MSN 570 Advanced Pathophysiology Questions
with solved solutions
Nephrotic syndrome - ANSWER>>characterized by massive proteinuria caused by
glomerular damage. corticosteroids are the mainstay; Associated with
glomerulonephritis and with an immune response that is noninflammatory.
Glomerular Injury: Diffuse and Focal - ANSWER>>Lesions that involve all or most
(> 50%) of the glomeruli (plural) are termed diffuse, and lesions that involve some
(< 50%) of the glomeruli are termed focal (e.g., focal segmental
glomerulonephritis).
Glomerular injury: Global and Segmental - ANSWER>>When a whole glomerulus
(singular) is affected, the lesion is termed global, and the lesion is considered
segmental if only a portion (< 50%) of the glomerulus is affected.
Glomerulonephritis - ANSWER>>An inflammatory disorder of the glomeruli, and
most forms occur as a result of activation of immune mechanisms.
Nephritic syndrome - ANSWER>>Associated with glomerulonephritis and an
immune response that is inflammatory. A key feature is the passage of
leukocytes, red blood cells, and plasma proteins which occur as a result of
inflammation.
1.) LIMITED proteinuria 2.) Oliguria and Azotemia 3.) Salt retention -- periorbital
edema and hypertension(salt/fluid retention) 4.) RBC casts and dysmorphic RBCs
in urine-- Immune Complex deposition activated Complement; C5a attracts
neutrophils which mediate the damage
Proliferative structural (histologic) descriptor - ANSWER>>refers to an increase in
glomerular cells (e.g., mesangial, endothelial, basement membrane). In the extra
,capillary space, this forms specific lesions that are termed crescents, which are
made of macrophages, fibroblasts, and other cells. These crescent cells
accumulate in the Bowman space and represent a rupture of the capsule.
sclerosing structural (histologic) descriptor - ANSWER>>refers to glomerular scar
formation, and when the scarring is between the glomerulus and tubules, it is
referred to as interstitial fibrosis.
necrotizing structural (histologic) descriptor - ANSWER>>refers to cellular death.
Benign prostatic hyperplasia (BPH)
Also called benign prostatic hypertrophy - ANSWER>>A common, nonmalignant
enlargement of the prostate gland that occurs as men age, usually appearing by
age 50.
Bladder cancer - ANSWER>>cancerous tumor that arises from the cells lining the
bladder; major sign is hematuria
Diagnostic procedures for hydronephrosis - ANSWER>>History
physical examination
urinalysis
renal ultrasound
CT
intravenous pyelogram
MRI.
Hydronephrosis - ANSWER>>An abnormal dilation of the renal pelvis and the
calyces of one or both kidneys that occurs secondary to a disease.
Polycystic kidney disease (PKD) - ANSWER>>inherited disease in which sacs of
fluid called cysts develop in the kidneys
, Renal cell carcinoma - ANSWER>>cancerous tumor that arises from kidney tubule
cells; most frequently occurring kidney cancer in adults (most common in those
50-70 years of age).
Renal cell carcinoma signs and symptoms - ANSWER>>Hematuria
An abdominal renal mass that is firm
Abdominal flank pain described as dull and achy
Unexplained weight loss
Other symptoms may include scrotal varicoceles. If the inferior vena cava is
affected, then manifestations can include edema, ascites, and hepatic problems.
Signs and symptoms of bladder cancer - ANSWER>>Painless hematuria that is
gross (i.e., visible) or microscopic. The hematuria is intermittent and occurs
throughout all of micturition as opposed to just the beginning.
Irritative symptoms such as frequency, urgency, and dysuria may be present and
occur due to detrusor overactivity, obstruction, or decrease in bladder capacity.
Flank or abdominal pain (e.g., suprapubic) are usually signs of more advanced
cancer.
Other general symptoms such as fatigue, weight loss, or anorexia are also
manifestations of more advanced disease. Physical examination findings may
reveal the presence of a pelvic or abdominal mass (if advanced) and prostate
induration.
Treatment for hydronephrosis - ANSWER>>treat underlying cause and facilitating
urine flow will be necessary if UTIs develop.
