells

A 
Helicobactor Pylori
50
80
metabolites
intestinal
58
Q

Chronic Gastritis: Metaplasia predisposes to intestinal type ___

A

carcinoma

59
Q

Autoimmune gastritis is more common in __ countries. The __ cells are selectively damaged. This leads to __ deficiency because less __ __ is produced. They will have __acidity and __ anemia.

A 
scandenavian
parietal
B12
intrinsic factor
hypo
megaloblastic
60
Q

What are the 2 types of stomach cancer that make up 95% of all stomach cancers?

A

Intestinal Type Adenocarcinoma

Diffuse stomach carcinoma

61
Q

Stomach cancer is most common in the __ __.

A

lesser curvature

62
Q

Horner’s Syndrome is defined as ___ of the ___ lymph nodes called __ nodes, due to either __ or __ cancer.

A 
lymphadenopathy
supraclavicular
Virchow's
stomach
lung
63
Q

Stomach cancer, or cancer of the GI tract metastasizes to the liver via the __ __ __

A

hepatic portal (venous) system

64
Q

Diffuse Stomach Carcinoma- more common than __ type adenocarcinoma. Involves entire __ wall. Has a __ latent period before metastisizes and often comes to medical attention late. Risk factors are undefined and __ __ and __ __ are usually absent.

A 
Intestinal
stomach
short
H. Pylori
chronic gastritis
65
Q

Diffuse Stomach Carcinoma: Is a schirrous cancer made of mostly ___. The stomach shrinks because of the __ __. It is sometimes called __ __ stomach or __ __ because the stomach is rigid and can’t distend.

A

stroma
connective tissue
leather bottle
linutus plastica

66
Q

Intestinal Type Adenocarcinoma- Less malignant than diffuse type carcinoma. It has a __ latent period. It also has predisposing factors. Tumor projects into the __ of the stomach. What are predisposing factors?

A 
long
lumen
Infection with H. Pylori
Diet (nitrites/ smoked food, salty, pickled food, lack of F&V)
Parietal Gastrectomy
Gastric Adenomas (40% cancerous at time of Dx, 30% with adjacent cancer at Dx
Barrett Esophagus
Family Hx
67
Q

Benign stomach polyps are malignant __% of the time. Colinic polyps become cancerous __% of the time.

A

4

40

68
Q

Krukenberg Tumor- Stomach cancer that spreads through the __ cavity to the __

A

abdominal

ovaries

69
Q

Epigastric Pain less than 30 minutes after a meal indicates __ __

A

stomach cancer

70
Q

Epigastric pain 30 min to 1 hour after eating indicates __ __ __

A

stomach peptic ulcer

71
Q

Epigastric pain 1 to 3 hours after eating indicates __ __ __

A

Duodenal peptic ulcer

Path 2 Lab (2 decks)

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