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105 Cards in this Set
- Front
- Back
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Severely ill pt. in shock developes Azotemia and Oliguria what would biopsy reveal
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Acute tubular necrosis
#1 reason for pre renal shock and acute renal failure, results from ischemia or toxic injury |
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Subepithelial Humps, PMN present,sore throat for 14 days earlier, periorbital edema
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Acute post streptococcal glomerulinephritis
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Fever rash, eosiniphils, after course of METHACILLIN
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acute interstitial pephritis
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renal stone developed from Urea spiltting organis
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Triple phosphate AKA- Struvite
Calcium Oxalate forms stone 75% |
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Infant, autosomal dominant, abdominal girth, abdominal pain, moderate hypertention, reduces liver funtion. pt. dies while waiting for evaluation by massive intracranial hemorrhage
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autosomal dominant infant polycystic kidney disease
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most common renal cell carcinoma (tumor)
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Clear cell carcinoma-
painless hematuria chromosome 3 flank pain |
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highly PIGMENTED history of bronchitis and many bullae
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Centriacinar
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alpha 1- antitrypsin
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Panacinar emphaysema
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pt. presents with asthma, what cell is likely to be increased
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eosinophils, (associated with mast cells, IgE)
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5 year old child aspirates a peanut resulting in atelectasis is called
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Abstructive/absorptive
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cavitary disease @ the apex of the lung
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Secondary TB (granulomatous, reactivation, reinfection)
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subplueral parenchymal nodule w associated lyph node involvement
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primary TB (GHON complex, mid lung first exposure)
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Most common Lobar pnuemonia
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Strep, diffuse has 4 stages1-congestion
2- red hepatization 3- Gray hepatization 4 resolution second type (Bronchial- patchy, Stap |
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4 stages of Lobar pnuemonia
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CRGR
Congestion Red Hepatization Grey Hepatization Resolution |
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Type II sensitivity reaction inclused
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Transfusion rx.
Hemolytic deases of newborn Good pasture Graves disease Myasthenia Gravis |
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Type I Hypersensitivy rx includes
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Asthma
Hayfever Laryngeal Edema IgE, Eosinophila Mast Cells Histamine Seratonin |
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Type I delayed phase
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Lukotrienes Prostoglandins
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what mediates type I sensitivity
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Mast cells
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Type III hypersensitivity is called what and acts systemically and locally
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Immune complex
Systemic-Serum Sickness Local-Arthrus reaction |
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Type III examples
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Snake bite- antivenom
Lupus rheumatoid arthitis |
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Type III does what to complement serum levels
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It would decrease complement serum level in the blood vessel wall
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Anti smith antibody is present in
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SLE(lupus)
maclopapular eruption |
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Aids pt. has abdominal pains and Acid-fast stool what the most likely cause of pt.s diarrhea
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Cryptosporidium
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CD4 recognizes antigen on
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MHC II molecules
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Type I hypersensitivy characterized by
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Mast cells and IgE
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TB tuberculin test is type _ hypersensitivity
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Type IV delayed hypersensitivity
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Pt. presents with blurred vision and positive for SS-B antibodies and history of rheumatois arthritis
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Sjogrens syndrome
Xerostomia associated with Lyphomas |
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Pt. presents with fatigue weight loss, admits to being an IV drug user what test should be administeres
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ELISA to look for antibodies then western blot to confirm particles, want to look @ Viral load
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Antibodies are produced by
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Plasma cells and plasma cells are produced by B-cells
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Pt. presents w weaknes weight loss, arrythmias, protruding tongue, positive CONGO RED stain the next appropriate stage would be to
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look @ serum stain under polarized light -Green apple
Amyloidosis |
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which hypersensitivity result in vaculities
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Type III Immune compleyx because it act on vascular wall- also cause fibrinoid necrosis
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Cross Beta pleated sheets
"Bence Jones" Over 50 Use Congo Red and flourescent light to dx. |
Amyloidosis- associated with Alziehmers and Endocrine disease
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Acute Respiratory Distress syndrome can be caused by
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Pancreatitis
Shock Sepsis |
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Pulmonary Thromboembolism
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Acute and large-Saddle embolism
Medium- block pulmonary=RBC escaping block bronchial=infarct-#1 chronic left sided heart disease Small thrombus-Cor Pulmonale- hypertrophy of right heart |
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#1 tumor of the lung
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Metastatic
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Bronchogenic tumors include
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Squamos cell
Adenocarcinoma Small Cell Carcinoma Large cell carcinimo |
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Whats the most aggressive Bronchogenic tumor
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Small cell"OAT" cell carcinoma
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Pulmonary TB has 2 types
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Primary- Ghon Complex- mid lung field
