robbypowell's version from 2015-11-11 13:29


Question Answer
Upper Urinary Tract System is composed of the ___ & _____Kidneys and Ureters
Lower Urinary Tract System is composed of the ___ & _____Urinary bladder and Urethra
Renal cortex contains what 3 structures?(renal corpuscles) glomeruli, proximal convoluted tubules, & distal convoluted tubules
What is the functional unit of the kidney?Nephron
The ____ layer of the bowman's capsule is made up of a single layer of simple squamos epithelium and does not function in filtrationParietal
The ____ layer of the bowman's capsule is adjacent to the Glomerular basement membrane and made up of PodocytesVisceral
What cells make up the visceral layer of bowman's capsule?Podocytes
What cells make up the parietal layer of bowman's capsule?Simple Squamos Epithelium
Are podocytes Endothelial or Epithelial?Epithelial
What are the endothelial cells of Glomerulus?Capillary cells (wall of capillaries)
specialized smooth muscle cells that function to regulate blood flow through the capillariesMesangial cells
Glomerular barrier has high permeability to what?Water and Solutes (smaller than Albumin)
3 waste products of metabolism removed by kidneyUrea; Uric Acid; Creatinine
The kidney regulates ____ & ____ which effectively regulates Blood Pressure and Extracellular fluid volumeSalt & water
The kidney regulates blood pH by regulating what two molecules?H+ concentration; H2CO3- concentration (bicarb)
What type of hypertension is typically seen in smokers, African Americans & Diabetes Mellitus?Essential (aka Primary)
95% of Hypertension cases are _____ HypertensionEssential (aka Primary)
What is the most common underlying cause of Secondary Hypertension?Renal Disease
5% of Hypertension cases are _____ HypertensionSecondary
The majority of Hypertension cases are _____... (90% of cases) these remain stable over years & easily controlled by medications, diet & exerciseBenign
A minority of Hypertension cases are _____.. (5%) these will run a rapidly progressive course & if not treated may cause death in a year or twoMalignant
Hyaline Arterosclerosis leads to ____ HypertensionBenign
Hyperplastic Arterosclerosis leads to ____ HypertensionMalignant
condition with Intimal thickening, in response to hemodynamic changes & subendothelial hyaline depositionHyaline arterosclerosis
term used for the renal changes in benign HTNBenign Nephrosclerosis
Increased incidence and severity of Benign NephrosSclerosis is seen w/ what 2 systemic conditions?Hypertension & Diabetes Mellitus
Granular appearance of the kidney (gross) is associated with what renal condition?Benign Nephrosclerosis
How many kidneys are affected with Benign Nephrosclerosis?BOTH
(name condition) Narrowed vascular lumens → ischemic atrophy which affect/reduce GFR w/ mild degree of proteinuria; Both kidneys affectedBenign Nephrosclerosis
Fibrinoid necrosis &/or Hyperplastic arteriolosclerosis lead to what type of Nephrosclerosis?Malignant
Diastolic P > ______ mm Hg→ cerebral edema, visual impairment, cardiovascular abnormalities, acute renal failure & death is possible120mmHg
“onion skin-like” small and medium arterioles lead to what type of Renal disease?Malignant Nephrosclerosis
Necrosis of arterioles is associated with what Renal disease?Malignant Nephrosclerosis
How many kidneys involved in Nephrosclerosis (malignant & benign)both
T/F: Malignant Nephrosclerosis definitively leads to activation of the Renin/Angiotensin system.True
T/F: Benign Nephrosclerosis definitively leads to activation of the Renin/Angiotensin system.False... it may activate
How is Benign Nephrosclerosis managed (as a disease)Salt-free diet
How many kidneys are affected by Goldblatt Kidney?Unilateral (condition aka Renal Artery Stenosis [Renovascular Hypertension]:)
This describes the pathogenesis of what condition? constriction of the renal artery causes renal ischemia ischemia→ release of Renin → HYPERTENSIONGoldblatt Kidney (aka Renal Artery Stenosis; Renovascular Hypertension)
Less common cause for renal hypertension (2-5% of cases)Goldblatt Kidney (Renal Artery Stenosis)
Glodblatt Kidney is also known as ... (2 diff names)Renal Artery Stenosis & [Renovascular Hypertension]
2 possible causes of goldblatt kidney1. Atherosclerosis of a renal artery (70%) in males & diabetics 2. Fibromuscular dysplasia (30%)
Arteriogram demonstrating significant renal artery constriction 2◦ to plaque... what Renal condition associated?Goldblatt Kidney
Treatment for Goldblatt kidneySurgical intervention (angioplasty or bypass)
Pathogenesis of Glomerular diseases is mostly by _____ mechanismsAutoimmune
Fibromuscular dysplasia of renal artery would lead to what condition?Goldblatt kidney
Nephrotic and Nephritic syndromes are classified as ____ diseases (renal is not answer)Glomerular
