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Biology Of Disease > Unit 4 > Flashcards

Unit 4 Flashcards

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AP® Biology flashcards Biology 101 flashcards
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
Q

Diffuse Alveolar Damage Causes

A

Pneumonia
Aspiration of Gastric Contents
Sepsis
Trauma with Shock

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26
Q

Diffuse Alveolar Damage General Pathology

A

Leakage of cellular contents and fluid into the airway

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27
Q

Phases of Diffuse Alveolar Damage

A
  1. Edema
  2. Hyaline Membrane Appearance
  3. Interstitial Inflammation and Fibrosis
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28
Q

ARDS Clinical Definition

A

Rapid onset dyspnea with low blood oxygen levels
Diffuse bilateral lightly colored infiltrates on chest xray

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29
Q

ARDS must be differentiated from this pathology

A

Left side heart failure

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30
Q

Three Types of Obstructive Diffuse Pulmonary Diseases

A

Asthma
COPD
Bronchiectasis

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31
Q

Restrictive Lung Disease Definition

A

Reduced expansion and decreased total lung capacity

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32
Q

Obstructive Lung Disease Definition

A

Limitation of airflow on expiration

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33
Q

General Components of COPD

A

Emphysema
Chronic Bronchitis

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34
Q

Pathological Components of COPD

A

Alveolar wall Destruction
Overinflation
Productive Cough
Airway Inflammation

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35
Q

General Components of Asthma

A

Muscle Spasm of the airway

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36
Q

Most Common Type of Asthma

A

Extrinsic

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37
Q

Antibody of Extrinsic Asthma

A

IgE

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38
Q

More Rare Type of Asthma

A

Non atopic

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39
Q

Drug of Drug Induced Asthma

A

Aspirin

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40
Q

Biochemistry of Drug Induced Asthma

A

Inhibition of COX without inhibition of LOX, which shifts the balance towards bronchoconstriction

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41
Q

Role of Leukotrienes in Asthma

A

Brochoconstriction and increased vascular permeability

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42
Q

Role of Prostaglandins in Asthma

A

Bronchoconstriction and vasodilation

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43
Q

Role of Histamines in Asthma

A

Bronchospasm and increased vascular permeability

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44
Q

Eosinophils in Asthma

A

Tissue damage and recruitment of additional inflammatory cells

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45
Q

Gross Pathology of Asthma

A

Lung Hyperinflation
Mucous Plugging
Edema

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46
Q

Histopathology of Asthma

A

Smooth muscle and mucous gland hypertrophy
Thickened collagen beneath basement membrane

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47
Q

Clinical Features of Asthma

A

Attacks of dyspnea, wheezing, cough, and chest tightness

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48
Q

COPD Pulmonary Function Test

A

Decreased FEV1/FVC

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49
Q

Emphysema Definition

A

Abnormal permanent enlargement of air spaces distal to the terminal bronchioles accompanied by distruiction of their walls

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50
Q

Centriacinar Emphysena

A

Upper lung respiratory bronchiole involvement

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51
Q

Panacinar Emphysema

A

Destruction of the entire acinus found in the lower lung

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52
Q

Distal Acinar Emphysema

A

Usually involves the upper lung in spontaneous pneumothorax patients

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53
Q

Irregular Emphysema

A

Irregular acinus involvement associated with previous scaring and NOT with smoking

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54
Q

Emphysema Pathology

A

Reactive oxygen species in tobacco attracts neutrophils that break down lung tissue

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55
Q

Chronic Bronchitis Definition

A

Persistent productive cough for most day for 3 consecutive months of the year for at least two years

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56
Q

Chronic Bronchitis Pathology

A

Oversecretion of mucous from proliferation of mucous glands

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57
Q

Pure Emphysema Clinical Picture

A

Prominent dyspnea and hyperventilation
Adequate oxygenation of hemoglobin
Barrel chest hunched over

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58
Q

COPD Clinical Picture

A

Persistent cough with sputum
Recurrent Infections

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59
Q

Causes of Bronchiectasis

A

60% Idiopathic
Cystic Fibrosis
Bacterial Pneumonia
Foreign Body Ingestion
Immunodeficiency

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60
Q

Bronchiectasis Clinical Picture

A

Productive cough with mucopurulent sputum

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61
Q

Bronchiectasis Pathology

A

Permanent dilation of the bronchioles caused by destruction of the walls and supporting tissue

