Path 2 - Midterm Flashcards
T or f
The major function of the kidneys are to regulate the body’s concentration of water and salt.
FALSE
Excretion of waste products of metabolism is its major function.
List the 4 main functions of the Kidneys
Excretion of waste products of metabolism
Water and Salt concentration
Acid/Base balance of plasma
Secretion of hormones
All of the following are secreted from the Kidneys except:
- Prostaglandins
- Angiotensiongen
- Erythropoietin
- Renin
Angiotensiongen
What cells make renin?
Juxtaglomerular cells
What condition will result if there is a failure or defect in the production of erythropoietin?
Anemia
T or F
The renal pyramids are the major site of filtration of the blood and primary urine production
False
This is describing the Cortex. The pyramids collect urine.
T or F
Almost all diseases of the Glomerulus are caused by immune system pathologies
True
Which microscopic compartment of the kidneys are mainly affected by toxins and infections
Tubules
Interstitial Tissue
What microscopic compartment of the kidney is mainly affected by pulmonary pathologies?
NONE!! TRICK QUESTION
The kidney vessels are mainly affected by Cardiovascular pathologies not just pulmonary.
Where is the Glomerulus located?
Within the Bowman’s Capsule
Which layer of the capillaries within the Glomerulus have fenestrations?
Endothelial cells
What is the name of the outermost layer of the capillaries within the Glomerulus?
Visceral Epithelial cells
Aka for Visceral Epithelial Cells
Podocytes
Name the glycoprotein located between the podocyte slits that aids in selective filtration
Nephrin
These cells are similar to podocytes but they line the inner surface of the Bowman’s Capsule
Parietal Epithelial Cells
List all the functions of the Mesangial Cells
Contractile components Produce chemicals that help for glomeruli function Proliferations Secretion of some hormones Network of arterioles
Which cells of the Glomerulus account for scar tissue in the healing process and contain many monocytes?
Mesangial Cells
Where in the Glomerulus are the Juxtaglomerular cells located?
In the area where the afferent arteriole enters the Glomerulus
Circulating immune complex deposition is what type of hypersensitivity rxn?
Type 3
Where in the glomerulus do the immune complex of circulating immune complex deposition hide?
Subintimal layer - space between glomerular basement membrane and endothelial cells
The circulating immune complex deposition glomerulonephritis can result in damage to what structures?
Glomerular basement membrane
Endothelial Cells
Podocytes
T or F
Azotemia is a clinical abnormality characterized by increased levels of creatine and blood urea nitrogen in the blood stream.
False
Biochemical abnormality
What is the difference between Azotemia and Uremia
Azotemia is elevated levels of creatine and BUN but there are no clinical symptoms. When the process becomes advanced it is referred to as Uremia. Essentially uremia has symptoms and clinical manifestations.
T or F
Anti-GBM is a type 3 hypersensitivity
False
Type 2 - complement dependent
T or F
Heymann’s Glomerulonephritis is a Type 3 Hypersensitivity rxn
False
Not associated with a specific hypersensitivity reaction.
What is the pathogenesis of Heymann’s Glomerulonephritis?
Development of autoantibodies against Podocytes as well as some antigens within podocytes.
Describe what Nephritis Syndromes are
Basically when damage of glomerular walls leads to dramatic increased permeability for red blood cells = Hematuria
What is Oligouria?
Decrease in the amount of urine excreted per day. Results from a decrease in permeability of water in the glomerulus.
If there is a decrease of BP to less than ____ mmHG juxtaglomerular cells will increase pressure
50
What are the signs and symptoms of acute glomerulonephritis?
A little proteinuria Azotemia Hematuria Casts Hypertension Oliguria Swelling under the eyes.
What tonsils are more susceptible for infection?
Palantine
What disease associated with Nephritis syndromes is described as having molecular mimicry?
Acute Proliferative (post-streptococcal, post-infectious) Glomerulonephritis
What specific type of Strep is involved with Acute Proliferative (post-strep) Glomerulonephritis.
Beta hemolytic Strep A
Pathogenesis of Post Strep Glomerulonephritis
Immune system makes antibodies that bind to the antigen of strep. This antigen is very similar to that of Glomerular Tissue. Immune system is not able to tell which is which and will destroy both causing kidney damage!
T or F
Post-strep Glomerulonephritis is considered to be an infectious condition.
False!
Disease of immune system. Infection is the catalyst for the immune system to destroy healthy glomeruli tissue.
What are the recovery rates of Post-Strep Glomerulonephritis?
Children = 99%
Adults = 50%
* tx = corticosteroids
What type of Glomerulonephritis is clinically characterized by rapid & progressive loss of renal function associated with severe Oliguria & (if untreated) death from renal failure within weeks to months
Rapidly Progressive (Crescentric) Glomerulonephritis
T or F
Good Pasture’s Syndrome falls under Type 2 of Rapidly Progressive Glomerulonephritis
False
Type 1
Describe the pathogenesis of Crescentric Glomerulonephritis
Hyperplasia of Parietal Epithelial cells
- epithelial cells eventually will close the exit to proximal tubules resulting in an accumulation of primary urine in Bowman’s Capsule. This increase in pressure = atrophy of capillary network within the capsule.
Type 1 Rapidly Progressive Glomerulonephritis is what type of Hypersensitivity rxn?
Type II
What is Good Pasture’s Syndrome?
Characterized by autoimmune aggression against antigens of two types of basement membranes - Alveolar & Glomerular
What is a typical manifestation of Goodpasture’s Syndrome in the lungs?
Hemoptysis
- damage of alveolar wall leads to hemorrhage and blood within the alveoli. Patient will literally drown in their own blood.
How is Goodpasture’s Syndrome Treated?
Plasmapheresis - blood is taken from patient and spun in a centrifuge, the plasma is thrown again and blood cells given back in glucose solution. Mechanical cleaning of blood to get rid of the antibodies.