Chronic glomerular syndrome, mainly by damaged Glomerular Basement Membrane, and characterized by daily protein loss in urineNephrotic Syndrome
Edema is associated (primarily) with what Glomerular disease?Nephrotic Syndrome
Azotemia & Hypertension are associated with what Glomerular disease?Nephritic Syndrome (such as Post-streptococcal GN)
a group of conditions characterized by increased basement membrane permeability, permitting urinary loss of plasma protein, particularly ALBUMIN in glomerular filtrateNephrotic Syndrome
Proteinurea is associated with what Glomerular disease?Nephrotic Syndrome
Major protein lost in Nephrotic SyndromeAlbumin
Neprhotic syndrome results in a drop in _____ pressureOncotic (bc of Hypoalbuminemia)
3 possible causes of Secondary Nephrotic SyndromeDiabetes, Lupus Erythematous, Amyloidosis
Membraneous Glomerulopathy is an autoimmune disease that is the primary cause for what Glomerular syndrome?Nephrotic syndrome
Cause of Primary (autoimmune) Nephrotic Syndrome?Membraneous Glomerular
in what part of kidney are loops of henle found?Medulla (not cortex)
Podocytes wrap around ____ _____Glomerular capillaries
What hormone helps to retain water through its action on renal tubules?ADH
Major calyces mover urine into ___ ___ (what part of urinary system)Renal Pelvis
T/F: Tubular epithelial cells are found in the GlomerulusFalse
What type of cells are not found in the GlomerulusTubular Epithelial cells
a state of elevated Blood Urea Nitrogenous compounds is called ____Azotemia
3 Dental/Medical care risks for patients with Renal FailureBleeding problems, Susceptibility to infection, Drug Interactions (failure to remove --> excess toxicity)
How can Uremia be corrected?Dialysis
When there is significant WBC suppression what preventative measure is suggested?Broad Spectrum antibiotics
hormone that stimulates rate of production, maturation & release of RBCs from bone marrowErythropoietin
Where is Erythropoietin produced?Kidney
what proteolytic enzyme that regulates BP is produced in kidneyRenin
where does transformation of pro-vitamin D to active vitamin D take place?kidney
___ ____ ____ begins as 10-20% decline in glomerular filtration rate [GFR]Diminished Kidney Reserve
____ ____ is decline 20-50% of GFR (nitrogenous compounds begin to accumulate in blood)Renal Insufficiency
____ ____ final stage where the kidney can no longer maintain its excretory, metabolic, and endocrine functions beyond normal compensatory mechanismsRenal Failure
sudden loss of renal function resulting in oliguria/anuria & elevated blood urea nitrogenous compounds (BUN) aka, azotemiaACUTE Renal Failure
What type of systemic complications are associated with Chronic Renal Failure?Cardiovascular
Two main causes of Acute Tubular Necrosis (death of tubular epithelial cells)Ischemia & Nephrotoxicity
The most common cause for acute renal failureAcute Tubular Necrosis
Heart failure could lead to _____ Acute Tubular NecrosisIschemic
T/F: Seizures are associated with Acute Tubular NecrosisTrue
With adequate care and ______, patients with Acute Tubular Necrosis have a very low mortality rateDialysis
patchy, multifocal tubular necrosis along the nephron & PCT w/ skipping areas of healthy tubulesIschemic Acute Tubular Necrosis
Diffuse tubular necrosis in PCTToxic Acute Tubular Necrosis (caused by Nephrotoxicity)
Patchy tubular necrosis is caused by ______Ischemia
Diffuse tubular necrosis is caused by ______Nephrotoxicity
common suppurative infection of the renal pelvis by bacteriaAcute Pyelonephritis
What renal condition is associated with Urinary Tract infections?Acute Pyelonephritis
_________ ____ is the principal organism (enteric gram-negative rods) associated with Acute Pyelonephritis, also ____ or ____ pathogens E. Coli; Staph; Strep
Ascending infection from Lower UTI (Cystitis & Urethritis)Acute Polynephritis
Kidney disease associated with use of a catheterAcute Pyelonephritis (b/c of bacterial infection)
Enlarged prostate w/ urinary tract obstruction can cause what kidney disease?Acute Pyelonephritis
Congenital malformation of the uterer's entrance into bladder allowing back flowVesicoureteral Reflux
Term: pus in urine & leukocyte castsPyuria
Kidney gross features of Hyperemia, Patchy suppuration (abscesses, sometimes large), Unilateral involvement associated with what Kidney disease?Acute Pyelonephritis
Pyuria associated with what kidney disease?Acute Pyelonephritis
Treatment for Acute PyelonephritisAntibiotics
chronic, persistent & potentially scarring, low grade infection of the kidneyChronic Pyelonephritis
Clinical Features: Pain is Insidious in onset; Recurrent w/ low back pain; Fever w/ frequent pyuria & bacteriuria; Pyelograms show shrinking and deformed kidneys secondary to scarringChronic Polynephritis
Most common cystic condition of the kidneyPolycystic Kidney disease (autosomal dominant... adult type)
