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Flashcards in Week 2 Deck (47):
1

Rapidly progressive (Crescentic) glomerulonephritis : Type __: Anti GBM- Idiopathic more than __% of the time. Good pastures syndrome: Characterized by development of autoimmune aggression against __ and __ basement membranes. Antibodies form against antigens of membranes. Type __ hypersensitivity reaction.

1
50
Glomerular
alveolar
2

2

Good Pasture's: Alveolar basement membrane- ___ (coughing up blood) Inflammation of this membrane causes the formation of ___ in the __ and they can no longer exchange ___

Hemoptysis
exudates
alveoli
air

3

Good Pasture's: Glomerular basement membrane- here there is destruction of __ around the membranes. This is curable via ___. Blood from the arterioles is centrifuged and the blood cells are removed from the ___ in the plasma then reinjected into the body. Involves which 2 systems?

tissues
plasmapheresis
antibodies
Respiratory
kidneys

4

Rapidly Progressive (Crescentic) Glomerulonephritis: Type 2 (Immune complex deposition): Systemic Lupus Erythematosus- Type __ Hypersensitivity reaction: Classic AI disease that involves young ladies and is more common in __ __. What are some causes?

3
African Americans
Sulfasalysitic Drugs
Vaccination
UV radiation

5

Rapidly Progressive (Crescentic) Glomerulonephritis: Type 2 (Immune complex deposition) Systemic Lupus Erythematosus: AI reaction against antigens of __ and __. Mostly involves the __(4)__

cell nucleus
cytoplasm
Skin
Lungs
Kidney
Cerebral Vessels

6

Rapidly Progressive (Crescentic) Glomerulonephritis: Type 2 (Immune complex deposition) Systemic Lupus Erythematosus: results in serious ___ and possibly ___. Primary manifestation of systemic lupus is the __ __.

HTN
stroke
butterfly rash

7

Systemic Lupus Erythematosus: Systemic Lupus: Involvement of the __ develops quickly. This is the major cause of death in this disease. Vasculitis of __ vessels is possible in SLE. Survival is __% of the time. Tx is __ (corticosteroid)

kidneys
cerebral
90
TMT

8

Systemic Lupus Erythematosus: Post Infection may be part of type __. Henoch Schonlein Purpura- ( ___ vasulitis)- usually develops in ___.

2
Hemorrhagic
Boys (in 20s)

9

Henoch Schonlein is characterized by what 4 syndromes?

Abdominal Syndrome
Cutaneous Syndrome
Articular Syndrome
Crescentic Glomerulonephritis

10

Abdominal syndrome is characterized by __ __ of the __ and __ walls (gastroduodenitis)

hemorrhagic inflammation
stomach
duodenal

11

Cutaneous Syndrome is characterized by __ hemorrhages in the __ and __- leads to __ rash

cutaneous
buttock
abdomen
purpura

12

Articular syndrome is characterized by __ __ or at least __ in the __

subclinical arthritis
pain
joints

13

Crescentic glomerulonephritis: If the pt has the 1st 3 syndromes, the addition of crescentic glomerular nephritis makes the prognosis worse: __% survival

70

14

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: MOST DANGEROUS: Type __ Hypersensitivity reaction- Is characterized by the development of ___. It is inflammation of the vasular wall and manifested by what kind of antibodies?

NO Hypersensitivity reaction
vasculitis
anti-neutrophil plasmocytic auto-antibodies

15

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: What are the 5 types?

Idiopathic (more than 50%)
Wegener's Granulomatosus
Polyarteritis Nodosa
IgA Nephropathy (AKA Berger's)
Buerger's (AKA Thromboangitis Obliterans)

16

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Wegener's Granulomatosus: Develops in middle aged __. Characterized by necrotizing vasculitis of the upper and lower __ tract and rapid progression of __. You see a melting of the __ of the __ which can lead to __ and __ inflammation. Pt is undergoing decay.

Males
Respiratory
Glomerulonephritis
bones
face
infection
supprative

17

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Wegener's Granulomatosus: What will the pt. die from?

Acute renal failure or secodary complications

18

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Polyarteritis Nodosa: vasculitis of the vessels throughout the body with __ of the arteriole wall, which gives it the name nodosa. Pouching can lead to __ of the wall and __ of the lumen. These nodes are on every __ of the body and causes __. This disease can manifest everywhere but where?

pouching
rupture
obstruction
organ
death
-Lungs and arch of Aorta

*incurable

19

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: IgA Nephropathy (Berger's): ___ following __ __ infection. Many cases month after month. Could also be cause by acute __ or __ infection. Pt will experience pain in the __.

Hematuria
acute respiratory
intestinal
urinary
loin (lumbar spine)

20

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: IgA Nephropathy (Berger's): Hallmark is deposition of __ complexes into the immune mesangium. (__% increase). There will also be increased concentration of IgA in the __. Can manifest with __ __ __. If not controlled can switch to __ __

IgA
50
Blood
Henoch-Schonlein
Purpura
Chronic Glomerulonephritis

21

What is the most common glomerular disease worldwide?