Wilms tumor, or nephroblastoma - ANSWER>>a rare cancer of the kidney that
occurs in children from residual embryonic or fetal tissue
with solved solutions
Nephrotic syndrome - ANSWER>>characterized by massive proteinuria caused by
glomerular damage. corticosteroids are the mainstay; Associated with
glomerulonephritis and with an immune response that is noninflammatory.
Glomerular Injury: Diffuse and Focal - ANSWER>>Lesions that involve all or most
(> 50%) of the glomeruli (plural) are termed diffuse, and lesions that involve some
(< 50%) of the glomeruli are termed focal (e.g., focal segmental
glomerulonephritis).
Glomerular injury: Global and Segmental - ANSWER>>When a whole glomerulus
(singular) is affected, the lesion is termed global, and the lesion is considered
segmental if only a portion (< 50%) of the glomerulus is affected.
Glomerulonephritis - ANSWER>>An inflammatory disorder of the glomeruli, and
most forms occur as a result of activation of immune mechanisms.
Nephritic syndrome - ANSWER>>Associated with glomerulonephritis and an
immune response that is inflammatory. A key feature is the passage of
leukocytes, red blood cells, and plasma proteins which occur as a result of
inflammation.
1.) LIMITED proteinuria 2.) Oliguria and Azotemia 3.) Salt retention -- periorbital
edema and hypertension(salt/fluid retention) 4.) RBC casts and dysmorphic RBCs
in urine-- Immune Complex deposition activated Complement; C5a attracts
neutrophils which mediate the damage
Proliferative structural (histologic) descriptor - ANSWER>>refers to an increase in
glomerular cells (e.g., mesangial, endothelial, basement membrane). In the extra
,capillary space, this forms specific lesions that are termed crescents, which are
made of macrophages, fibroblasts, and other cells. These crescent cells
accumulate in the Bowman space and represent a rupture of the capsule.
sclerosing structural (histologic) descriptor - ANSWER>>refers to glomerular scar
formation, and when the scarring is between the glomerulus and tubules, it is
referred to as interstitial fibrosis.
necrotizing structural (histologic) descriptor - ANSWER>>refers to cellular death.
Benign prostatic hyperplasia (BPH)
Also called benign prostatic hypertrophy - ANSWER>>A common, nonmalignant
enlargement of the prostate gland that occurs as men age, usually appearing by
age 50.
Bladder cancer - ANSWER>>cancerous tumor that arises from the cells lining the
bladder; major sign is hematuria
Diagnostic procedures for hydronephrosis - ANSWER>>History
physical examination
urinalysis
renal ultrasound
CT
intravenous pyelogram
MRI.
Hydronephrosis - ANSWER>>An abnormal dilation of the renal pelvis and the
calyces of one or both kidneys that occurs secondary to a disease.
Polycystic kidney disease (PKD) - ANSWER>>inherited disease in which sacs of
fluid called cysts develop in the kidneys
, Renal cell carcinoma - ANSWER>>cancerous tumor that arises from kidney tubule
cells; most frequently occurring kidney cancer in adults (most common in those
50-70 years of age).
Renal cell carcinoma signs and symptoms - ANSWER>>Hematuria
An abdominal renal mass that is firm
Abdominal flank pain described as dull and achy
Unexplained weight loss
Other symptoms may include scrotal varicoceles. If the inferior vena cava is
affected, then manifestations can include edema, ascites, and hepatic problems.
Signs and symptoms of bladder cancer - ANSWER>>Painless hematuria that is
gross (i.e., visible) or microscopic. The hematuria is intermittent and occurs
throughout all of micturition as opposed to just the beginning.
Irritative symptoms such as frequency, urgency, and dysuria may be present and
occur due to detrusor overactivity, obstruction, or decrease in bladder capacity.
Flank or abdominal pain (e.g., suprapubic) are usually signs of more advanced
cancer.
Other general symptoms such as fatigue, weight loss, or anorexia are also
manifestations of more advanced disease. Physical examination findings may
reveal the presence of a pelvic or abdominal mass (if advanced) and prostate
induration.
Treatment for hydronephrosis - ANSWER>>treat underlying cause and facilitating
urine flow will be necessary if UTIs develop.
Wilms tumor, or nephroblastoma - ANSWER>>a rare cancer of the kidney that
occurs in children from residual embryonic or fetal tissue