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62
Q

Pure Emphysema Oxygenation

A

Normal hemoglobin oxygenation

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63
Q

Chronic Bronchitis With Emphysema Oxygenation

A

Low, which causes cyanosis

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64
Q

Diffuse Interstitial Restrictive Lung Disease General Pathology

A

Fibrosis of interalveolar walls which yields reduced compliance

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65
Q

Diffuse Interstitial Restrictive Lung Disease Etiologies

A

Idiopathic
Occupational
Drugs
Radiation
Autoimmune

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66
Q

Major Categories of Diffuse Interstitial Restrictive Lung Disease

A

Fibrosing
Granulomatous
Eosinophilic
Smoking Related

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67
Q

Diffuse Interstitial Restrictive Lung Disease Pathological Definition

A

Idiopathic pulmonary fibrosis

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68
Q

Diffuse Interstitial Restrictive Lung Disease Histological Definition

A

Usual interstitial pneumonia

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69
Q

Usual Interstitial Pneumonia Histological Pattern

A

Fibroblastic Foci
Older areas with dense collagen

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70
Q

Usual Interstitial Pneumonia Gross Pathological Finding

A

Honeycomb lung

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71
Q

Usual Interstitial Pneumonia Clinical Progression

A

Gradually progressive dyspnea
Poor prognosis

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72
Q

Usual Interstitial Pneumonia Gender and Age

A

Males 40 to 70 years

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73
Q

Nonspecific Interstitial Pneumonia Gross Pathology

A

Uniform fibrosis

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74
Q

Nonspecific Interstitial Pneumonia Clincial Features

A

Nonsmoking women
Cellular and fibrotic pattern

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75
Q

Cryptogenic Organizing Pneumonia Pathology

A

Plugs and loose organizing connective tissue in bronchioles and alveolar ducts

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76
Q

Pneumoconioses General Cause

A

Lung reacts to inhaled particles

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77
Q

Pneumoconioses Specific Causes

A

Coal Dust
Silica
Asbestose

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78
Q

Pneumoconioses Cellular Pathology

A

Damage caused by macrophages

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79
Q

Silicosis makes you more susceptible to this infection

A

TB

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80
Q

Asbestos makes you more susceptible to these two pathologies

A

Mesothelioma
Lung Cancer

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81
Q

These drugs increases risk for pulmonary fibrosis

A

Bleomycin
Ameodarone
Radiation

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82
Q

Sarcoidosis general definition

A

Idiopathic multisystem granulomatous disease

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83
Q

Sarcoidosis Classic Presentation

A

Enlarged hilar lymph nodes

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84
Q

Sarcoidosis Population

A

Young black Americans

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85
Q

Sarcoidosis Histopathology

A

Non necrotizing granulomas around lymph space

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86
Q

Sarcoidosis Gross Pathology

A

Granulomas around lymph spaces

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87
Q

Hypersensitivity Pneumonitis Hypersensitivity Type

A

Type III and Type IV

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88
Q

Hypersensitivity Pneumonitis General Cause

A

Immune reaction from inhaled particles like from a horse barn or bird ownership

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89
Q

Hypersensitivity Pneumonitis Acute Clinical Presentation

A

Fever, cough, and dyspnea about 4 to 8 hours after exposure to insult

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90
Q

Hypersensitivity Pneumonitis Chronic Clinical Presentation

A

Cough, dyspnea, weight loss, with an insidious course

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91
Q

Hypersensitivity Pneumonitis Gross Pathology

A

Progression from normal to nodules to fibrosis with honeycombing

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92
Q

Hypersensitivity Pneumonitis Histopathology

A

Progresses from necrotizing alveolitis to poorly formed granulomas to fibrosis with honeycomb change

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93
Q

Two Smoking Related Interstitial Diseases

A

Desquamative Interstitial Pneumonia
Respiratory Bronchiolitis

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94
Q

Smoking Related Interstitial Disease Histopathology

A

Brown macrophages

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95
Q

Pulmonary Eosinophilia Treatment

A

Steroids

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96
Q

Pulmonary Eosinophilia Diagnosis

A

Bronchoalveolar Lavage

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97
Q

Pulmonary Thromboembolism Deaths

A

Over 50,000 US Deaths per Year

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98
Q

Pulmonary Thromboembolism Origin

A

95% clots from the legs

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99
Q

Pulmonary Thromboembolism Risk Factors

A

Prolonged Immobilization
Trauma
Congestive Heart Failure
Pregnancy
Oral Contraceptives
Cancer
Genetic Hypercoagulability

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100
Q

Pulmonary Thromboembolism Outcomes

A

Death
Lysis
Reorganization
Rare Infarction

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101
Q

Pulmonary Hypertension Primary Cause

A

Blood Clots

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102
Q

Pulmonary Hypertension Definition

A

Pulmonary blood pressure 1/4 that of systemic

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103
Q

Primary Pulmonary Hypertension Population

A

Young people

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104
Q

Secondary Pulmonary Hypertension Causes

A

Pulmonary emboli
Emphysema
Left to right shunt
Mitral Stenosis
Left Heart Failure