Secondary- reinfection/reactivation- Apex cavity type IV hypersensitivity |
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most common Primary Atypical pnuemonia
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Mycoplasm Pneumoniae- Interstitial confinement
common in children accumulatiuons in alveolar wall |
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Lung abcess is due to what bacteria
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Staph A. pyogenic
Right lung usaully affected Alcohol or drug overdose bronchial obstruction |
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Atelectasis by congenital means is due to
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Hyaline membrane disease or prematurity
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Aquired Atelectasis can be either
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Abstructive/absoptive- by means of and obstruction- lung will shift towards collapsed lung
Compression- due to trauma or external pressure i.e. hydrothorax- mediastinum will shift awat from collapsed lung |
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Acute atalectasis is usaully due to
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post-op complications
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Pulmonary edema can be caused by
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Left ventricular failure
shock leading to incrasesed capillary permeability or rapid ascent to high altitudes |
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Bronchiogenis cyst
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usually in area of suprasternal notch
lined by respiratory epithelial has cilia |
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Pulmonary sequestration is usaully complicating due to
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infection- cystic lung disease
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Bronchietctasis is?
it may lead to |
permanent abnormal dilitation of bronchials caused by chronis infection
May lead to lung abcess and COR PULMONALE |
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Bronciectasis is often seen in pt's with
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Kartagener disease-
Serile situ inversus sinusitis |
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Emphysema is
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permanent dilitation and destruction- lack of elastic recoil
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Emphysema usually caused by smoking and assiciated with pigmentation
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Centilobar- terminal bronchiole(APICAL) usually caused by smoking
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emphysema associated with a genetic defieciency in alpha 1 antitrypsin
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Panacinar
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emphysema associated with distal part of acina
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Paraseptal or DISTAL
there is also an Irregular emphysema- assocated with scar tissue |
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Chronic bronchitis is defined by
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have a chronis cough for 3 months for 2 consecutive years- hypertrophy of mucus glands- can lead to cor pulmonale
clearly linked to SMOKING |
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COPD Chronic obstrutive pulmonar disease is characterized by
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Obstruction of airflow
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Bronchial asthma is characterized by in increase in this antibodies and have these associated with them
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Ige and MAST cell
Curshman spirals charlot leden crystals smooth muscle hypertrophy |
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Acute pyelonephritis is what type of infection usaully caused by
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Bacterial- Neutreutrophils WBC
ECOLI obstruction and instrumentation |
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In Acute pyelonephitis you will find this in urine
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WBC cast
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Acute pyelonephritis can lead ultimately to chronic pyelonephritis which causes
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chronic renal failure
Chronic*scarred kidney and dialated blunted calyces |
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Drug induced interstitial nephitis ultimately causes
The drugs usually involves |
chronic*Papillary necrosis
Methecillin, nsaids type I hypersensitivity(eosinophils) chronic anelgesic abuse |
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Chronic interstitial nephritis is due to
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Analgesic nephropathy
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Acute tubular necrosis is the most common cause of
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#1 cause of ACUTE Renal Failure
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Acute tubular necrosis is usaully due to
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Shock or toxic injury
ex:antifreeze, aminglycosides usually ends in acute renal failure |
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Acute tubular necrosis usaully requires
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Dialysis
epithelial cell necrosis and sloughing off evidence of regeneration proximal tubule usually affected |
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Vascular Hypertension cause is usually
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Idopathic
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Vascular Hypertension usaully causes
diastolic higher than 120 |
Benign Nephrosclerosis
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benign Nephrosclerosis usaully presents as having this appearance
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Onion skin an Hyaline thickening
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Vascular hypertention can cause a fast acute change called
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Malignant Nephosclerosis which is a medical emergency
causing petechial hemorrhage again onion skin appearance |
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Adult renal polycystic kidneys are autosomal dominant and cause
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enlarged kidney
hematuria Flank Pain |
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Infant polycystic kidney will have this appearance
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smooth and can cause compression of lungs and other organs as they are enlarged
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Nepholithiasis(Stones) are two types
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Calcium Oxalate or Struvite aka; triple phosphate
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Nephrolithiasis are due to high concentration of
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Cacium 90%- stone will cause obstruction which leads to hydronephrosis which causes dialation of calyces and the medulla will thin out
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Hydornephrosis is causes by
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Foreign bodies, nephrolithiasis(stones) which will cause dialation of the calyces
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Renal cell carcinoma most common type is-
and is also known as |
Clear cell, silent hematuria or ADENOCARCINOMA
mutation with chromosome #3 usually in the upper pole |
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Renal cell carcinoma also cause
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Paraneoplastic syndrome
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Wilms tumor is most common tumor in
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Children- usaully an abdominal mass found by Dr.