Berger's (IgA Nephropathy)

22

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Buerger Disease: Characterized by vaculitis of the __ and __ sized arteries. Predominant in __ and __ arteries. If it is in the veins will cause __. Will cause inflammation of the __.

middle
small
Radial
Tibial
phlebitis
veins

23

Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Buerger Disease: Common in people who __ and common in which countries? Characterized by __ syndrome and smoking. Will cause instep claudication- __ on walking, then will stop, walk more, stop again, etc... The muscles need more __ supply but they aren't getting enough because of vessel dysfunction. Results in __ of extremities.

smoke
India and Israel
Raynaud's
Pain
blood
amputation

24

Nephrotic Syndrome: Damage to __. There is decreased permeability of __ and draatically increased permeability of __ (primary probem), especially __. Escape from the blood to the urine.

glomeruli
water
protein
albumin

25

Massive (heavy) priteinuria is more than __ grams. There is especially loss of __

3.5
albumin

26

Nephrotic syndrome is manifested by what 4 things?

Massive Proteinuria
Hypoalbuminemia
Generalized Edema
Hyperlipidemia/ lipiduria

27

Nephrotic Syndrome: Hypoalbuminemia- When the correct levels of albumin are outside and inside the vessel, this creates the __ pressure. When the albumins are allowed to escape into the tissues it creates more pressure in the __. There will be loss in blood __ and __ will try to retain water and the fluid will be retained in the __

oncotic
tissues
volume
aldosterone
fluid
tissues

28

Nephrotic Syndrome: Hyperlipidemia/ lipiduria- Body wants to restore the number of proteins so there is an increase in number of __ by the liver resulting in hyperlipidemia and lipiduria. Will cause __ __ to form. Changes the __:__ ratio because of loss of albumin.

lipoproteins
fatty casts
Albumin: Globulin

29

Nephrotic Syndrome: Hyperlipidemia/ lipiduria- What are the 3 proteins in blood and in what percentages?

Albumins- 55%
Globulins- 45%
Fibrinogen 5-7%

30

albumin functions?

Prevent escape of fluif portion of blood into surrounding tissue
-maintains oncotic pressure

31

Globulin functions?

Antibodies
-ratio of albumins to globulin is greater than 1 (55/45)
With Nephrotic syndrome, the ration changes to less than 1

32

Fibrinogen functions?

Repair damaged skin

33

Nephrotic Syndrome: Whata re the primary Glomerular disease that may lead to this?

Minimal change disease (lipoid nephrosis)
Membranous GMN
Focal Segmental GMN --> Chronic GMN --> Renal Failure
Membranoproliferative GMN

34

Nephrotic Syndrome: What systemic Diseases may cause this?

Diabetes Mellitus
Amyloidosis

35

What is the most dangerous Nephrotic condition?

Focal Glomerulosclerosis

36

Which 2 diseases are associated with Nephrotic Syndrome?

Alport Syndrome
IgA Nephropathy (Berger)

37

Alport Syndrome: Common in __ __. Posterior Cataract, __ dislocation and corneal __. Also causes __ damage due to nerve deafness.

young boys
Lens
dystrophy
hearing

38

Acute Pyelonephritis: Definition?

Supprative inflammation of the kidney pelvis and parenchyme

39

Acute Pyelonephritis: How does the infection get to the kidney?

-Through the blood (must have bacteremia)
-Through lymphatic vessels
-Ascending Route: MC. (through Bladder) Problem with bladder valve allows infection to go back into bladder.
-Common cause is E. coli

40

What are 2 problems associated witha cute pyelonephritis?

Formation of pus in kidney parenchyme (abcess)
Development of necrotizing papilitis- especially in DM
-will see many WBCs that cover field of vision
-will also see WBC casts

41

Acute Pyelonephritis manifestations

High fever- and chills: causes shaking
pain of posterior thorax (+ murphys punch)
Bacteria and WBC casts in urinalysis
Increased blood in urine
Abcess of kidney parenchyme

42

Acute Pyelonephritis can develop __ necrosis or necrotizing __- can cause gross __. More typical for nephropathy is __ __

pappilary
papulitis
Hematuria
Diabetes Mellitus

43

Acute Pyelonephritis Tx

Antibiotics. Very effective. If pt doesnt recover it becomes chronic pyelonephritis wich can result in chronic renal failure. Treat to full recovery.

44

MCC of chronic renal failure

Chronic Pyelonephritis
-dialysis works for 2-3 years
-kidney replacemen may work but usually not successful

45

Diabetic Nephropathy: What are the 3 factors?

Glomerular Lesions
Renal Vascular lesions
Pyelonephritis

46

Diabetic Nephropathy: Glomerular lesions cause thickening of ___. Also causes diffuse increase of __ matrix (diffuse glomerulosclerosis). Nodular glomerulosclerosis is characterized by __-__ lesions- ball-like deposits of laminated __ within the mesangium.

GBM
mesangial
Kimmerlstiel-Wilson
matrix

47

Diabetic Nephropathy: Renal Vascular Lesions: __ arteriosclerosis of both afferent and efferent arterioles.

Hyaline