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105
Q

Diffuse Alveolar Hemorrhage Syndromes

A

Goodpasture Syndrome
Granulomatosis with Polyangiitis
Idiopathic

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106
Q

Diffuse Alveolar Hemorrhage Syndrome Histopathology

A

Lungs with excessive hemosederin

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107
Q

Types of Infective Pneumonia

A

Community Acquired
Hospital Acquired
Aspiration

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108
Q

Community Acquired Pneumonia Most Common Organism

A

Strep after flu or COVID

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109
Q

Bacterial Pneumonia Anatomic Types

A

Lobar
Bronchopneumonia

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110
Q

Atypical Community Acquired Pneumonia Causative Organisms

A

Mycoplasma
Chlamydia

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111
Q

Bacterial Pneumonia Histopathology

A

Excessive neutrophils in the alveoli

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112
Q

Complications of Pneumonia

A

Abscess
Sepsis

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113
Q

Lung Abscess Causes

A

Tumor
Trauma
Infection seeding thru Blood

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114
Q

Tuberculosis Deaths Worldwide

A

3 million

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115
Q

Tuberculosis Causative Organism

A

Mycobacterium tuberculosis

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116
Q

Tuberculosis Spread

A

Respiratory dropletts

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117
Q

Primary TB Characteristics

A

Mid to lower lung
Ghon Complex
90 to 95% asymptomatic

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118
Q

Secondary TB Characteristics

A

Apical Lung
Caseation
Fibrosis
Cavitation

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119
Q

Primary TB Population

A

Those with NO previous exposure to TB

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120
Q

Secondary TB Population

A

Those with previous exposure to TB

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121
Q

Miliary TB Organ System Involvement

A

Vascular Spread

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122
Q

Common Non TB Mycobacterial Disease

A

M. avium
M. kansasii

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123
Q

Non TB Mycobacterial Disease Population

A

HIV Patients

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124
Q

Non TB Mycobacterial Disease Presentation

A

Apical lung disease that look like TB

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125
Q

Candida albicans Organ System

A

Mucous membranes

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126
Q

Cryptococcus neoformans Population

A

HIV patients

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127
Q

Cryptococcus neoformans Organ System

A

CNS

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128
Q

Aspergillosis Organ System

A

Often in the lungs
Sometimes invasive cavitary mass

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129
Q

Most Common Fungal Infection In Nebraska

A

Histoplasmosis

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130
Q

Histoplasmosis Organ System Presentation

A

Granulomas in the lungs

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131
Q

Blastomycosis Organ Systems

A

Pulmonary
Skin

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132
Q

Coccidioides Microscopic Presentation

A

Large spherules containing endospors

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133
Q

Pneomocystis jiroveci Microscopic Presentation

A

Ping Pong Ball Shape

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134
Q

Pneomocystis jiroveci Population

A

Almost exclusively HIV patients

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135
Q

Bronchogenic Carcinoma Definition

A

Malignancy from bronchial epithelium

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136
Q

Bronchogenic Carcinoma Population

A

2 to 1

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137
Q

Bronchogenic Carcinoma Genetic Mutations

A

TP53 and KRAS

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138
Q

Other Bronchogenic Carinoma Associations

A

Air Pollution
Asbestose
Radon
Uranium
Nickel

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139
Q

Two Type of Lung Cancer

A

Small Cell
Non Small Cell

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140
Q

Three Types of Non Small Cell Cancer

A

Squamous Cell 25 to 30%
Adenocarcinoma 30 to 35%
Large Cell Carcinoma 10 to 15%

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141
Q

First Morphological Change in Lung Cancer

A

Squamous metaplasia

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142
Q

5 Year Survival of Squamous Cell Carcinoma

A

10 to 20%

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143
Q

5 Year Survival of Adenocarcinoma Lung Cancer

A

10%

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144
Q

Large Cell Lung Cancer General Microscopic Morphology

A

Nonspecific and undifferentiated

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145
Q

Small Cell Lung Cancer Morphology

A

Small round blue cells

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146
Q

Small Cell Lung Cancer 5 Year Survival

A

1 to 3%

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147
Q

Do small cell lung cancers get surgery?