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Prognosis of Wilms tumor with surgery and radaition therapy?
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good prognosis
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Carcinoma of the urinary bladder usually affect what type of cells
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transition cell carcinoma has a four scale grading- I-4 cells thick
2-7 cell thick 3-10 cell thick 4- Anaplastic(disarrayed) |
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Cacinoma of the bladder is usaully measured in its invasion of
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the muscular layer
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Mahler
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Developed 6-stage theory that describes the process of separation and individuation: normal infantile autism; symbiosis; differentiation; practicing; rapprochement; object constancy. Separation is becoming a discrete physical entity by physically distancing.
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The hallmark of acute glomeruli nephritis is
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RBC cast in urine
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Hallmark of acute pyelonephritis is
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WBC cast
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Nephrotic syndrome is due to
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Leaky basement membrane and foot process destruction
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Nephrotic syndrome usaull presents as
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Heavy proteinuria
Hyperlipidemia Lipiduria Edema GRF is normal |
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Nephritic syndrome usaully presents as
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Obstruction of glomeruli wall, this blockage causes damage to wall and you will see rbc in urine(hematuria) increase BP due to RENIN and decrease GFR which increases BUN and creatinin levels
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With nephritic syndrome you see what type of edema
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Periorbital
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Renal tubular defect manifest as
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Nocturia and polyuria
metabolic acidosis |
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Pre-renal causes of Acute renal failure are
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Shock
-hypovolemic -septic -cardiogenic |
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Renal causes of Acute renal failure
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Severe Nephritis
malignant hypertension |
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Post renal causes of acute renal failure
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Stone
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Chronic renal failure is characterized by a GFR
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@ or less than 25 ml/min
Uremia |
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Glomeruli diseases that deposit Ag-Ab complexes in the glomerulus wall are type--- hypersensitivity
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type III
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Injury to the glomerulus by anitbodies reactin in situ are type---hypersensitivity
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type II
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Diseases causing Nephrotic syndrome
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Minimal change
Membraneous proliferative Membranous glomeruli nephritis Focal segment glomeruliscerosis IgA nephropathy SLE A |
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Diseases cause by Nephritic syndrome
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V
Post streptococcal GN Rapidly progressive cresentic IgA Membranoproliferative SLE |
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Minimal change is usaully in children and treatment prognosis is usaully
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good with steroid tx.
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Membranous glomerulonephropathy is in adult and a result of
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Immune complex deposits in BM
causes "Spikes and domes" although it nephotis you see hematuria and hypertension |
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Focal segment sclerosis is usaully due to
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Heroin and HIV and AIDS
incease in IgM antibodies |
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Membranoproliferative glomerulinephritis presents as a decrease in
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C3, hypocomplement, charaterized by mesangial and endothelial cell proliferation
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Membranoproliferative has two types(aka mesanigoproliferative)
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1- Subendothelial deposits in basement membrane
2-Dense ribbon like deposit renal failure in ten years TYPE 2 worst |
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membranoproliferative can have this type of appearance
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Train track- due to splittin of BM
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Acute post streptococcal GN is a nephritic syndrom and presents with
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lumpy bumpy deposits it is a
Immune complex disease- type III |
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Rapidly progressin cresentic GN is usaully deposited in this form
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linear and found in good pastures disease
Very poor prognosis |
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Rapidly progressing cresentic GN has 3 types
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1-good pastures- usaully need kidney transplant
2-immune complex 3-wegners - PANCA |
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IgA nephropathy (Bergers Disease) characteristic presentation is
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Mesangial proliferation
usaully in young men |
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Chronic glomerulinephritis is the
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"END" stage of many glomeruli diseases
#1- Rapidly progressing GN #2-Focal Segmental #3-membranpproliferative #4-Iga #5-membranous #6- Post-Step |
