Path II Midterm

Question 1

Kidney Functions

Answer 1

excretion of waste products of metabolism
regulation of water and salt concentration in body
maintenance of plasma pH
secretion of some hormones (renin, erythropoietin, prostaglandins)

Question 2

what is the functional unit of the kidneys

Answer 2

nephron

Question 3

What are the four compartments of the kidney?

Answer 3

glomeruli
tubules
interstitium
blood vessels

Question 4

Which part of the kidney contains nociceptors?

Answer 4

capsule- sensitive to distention

Question 5

glomerulopathy

Answer 5

disease of the glomerulus

Question 6

Glomerulonephritis

Answer 6

inflammation of glomeruli of kidney

occurs through several different mechanisms

Question 7

Circulating immune complex deposition glomerulonephritis

Answer 7

Type III hypersensitivity
antigen-antibody immune complexes settle in the walls of the glomerulus
as phagocytes try to digest the complexes, the walls of the vessels are damaged causing local vasculitis

Question 8

Anti-GBM glomerulonephritis

Answer 8

type II hypersensitivity
antibodies are formed against the basement membrane in the glomerulus
phagocytes release destructive enzymes onto the basement membrane and destroy it

Question 9

Heymann glomerulonephritis

Answer 9

no specific type of hypersensitivity
immune aggression against the podocytes and some antigens within them
leads to destruction of the podocytes

Question 10

Nephritic syndrome

Answer 10

Hematuria
oliguria
azotemia
hypertension

Question 11

Why is there hypertension with nephritic syndrome?

Answer 11

juxtaglomerular cells release renin as a result of a decreased GFR

Question 12

What is the difference between azotemia and uremia

Answer 12

azotemia is a biochemical abnormality characterized by increased levels of creatine and BUN
uremia is the advanced process with symptoms and clinical manifestations

Question 13

Diseases associated with Nephritic syndrome

Answer 13

acute proliferative glomerulonephritis
rapidly progressive glomerulonephritis
Berger's disease
Alport Syndrome
Chronic glomerulonephritis

Question 14

Acute Proliferative glomerulonephritis

Answer 14

Type III hypersensitivity
caused by beta hemolytic streptococcus group A
immune complex settles in the subentimal layer of the of the membrane (between basement membrane and endothelium)

Question 15

Rapidly progressive glomerulonephritis

Answer 15

aka crescentic
a group of disorders marked by hyperplasia of the parietal cells of the bowman’s capsule that merge and form a crescent shape
leads to pressure atrophy of the glomerulus

Question 16

Type I Rapidly progressive glomerulonephritis

Answer 16

anti- glomerulus basement membrane
type II hypersensitivity
goodpastures syndrome

Question 17

goodpasture syndrome

Answer 17

Type I Rapidly progressive glomerulonephritis

formation of antibodies against the basement membrane of alveoli and glomeruli
leads to accumulation of RBC’s in the lungs and hemoptysis

Question 18

Type II Rapidly progressive glomerulonephritis

Answer 18

Type III hypersensitivity
idiopathic
associated with SLE and hemorrhagic vasculitis

Question 19

SLE

Answer 19

type II Rapidly progressive glomerulonephritis

occurs in young women, kidneys are the most involved organ
anti-nuclear antibodies are produced against ds DNA

Question 20

Henoch-Schonlein purpura

Answer 20

hemorrhagic vasculitis
skin syndrome –> articular syndrome –> abdominal syndrome –> GMN

GMN is irreversible

Question 21

Type III rapidly progressive glomerulonephritis

Answer 21

Pauci-immune
not related with a specific type of hypersensitivity
idiopathic vasculitis

associated with Wegener’s granulomatosis and polyarteritits nodosa

Question 22

Wegener’s granulomatosis

Answer 22

anti-neutrophil cytoplasmic autoantibodies result in necrotic vasculitis of arteries, arterioles and capillaries
necrotic granulomas of the respiratory tract

Question 23

polyarteritis nodosa

Answer 23

characterized by vasculitis of the body
only areas of the body not involved are aortic arch and vessels of lung
destruction of kidney
wet gangrene as a complication