A

NO

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148
Q

Carcinoid Tumor of Lung

A

Low grade malignancy of the lung

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149
Q

Lung Hamartoma Definition

A

A noncancerous abnormal collection of cartilage, fat, and epithelium in the lung

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150
Q

Three Types of Pleural Effusion

A

Hemothorax
Transudate
Exudate

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151
Q

Hemothorax Fluid

A

Blood

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152
Q

Transudate Fluid

A

Noninflammatory fluid

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153
Q

Exudate Fluid

A

Inflammatory, often pus

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154
Q

Most Common Pleural Tumor

A

Mesothelioma

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155
Q

Most pleural tumors are this type

A

Metastasis

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156
Q

Common Causative Organism

A

Rhinoviruses
Coronavirus

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157
Q

Acute Pharyngitis Common Name

A

Sore throat

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158
Q

It is important to recognize this diagnosis in acute pharyngitis

A

Strep

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159
Q

Bacterial Epiglotisis Population

A

Children

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160
Q

Bacterial Epiglotisis Clinical Presentation

A

Fevor
Stridor
Lethargy
Bending Over
Drooling

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161
Q

Bacterial Epiglotisis Causative Organism

A

HIB

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162
Q

Acute Laryngitis Etiology

A

Virus
Occasionally diphtheria

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163
Q

Diptheria Laryngitis Anatomical Feature

A

Dirt gray pseudomembrane from necrosis

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164
Q

Croup Classic Symptoms

A

Stridor
Barking Cough

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165
Q

Croup Causative Organisms

A

Parainfluenza Virus
Respiratory Syncytial Virus

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166
Q

Nasopharyngeal Carcinoma Causative Organism

A

EBV

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167
Q

Multiple Squamous Papilloma Causative Organism

A

HPV

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168
Q

Solitary Squamous Papilloma Population

A

Adults

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169
Q

Multiple Squamous Papilloma Population

A

Children

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170
Q

Laryngeal Carcinoma Population

A

Over 40
Men
Smokers

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171
Q

Laryngeal Carcinoma Microscopic Morphology

A

Squamous cell carcinoma

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172
Q

Main Acid Base Buffer

A

HCO3-

173
Q

The body regulates pH through controlling these two things

A

Partial pressure of CO2
HCO3 Concentration in Blood

174
Q

Acid Base Body Inputs

A

Diet
Metabolic Products

175
Q

Two Systems That Regulate Acid Base

A

Lungs
Kidneys

176
Q

Carbonic Anhydrase Function

A

Converts CO2 to H2CO3

177
Q

CO2 is Regulated by This System

A

Lungs

178
Q

HCO3- is Regulated by This System

A

Kidneys

179
Q

This System QUICKLY Changes Body pH

A

Lungs

180
Q

This System SLOWLY Changes Body pH

A

Kidneys

181
Q

Arterial Blood Gas must be tested this quickly after a blood draw

A

Within 30 minutes

182
Q

Is the HCO3- measured directly in an ABG

A

NO, it is CALCULATED

183
Q

Normal pH

A

7.35 to 7.45

184
Q

Normal PaCO2

A

35 to 45 mmHg

185
Q

Normal HCO3-

A

18 to 26 meq/L

186
Q

Acidosis Definition

A

A process that increases H+ and decreases pH

187
Q

Acidemia Definition

A

A net acidic state in the blood

188
Q

Alkalosis Definition

A

A process that decreases H+ and increases pH

189
Q

Alkalemia Definition

A

A net alkali state in the blood

190
Q

Lethal Acidemia Effects

A

Coma
Decreased Consciousness
Cardiac Rhythm Changes

191
Q

Lethal Alkalemia Effects

A

Mental Excitability
Tetany and Seizures
Cardiac Rhythm Changes

192
Q

Respiratory Acidosis General Cause

A

Issue with the lungs

193
Q

Metabolic Acidosis General Cause

A

Issue with the kidneys

194
Q

The body stays on this side of an acid base issue

A

The body always stays on the side of the primary issue

195
Q

Relationship Between pH and the GI Tract

A

Patients vomit acid and poop bicarb

196
Q

Steps for Acid Base Interpretation

A
  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
Q

Normal pH in an acid base disorder indicates what?

A

TWO primary processes

198
Q

Anion gap only works in this type of acidosis

A

Metabolic

199
Q

Large anion gap indicates this general pathology

A

An extra source of acid

200
Q

H+ is physiologically linked to this cation

A

K+

201
Q

Common Sources of Anion Gap Acidosis

A

CATMUDPILES

202
Q

Main Hormones Produced by Kidneys

A

Erythropoietin
Vitamin D

203
Q

Components of the Kidney

A

Glomeruli
Tubules
Blood Vessels

204
Q

Glomerular Filtration Fraction

A

About 20% of blood volume filtered

205
Q

Amount of water and electrolyte resorption in the kidneys

A

99%

206
Q

Azotemia General Definition

A

Increase in nitrogen containing substances in the blood, specifically BUN and creatinine

207
Q

Prerenal Azotemia General Mechanism

A

Inadequate blood flow to kindey

208
Q

Renal Azotemia General Mechanism

A

Kidney damage

209
Q

Postrenal Azotemia General Mechanism

A

Obstruction of urine flow

210
Q

Acute Renal Failure General Definition

A

Marked decrease or cessation of urinary output

211
Q

Acute Renal Failure Common Causes

A

Acute Tubular Necrosis
Rapid Glomerulonephritis
ADD

212
Q

Chronic Renal Failure General Definition

A

The final common pathway of most renal disease

213
Q

Chronic Renal Failure Clinical Presentation

A

Uremia
Hypertension

214
Q

Chronic Renal Failure Microscopic Pathology

A

Scarred down kidneys

215
Q

Uremia General Definition

A

Constellation of clinical, metabolic, and endocrine effects of chronic renal failure

216
Q

Uremia Components

A

Azotemia
Uremic Gastroenteritis
Uremic Neuropathy
Uremic Pericarditis

217
Q

Proteinuria Definition

A

Protein in the urine

218
Q

Gross Hematuria Defintion

A

Frank blood in the urine

219
Q

Microscopic Hematuria Definition

A

RBCs seen microscopically in urine

220
Q

Nephrolithiasis Definition

A

Kidney stones

221
Q

Nephrotic Syndrome Presentation

A

Massive Proteinuria
Hypoprotenemia
Edema
Hyperlipidemia

222
Q

Nephritic Syndrome Presentation

A

Mild to moderate proteinuria
Hematuria with. RBC Casts in Urine
Oliguria and Azotemia
Hypertension
Acute Onset