Polycystic Kidney Disease (adult) Pattern of inheritance is Autosomal ______ on chromosome ____Dominant; 16
Periorbital edema is associated (primarily) with what Renal Condition?Nephrotic syndrome
findings: proteinuria & edema (in excess of 3.5g/day in adults) & NO Azotemia, Hypertension or Hematuria (what condition)?Nephrotic Syndrome
Most common cause of Nephrotic syndromeMembraneous Glomerulo-Nephritis
Autoimmune, w/ deposition of antigen-antibody complexes in capillary walls (Idiopathic in ~85% of cases (autoimmune reaction to endogenous antigen))Membraneous Glomerulo-nephritis
Membraneous Glomerulo-nephritis has an ______ causeAutoimmune
What are 2 infections that can cause Membraneous Glomerulo-Nephritis?Syphilis & Hepatitis B
(immune) subendothelial deposits→ diffuse thickening of GBM... what condition?Membraneous Glomerulo-nephritis
leading cause of chronic renal failure in the USDiabetes Mellitus
Hyperglycemia leads to _____ thickness of GBMIncreased
Advanced end-stage kidney disease occurs in ~ ___ of DM cases40%
autoimmune multisystem disease characterized by an array of autoantibodies, particularly ANAs & anti-DNA AbsSystemic Lupus Erythematous
Scaly lesions in sun-exposed areas is a symptom of what systemic disease?Systemic Lupus Erythematosus
Butterfly Rash on the face is a symptom of what systemic disease?Systemic Lupus erythematosus
Condition with Deposition of immune complexes (ANAs & others) in the mesangium or basement membrane which leads to basement membrane thickenings – Wire-loopsLupus Glomerulonephritis
What does ANA (associated with Lupus) stand for?Anti-Nuclear Antibodies
Lupus Glomerulonephritis leads to ____ syndrome and can cause chronic renal failureNephrotic (proteinurea) (thickening of GBM)
3 Treatments for Lupus GlomerulonephritisImmunosuppressants (corticosteroids), Dialysis, Renal Transplant
Lupus Glomerulonephritis is treated with what drug?Corticosteroids (Immunosuppressants)
Which Ig is associated with Lupus?IgG
heterogenous group of disorders characterized by deposition of extracellular proteinaceous material produced by immunologically altered cellsAmyloidosis
Sarcoidosis, Osteomyelitis, Hemodialsis are all secondary causes of what condition?Amyloidosis (amyloid deposition)
malignant plasma cell proliferation is ____ ____Multiple Myeloma
Multiple Myeloma is a secondary cause of what Renal condition?Amyloidosis (amyloid deposition)
fatigue, weight loss, paresthesia and orthostatic hypotension are clinical features of _____ depositionAmyloid (Amyloidosis)
Proteinaceous deposits (eosinophilic) may compress & eventually obliterate glomeruli, connective tissue & vessels which lead to renal failureAmyloidosis
Congo red stain tests for deposition of ____Amyloid
Macroglossia associated with deposition ____, which can cause renal failure (via Nephrotic syndrome)(in addition to a lot of other problems)Amyloid
once diagnosis of amyloid deposition is made, the patient should be evaluated for secondary amyloidosis, and screened for ____ ____Multiple Myeloma
Renal dialysis may not be helpful for what condition... because it results in multiple organ failureAmyloidosis
Inflammatory rupture of glomerular capillaries with resulting HematuriaNephritic Syndrome
Thickened GBM results in ____ syndromeNephrotic
Ruptured glomerular capillaries resuts in ____ syndromeNephritic
Oliguria, Hematuria & Azotemia are symptoms of _____ syndromeNephritic
Nephritic syndrome is usually _____ onsetAcute (sudden)
which syndrome? Periorbital edema with Azotemia and HematuriaNephritic Syndrome
which syndrome? Periorbital edema with Oliguria and HematuriaNephritic syndrome
which syndrome? Periorbital edema with ProteinuriaNephrotic syndrome
Post-Streptococcal GN (Acute Proliferative Glomerulonepheritis) associated with what syndrome?Nephritic (ruptured Glomerular capillaries)
More mesangial cells is a sign of what syndrome? (histologically) Nephritic
Mesangial sclerosis but no increase in number of mesangial cells is a sign of what syndrome (histologically)Nephrotic
Post-streptococcal GN is associated with Immune autoantibodies form against what bacterial antigen?M protein (on surface of group A Beta-Hemolytic Streptococci)
Specifically... what type of strep causes Post-streptococcal GN or Rheumatic FeverGroup A Beta-Hemolytic
Child that recently had throat infection now has "tea-colored urine" what syndrome? what is cause?Nephritic Syndrome, Post-Streptococcal GN
Children with Post-streptococcal GN would have elevated ____ & ____ levelsElevated BUN (azotemia) & anti-streptolysin O (ASO)
Hyper -cellular glomeruli in Post-streptococcal GN is due to proliferation of what 3 types of cells?mesangial, endothelial cells and neutrophils

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