Question 24

IgA nephropathy

Answer 24

aka Berger’s disease
deposition of IgA and IgA complex in the kidney
most common glomerular disease in the world

Question 25

thrombangitis obliterans

Answer 25

aka buerger's disease vasculitis of mid and small arteries inflammation of vessels that supply nerves with blood associated with smoking

Question 26

major symptoms of buerger's

Answer 26

instep claudication narrowing of vessel lumen Raynaud's ends with gangrene in extremities

Question 27

Alport syndrome

Answer 27

hereditary glomerulonephritis develops nephritic syndrome renal failure by 25 years old

Question 28

Nephrotic Syndrome

Answer 28

proteinuria hypoalbuminemia generalized edema hyperlipidemia/lipiduria

Question 29

what ratio changes in nephrotic syndrome

Answer 29

albumin-globulin

Question 30

Causes of nephrotic syndrom

Answer 30

``` Minimal change disease membranous glomerulonephritis focal glomerulosclerosis membranoproliferative glomerulonephritis diabetes mellitus amyloidosis ```

Question 31

acute pyelonephritis

Answer 31

more common than glomerulonephritis | suppurative inflammation of kidney pelvis and parenchyma

Question 32

routes of infection with acute pyelonephritis

Answer 32

ascending (most common) lymphogenic hematogenic

Question 33

Diabetic nephropathy

Answer 33

decreased GFR, increased BP diffuse glomerulosclerosis nodular glomerulosclerosis, renal vascular lesion

Question 34

peptic ulcer

Answer 34

breech into mucosa

Question 35

erosion

Answer 35

aka sloughing | superficial damage to the mucosal wall

Question 36

Defensive forces to the mucosal layer

Answer 36

surface mucous secretion bicarbonate secretion mucosal blood flow elaboration of prostaglandins

Question 37

pyloric stenosis

Answer 37

healing of peptic ulcer near pylorus scar tissue results in dramatic shrinking of lumen of pyloric canal results in loss of G cells/hypoacidity

Question 38

hypertrophic pyloric stenosis

Answer 38

congenital | pyloric sphincter is too thick

Question 39

manifestations of hypertrophic pyloric stenosis

Answer 39

visible peristalsis dehydration weight loss

Question 40

hiatal hernia

Answer 40

separation of diaphragmatic crura | widening of space between muscular crura and esophageal wall

Question 41

axial hernia

Answer 41

aka sliding | most common

Question 42

non-axial hernia

Answer 42

aka paraesophageal | results in venous infarct and gangrene

Question 43

achalasia

Answer 43

failure of the relaxation with consequent dilation of esophagous sphincter

Question 44

achalasia is associated with

Answer 44

aperistalsis incomplete relaxation of lower esophageal sphincter with swallowing increased resting tone of lower esophageal sphincter

Question 45

Primary achalasia

Answer 45

idiopathic may be associated with myenteric plexus damage may be associated with innervation of esophageal wall

Question 46

secondary achalasia

Answer 46

protozoa trypansome cruzi has toxic effect on myenteric pleuxus results in chagas disease

Question 47

Mallory-Weiss syndrome

Answer 47

formation of longitudinal tears of the esophagus | due to multiple retching

Question 48

Barrett espohagus

Answer 48

replacement of normal stratified squamous with metaplastic columnar epithelial containing goblet cells

Question 49

Zollinger-Ellison syndrom

Answer 49

associated with marked hypersecretion of gastrin due to a gastrinoma

Question 50

rheumatic fever

Answer 50

affects joints, skin, heart, and nervous system | associated with beta hemolytic strep group a

Question 51

rheumatic myocarditis

Answer 51

100% involvement of the myocardium

Question 52

pathomnemonic sign for rheumatic myocarditis

Answer 52

aschoff's nodes

Question 53

rheumatic pericarditis

Answer 53

rare | results in fibrous inflammation

Question 54

rheumatic endocarditis

Answer 54

80% of cases inner layer of heart involved attacks valves and impairs blood flow