223
Q

This implies glomerular disease

A

Hematuria and or proteinuria

224
Q

Messangial Cells

A

Cells at the center of glomerulus that hold things together

225
Q

Special Feature of Glomerular Capillaries

A

Fenestration

226
Q

Podocytes

A

Line urinary space of glomerulus

227
Q

Special Feature of Podocytes

A

Negative charge on surface that repels proteins

228
Q

Most common cause of renal disease and failure

A

Glomerular disease

229
Q

Most glomerular disease are this type of disease

A

Type III Immune Hypersensitivity

230
Q

Laboratory Diagnosis of Glomerular Disease

A

Autoantibodies
Complement Levels

231
Q

Pathological Diagnosis of Glomerular Disease

A

Light Microscopy
Immunofluorescence
Electron Microscopy

232
Q

Minimal Change Disease Pathological Presentation

A

Normal Light Microscopy
Normal Immunofluorescence
DIFFUSE FOOT PROCESS EFFACEMENT on electron microscopy

233
Q

Minimal Change Disease General Category

A

Nephrotic Disease

234
Q

Minimal Change Disease Population

A

Kids

235
Q

FSGS Pathological Presentation

A

Same as minimal change disease with SCARRING OF THE GLOMERULUS

235
Q

FGSG Causes

A

Idiopathic
HIV
Drugs

236
Q

FSGS General Category

A

Nephrotic Syndrome

237
Q

Membranous Nephropathy Cause

A

Type III Hypersensitivity

238
Q

Membranous Nephropathy Pathological Presentation

A

Diffuse thickening of loops
Antibody deposits
Positive IgG and complement deposits

239
Q

Membranous Nephropathy General Category

A

Nephrotic Syndrome

240
Q

Membranous Nephropathy Population

A

Adults

241
Q

Other Causes of Nonnephrotic Proteinuria

A

Diabetic Glomerulosclerosis
Amyloidosis
Light Chain Nephropathy

242
Q

Diabetic Glomerulosclerosis Buzzword

A

Kimmelstiel Wilson Nodules

243
Q

Amyloidosis Buzzword

A

Congo Red Positive

244
Q

Light Chain Nephropathy

A

Bence Jones Protein

245
Q

Most Common Cause of Postinfectious Glomerulonephritis

A

Group A Strep

246
Q

Postinfectious Glomerulonephritis Pathological Presentation

A

Immune complex humps in glomerular capillaries

247
Q

Postinfectious Glomerulonephritis General Category

A

Nephritic

248
Q

Rapidly Progressive Glomerulonephritis Pathological Presentation

A

Crescents of cells in the glomerular space

249
Q

Rapidly Progressive Glomerulonephritis General Category

A

Nephritic

250
Q

Rapidly Progressive Glomerulonephritis Causes

A

Anti GBM Disease
Pauci immune disease that activate neutrophils and DO NOT DEPOSIT ANTIBODIES

