patho 938-844 vascular diseases

Question 1

what is the term used for the renal pathology associated with sclerosis of renal arterioles and small arteries and is strongly associated with hypertension

Answer 1

nephrosclerosis

Question 2

what 2 processes participate in the arterial lesions of nephrosclerosis

Answer 2

medial and intimal thickening and hyalinization of arteriolar walls

Question 3

what is the loss of mass with nephrosclerosis due mainly to

Answer 3

cortical scarring and shrinking

Question 4

what does the patchy ischemic atrophy of nephrosclerosis consist of

Answer 4

foci of tubular atrophy and interstitial fibrosis; variety of glomerular alterations

Question 5

what is the renal vascular disorder (nephrosclerosis) associated with malignant or accelerated hypertension

Answer 5

malignant nephrosclerosis

Question 6

what is a frequent cause of renal failure in individuals with systemic sclerosis

Answer 6

malignant nephrosclerosis

Question 7

what is the fundamental lesion in malignant nephrosclerosis

Answer 7

vascular injury

Question 8

what do patients with malignant hypertension that have malignant nephrosclerosis have elevated levels of

Answer 8

plasma renin

Question 9

what are the 2 histologic alterations characterizing the blood vessels in malignant hypertension

Answer 9

fibrinoid necrosis of arterioles and intimal thickening caused by proliferation of elongated, concentrically arranged smooth muscles (known as onion skinning)

Question 10

what does the lesion hyper plastic arteriolitis correlate with

Answer 10

renal failure

Question 11

what is hypertension secondary to renal artery stenosis caused by

Answer 11

increased production of renin from the ischemic kidney

Question 12

what is the most common cause of renal artery stenosis

Answer 12

narrowing at the origin of the renal artery by an atheromatous plaque

Question 13

what is the second most common cause of renal artery stenosis

Answer 13

fibromuscular dysplasia of the renal artery

Question 14

what 2 syndromes are included in thrombotic microangiopathy

Answer 14

thrombotic thrombocytopenia purport (TPP) and hemolytic-uremic syndrome (HUS)

Question 15

what is typical HUS most commonly associated with

Answer 15

consumption of food contaminated by bacteria producing shiva-like toxins

Question 16

what is ADAMTS13 and what disorder is it typically deficient in

Answer 16

it is a plasma metalloprotease that regulates the function of von willebrand factor; deficient in TPP

Question 17

what are the pathogenic triggers that dominate in thrombotic microangiopathies

Answer 17

endothelial injury and excessive platelet activation & aggregation

Question 18

what does typical HUS typically follow

Answer 18

a prodrome of influenza-like or diarrheal symptoms

Question 19

what is the most common deficiency in adults that acquire atypical HUS

Answer 19

deficiency of factor H

Question 20

what pentad is TPP most classically manifested by

Answer 20

fever, neurologic symptoms, microangiopathic hemolytic anemia, thrombocytopenia, renal failure

Question 21

what is the dominant feature of TPP

Answer 21

CNS involvement

Question 22

what are the most common abnormalities with sickle cell nephropathy

Answer 22

hematuria and diminished concentrating ability (hyposthenuria)

Question 23

when does diffuse cortical necrosis most frequently occur

Answer 23

after obstretric emergency

Question 24

where are the alterations that occur with diffuse cortical necrosis

Answer 24

sharply limited to the renal cortex