251
Q

Anti GBM Disease Etiology

A

Antibody formation to type 4 collagen

252
Q

Asymptomatic Hematuria Causes

A

IgA Nephropathy
Hereditary Nephritis

253
Q

IgA Nephropathy Pathological Presentation

A

Increased cells in the mesangium

254
Q

IgA Nephropathy Population

A

Asian and Native American

255
Q

Hereditary Nephritis Genetics

A

X linked mutation in type 4 collagen

256
Q

Hereditary Nephritis Key Associations

A

Sensorineural Hearing Loss
Vision Issues

257
Q

SLE Pathological Presentation

A

Positive ANA in 90% of patients
Full house immunofluorescence

258
Q

Two important classes of SLE

A

Class IV Diffuse Proliferative
Class V Membranous

259
Q

Two Categories of Tubulointerstitial Disease

A

Inflammation and Infection
Drugs

260
Q

Causative Organism in Pyelonephritis

A

Gram Negative Rods like E coli

261
Q

Pyelonephritis Pathological Presentation

A

Neutrophils in tubules

262
Q

Pyelonephritis Clinical Presentation

A

Fever and flank pain

263
Q

Drug Induced Tubulointerstitial Nephritis Causes

A

Antibiotics
Synthetic Penicillins
Rifampin
Diuretics
NSAIDS
Lithium

264
Q

Drug Induced Tubulointerstitial Nephritis Timecourse

A

Two weeks after drugs started

265
Q

Drug Induced Tubulointerstitial Nephritis Pathological Presentation

A

Eosinophils

266
Q

Most Common Cause of Acute Renal Failure

A

Acute Tubular Necrosis

267
Q

Acute Tubular Necrosis Pathologic Presentation

A

Destruction of tubular epithelial cells

268
Q

Acute Tubular Necrosis Ischemic Causes

A

General Ischemia
Massive Hemolysis
Sepsis

269
Q

Acute Tubular Necrosis Toxic Causes

A

Hg
Organic Solvents
Gentamicin
Xray Contrast

270
Q

Nephrolithiasis Causes

A

Calcium Oxalate MOST COMMON
Magnesium Phosphate
Uric Acid

271
Q

Magnesium Phosphate Stones are associated with this pathology

A

Proteus UTI

272
Q

Uric Acid Stones are associated with this pathology

A

Gout
Chemotherapy

273
Q

Most common vascular kidney disease

A

Hypertensive Nephrosclerosis

274
Q

Hypertensive Nephrosclerosis Pathological Presentation

A

Intimal thickening of large arteries
Hyaline thickening of small renal arteries

275
Q

Malignant Nephrosclerosis Etiology

A

Very high blood pressure precipitates acute renal failure

276
Q

Malignant Nephrosclerosis Pathological Presentation

A

Fibrinoid necrosis of kidney vessels

277
Q

Paraprotein Related Disorders Buzzwords

A

Positive Congo Red
Bence Jones Protein

278
Q

Renal Agenesis Etiology

A

No kidney development
Bilateral kidney loss is incompatible with life

279
Q

Horseshoe Kidney Occurrence

A

1 in 500 to 1 in 1000

280
Q

Renal Displasia Cause

A

Kidney forms incorrectly and causes nonfunctional tissues in the kidney

281
Q

Adult Polycystic Kidney Disease Genetics

A

Autosomal Dominant

282
Q

Adult Polycystic Kidney Disease Occurrence

A

1 in 1000

283
Q

Most Common Type of Kidney Tumor

A

Renal Cell Carcinoma

284
Q

Renal Cell Carcinoma Associations

A

Smoking
Polycythemia

285
Q

Renal Cell Carcinoma spreads this way

A

Invades blood vessels

286
Q

Most Common Type of Renal Cell Carcinoma

A

Clear Cell

287
Q

How much of the fluid filtered by the glomerulus reenters the blood?

A

About 60%

288
Q

General Function of the Loop of Henle

A

Concentration

289
Q

Markers of Nephron Function

A

Glomerular Filteration Rate GFR

290
Q

GFR Measures This

A

The amount of blood filtered by the glomeruli per unit time

291
Q

Normal GFR

A

100 to 120 mL/min

292
Q

Stage 1 GFR

A

90 or higher

293
Q

Stage 2 GFR

A

60 to 89

294
Q

Stage 3a GFR

A

45 to 59

295
Q

Stage 3b GFR

A

30 to 44

296
Q

Stage 4 GFR

A

15 to 29

297
Q

Stage 5 GFR

A

Less than 15

298
Q

This chemical is used to measure GFR

A

Creatinine

299
Q

Blood Urea Nitrogen BUN Measures This Function

A

Tubular Function

300
Q

Azotemia Clinical Defintion

A

Elevated BUN and Creatinine

301
Q

Normal Creatinine

A

0.6 to 1.3 mg/dL

302
Q

Creatinine Levels in Renal Failure

A

Over 10

303
Q

General Causes of Acute Renal Failure

A

Prerenal
Renal
Postrenal

304
Q

General Definition of Acute Renal Failure

A

When the patient suddenly stops producing urine

305
Q

Prerenal Renal Failure Mechanism

A

Inadequate blood flow to kidney

306
Q

Intrinsic Renal Failure Mechanism

A

Disease of the kidney itself

307
Q

Postrenal Renal Failure Mechanism

A

Obstruction of both ureters

308
Q

Pre renal BUN:Cr

A

Over 20:1

309
Q

Postrenal BUN:Cr

A

10 to 20:1

310
Q

Intrinsic BUN:Cr

A

Less than 10:1

311
Q

Methods of Urine Protein Measurement

A

Dipstick
24 Hour Urine Measurement

312
Q

Effective Substitute for 24 Hour Urine

A

Spot Urine Protein to Creatinine Ratio

313
Q

Microalbuminuria indicated what?

A

Early diabetic nephropathy

314
Q

Other Findings in Chronic Renal Failure

A

Anemia
Metabolic Acidosis
Decreased Na+
Increased K+
Decreased Ca2+
Increased PTH
Increased phosphorus

315
Q

Best Urine Test for Cytology

A

Spot Urine

316
Q

Best Urine Test for Culture

A

Clean Catch

317
Q

Best Urine for Testing Substances in Low Concentration

A

First Void Morning Urine

318
Q

Visual Urinalysis Components

A

Color
Turbidity
Specific Gravity

319
Q

Dipstick Urinalysis Components

A

Glucose
Bilirubin
Ketones
pH
Protein
Nitrite
Leukocytes

320
Q

Red Urine Causes

A

Blood
Porphyria
Beets
Drugs

321
Q

Orange Urine Causes

A

Bile
Drugs

322
Q

Brown Urine Causes

A

Hemoglobin
Acid Urine
Melanin
Alcaptonuria
Drugs

323
Q

Blood Glucose Renal Threshold

A

180 to 200 mg/dL

324
Q

Urine Sugar Tests

A

Dipstick for Glucose
Clinitest tablets for other sugars

325
Q

Urine Ketones Indicate This

A

DKA

326
Q

Urine Conjugated Bilirubin Indicates This

A

Biliary Obstruction
Liver Disease

327
Q

Urine Unconjugated Bilirubin Indicates This

A

Hemolysis
Hepatic Disease

328
Q

Chemical evidence of Urinary Disease

A

Protein
Nitrite
Leukocyte Esterase
Blood

329
Q

Urine Microscopic Analysis Checks for These General Things

A

Crystals and cells

330
Q

Urinary Sediment RBCs Indicate These Things

A

Some Are Normal
Bladder Tumor
Kidney Stones

331
Q

Urinary Sediment WBCs Indicate These Things

A

Some are Normal
UTI

332
Q

Urinary Sediment Eosinophils Indicate This

A

Drug Induced Nephritis

333
Q

Urinary Sediment Granular Casts Indicate These Things

A

Glomerular and tubular diseases

334
Q

Urinary Sediment Red Blood Cell Casts Indicate These Things

A

Specific Glomerular Disease
Nephritic Syndrome

335
Q

Urinary Sediment White Blood Cell Casts Indicate These Things

A

Acute Pyelonephritis

336
Q

Renal Imaging Assesses These Things

A

Collecting System
Size of Kidneys
Perfusion

337
Q

Zone 1 Hepatocyte Location

A

Closest to Portal Triad

338
Q

Zone 3 Hepatocyte Location

A

Closest to Hepatic Vein

339
Q

Zone 1 Hepatocyte Primary Function

A

Synthesis

340
Q

Zone 3 Hepatocyte Primary Function

A

Detoxification

341
Q

Stellate Cell Location

A

Space of Disse between hepatocytes and sinusoid endothelial cell

342
Q

Stellate Cell Noninflammatory Function

A

Vitamine A Storage

343
Q

End stage of liver fibrosis

A

Cirrhosis

344
Q

Acute Liver Disease Presentation

A

Pain
Some evidence of liver failure
Jaundice

345
Q

Chronic Liver Disease Presentation

A

Portal hypertension

346
Q

Clinical Features of Liver Failure

A

Jaundice
Hypoalbuminemia
Hyperammonemia
Hyperestrogenism
Coagulopathies
Encephalopathy

347
Q

Three Morphologic Features of Cirrhosis

A

Regenerative Nodules
Fibrosis Surrounding the Nodules
Whole Organ Damage

348
Q

Main Mechanism of Cirrhosis

A

Alteration of sinusoidal blood flow

349
Q

Cellular Mechanism of Cirrhosis

A

Stellate cells lay down collagen when exposed to inflammatory cytokines

350
Q

Prehepatic Portal Hypertension Causes

A

Portal vein thrombosis or narrowing

351
Q

Posthepatic Portal Hypertension Causes

A

Right side heart failure or hepatic outflow obstruction

352
Q

Intrahepatic Portal Hypertension Causes

A

Cirrhosis

353
Q

What organ enlarges with portal hypertension

A

Spleen

354
Q

Timeframe for Chronic Hepatitis

A

Longer than 6 months

355
Q

Serum Markers of Hepatitis

A

ALT and AST

356
Q

Acute Hepatitis Biopsy Pattern

A

Scattered lobular inflammation

357
Q

Chronic Hepatitis Biopsy Pattern

A

Portal and periportal inflammation

358
Q

Acute Hepatitis General Causes

A

Non hepatotropic infection
Drugs
Toxins

359
Q

Nisan trichrome stain colors collagen this color

A

Blue

360
Q

Chronic Hepatitis General Causes

A

Hepatitis B and D
Hepatitis C
Autoimmune
Wilson
Drugs
PBC and PSC
Graft vs. Host
Acute Rejection

361
Q

Hepatotrophic Viruses

A

Hepatitis A thru E

362
Q

Hepatitis A Transmission Route

A

Fecal Oral

363
Q

Hepatitis that will most likely cause chronic liver failure without treatment

A

Hepatitis C

364
Q

Hepatitis that occurs with hepatitis B coinfection

A

Hepatitis D

365
Q

Viral Hepatitis Histology Buzzword

A

Ground glass inclusions in the liver

366
Q

Autoimmune Chronic Hepatitis Key Features

A

70% Female
Negative Viral Serology
Elevated Serum IgG
High Autoantibody Titers
Another Autoimmune Disease
Plasma cells on biopsy

367
Q

Antibodies of Type 1 Autoimmune Hepatitis

A

Antinuclear
Anti smooth muscle

368
Q

Antibodies of Type 2 Autoimmune Hepatitis

A

Liver and kidney microsomal type 1 antibodies

369
Q

Antibodies of Type 3 Autoimmune Hepatitis

A

Antibodies to soluble hepatocyte antigen

370
Q

Main Mechanism of Toxic Liver Injury

A

Conversion of the chemical by the liver to a toxic substance

371
Q

Most Common Toxic Liver Injury Pattern

A

Idiosyncratic, where response varies person to person

372
Q

This is the leading cause of liver disease worldwide

A

Alcohol

373
Q

Alcohol use deaths per year

A

200,000

374
Q

Three Forms of Alcohol Related Liver Disease

A

Steatosis
Steatohepatitis
Cirrhosis

375
Q

How many moderate to heavy drinkers will experience liver steatosis

A

80%

376
Q

How many of those who experience steatosis will develop steatohepatisis

A

About 1/3

377
Q

Cellular Etiology of Steatosis

A

Lipid retention by hepatocytes

378
Q

Steatosis Starts Here

A

Hepatic zone 3

379
Q

Histological Features of Steatohepatitis

A

Hepatocyte swelling and necrosis
Mallory Bodies
Neutrophils in lobules
Fibrosis

380
Q

Nonalcohol related fatty liver disease causes

A

Obesity
Type 2 Diabetes
Hyperlipidemia

381
Q

Diseases of Hepatic Veinous Outflow

A

Heart Failure
Veno occlusive Disease
Budd Chiari Syndrome

382
Q

Mechanism of Liver Injury In Heart Failure

A

Enlarged heart blocks the inferior vena cava and outflow

383
Q

Budd Chiari Syndrome Involves These Vessels

A

Hepatic Veins

384
Q

Budd Chiari Syndrome Involves This General Pathology

A

Hypercoagulability

385
Q

Veno occlusive Disease Involves These Vessels

A

Microscopic terminal hepatic veins

386
Q

Veno occlusive Disease Involves This General Pathology

A

Toxin injury of the liver

387
Q

This side heart failure can cause liver disease

A

Right heart failure

388
Q

Right heart failure damages this hepatic zone first

A

Zone 3

389
Q

Inborn Errors of Metabolism That Can Cause Liver Injury

A

Hemochromatosis
Wilson’s Disease
Alpha 1 Antitrypsin Deficiency

390
Q

Hemochromatosis Genetic Cause

A

Autosomal recessive

391
Q

Hemochromatosis Pathophysiology

A

Too much iron absorbed from the gut which is then deposited in the liver, pancreas, and heart

392
Q

Hemochromatosis becomes symptomatic during this time

A

5th to 6th decade of life

393
Q

Hemochromatosis Specific Genetics

A

HFE Gene on 6p near MHC

394
Q

Hemochromatosis Population Occurence

A

1 in 220

395
Q

Laboratory Features of Hemochromatosis

A

Elevated serum iron and ferritin

396
Q

Wilson Disease Genetics

A

Autosomal Recessive

397
Q

Wilson Disease Specific Genetics

A

ATP7B on Chromosome 13

398
Q

Wilson Disease usually effects these organs

A

Liver
Eyes
CNS

399
Q

Wilson Disease Clinical Features

A

Liver disease
Parkinson like symptoms
Psychosis

399
Q

Alpha 1 Antitrypsin Deficiency Specific Genetics

A

Autosomal recessive mutations on SERPINA1

400
Q

Alpha 1 Antitrypsin Deficiency Pathophysiology

A

Low levels of protease inhibitor causes increased neutrophil activity

401
Q

Clinical Manifestation of Excess Bilirubin

A

Jaundice
Icterus
Itching

402
Q

Most Common Causes of Excess Bilirubin

A

Overproduction
Liver Injury
Outflow Obstruction

403
Q

Cholestasis Definition

A

Lack of bile flow where bilirubin becomes visible in tissue

404
Q

Unconjugated Bilirubin Solubility

A

Lipid soluble, so it generally circulates bound to albumin
Indirect Fraction

405
Q

Conjugated Bilirubin Solubility

A

Water soluble
Direct Fraction

406
Q

Liver processes bilirubin this way

A

Conjugates it, then excretes it in bile

407
Q

Energy intensive portion of bilirubin processing

A

Excretion in bile

408
Q

Unconjugated bilirubin can do this

A

Cross the blood brain barrier

409
Q

Major Causes of Hyperbilirubinemia

A

Increased Production
Liver Damage
Damaged Outflow

410
Q

Neonatal Jaundice Etiology

A

Conjugation enzymes do not fully develop until the 2nd week of newborn life

411
Q

Ocurence of Neonatal Jaundice

A

60% of term babies
80% of premature babies

412
Q

Gilbert Syndrome Presentation

A

Transient unconjugated hyperbilirubinemia under stress

413
Q

Bile Duct Injury Serum Markers

A

Alkaline Phosphatase
GGT
Direct Hyperbilirubinemia

414
Q

Two Main Immune Mediated Bile Duct Injuries

A

Primary Biliary Cholangitis
Primary Sclerosing Cholangitis

415
Q

Primary Biliary Cholangitis Pathological Presentation

A

Autoimmune attack of microscopic bile ducts
Granulomas

416
Q

Primary Biliary Cholangitis Population

A

10 to 1 Female to Male
Ages 40 to 50

417
Q

Primary Biliary Cholangitis Lab Findings

A

Antimitochondrial Antibodies
Elevated Cholesterol

418
Q

Primary Sclerosing Cholangitis Etiology

A

Inflammation and obliterative fibrosis of large bile ducts

419
Q

Primary Sclerosing Cholangitis Imaging Finding

A

Beaded appearance on ERCP

420
Q

Primary Sclerosing Cholangitis is strongly associated with this other disease

A

Ulcerative colitis

421
Q

Primary Sclerosing Cholangitis increases the risk for this disease

A

Adenocarcinoma of bile ducts

422
Q

Primary Sclerosing Cholangitis Pathological Finding

A

Periductal fibrosis

423
Q

Most liver malignancies are this type

A

Metastasis from somewhere else

424
Q

Most Common Primary Malignancies of Liver

A

Hepatocellular Carcinoma
Cholangiocarcinoma
Angiosarcoma
Hepatoblastoma

425
Q

Three major etiologies of hepatocellular carcinoma

A

HBV
Chronic Alcohol Use
Aflatoxins
Cirrhosis of any cause

426
Q

Hepatocellular Carcinoma Main Lab Finding

A

Elevated AFP in adults

Biology Of Disease (5 decks)

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