Exam (elaborations)
Med Path Final Exam 2024/2025
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Med Path Final Exam 2024/2025 Med Path Final Exam 2024/2025 Med Path Final Exam 2024/2025
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Med Path Final Exam90-120 - ANS Normal GFR range (mL/min)
<15 - ANS GFR value indicative of renal failure (mL/min)
Aging - ANS In a healthy adult, what will decrease GFR?
Loop of Henle - ANS Where in filtration process is urea removed from blood?
Azotemia - ANS High BUN
Dysfunction, high protein consumption, dehydration - ANS What all can elevate BUN value?
Creatinine should be fully excreted and not retained - ANS Why is creatinine an indicator of renal
health?
Serum creatinine - ANS Urine creatinine = _____ in healthy Pt
<400mL/day - ANS Threshold for oliguria
Low CO or blood volume - ANS Causes of prerenal dysfunction
Trauma, infection, nephrotoxic drugs - ANS Causes of intrarenal dysfunction
Obstruction (stone, prostatitis) - ANS Causes of postrenal dysfunction
,Hydronephrosis - ANS Urine backs up in ureter and swells in renal pelvis and calyces
E. coli - ANS Pathogen that most commonly secretes nitrites and is detected in UA
Direct trauma that cause prerenal dysfunction - ANS Ischemia, HTN, DM are examples of ____
Pyelonephritis - ANS Infection of the renal pelvis and parenchyma of the kidney, usually the result of
lower UTI
Nephritic Syndrome - ANS Hematuria, hypertension, moderate glomerular damage, and oliguria
Nephrotic Syndrome - ANS Severe proteinuria
Dysfunction is isolated to kidney - ANS What does primary glomerular disease indicate?
Systemic conditions are affecting the kidneys - ANS What does secondary glomerular disease indicate?
DM, HTN, SLE - ANS Examples of secondary glomerular disease
Nephrotic Syndrome - ANS Renal Function Results:
•Massive proteinuria (>3.5 g/day
•Hypoalbuminemia
•Severe edema
•Hyperlipidemia
•Lipiduria
,Dx?
Liver compensates for low albumin. Inherently synthesizes LDL as well - ANS Why does hyperlipidemia
occur in nephrotic syndrome?
Immunocompromised and thromboembolism - ANS Risks that develop from nephrotic syndrome
Loss of albumin - ANS Key sign of glomerular injury
Edema - ANS Losing albumin in nephrotic syndrome causes what?
Diet compensation and lower med doses - ANS Treatment for nephrotic syndrome
Primary (95%) - ANS Type glomerular disease more likely to develop in children
Focal and Segmental Glomerulosclerosis - ANS Most common cause of nephrotic syndrome in adults
(can occur in children too). Scar tissue develops on the glomeruli
50% chance of renal failure in 10 years - ANS Prognosis of FSGS
Minimal Change Disease - ANS Most common cause of nephrotic syndrome in children. Podocyte foot
proteins fuse together decreasing efficiency
Membranous Nephropathy - ANS Caused by an autoimmune reaction to an unknown renal antigen.
Subepithelial immune deposits. Thickening of GBM. Subepithelial spikes of GBM between the immune
deposits. Does not respond well to corticosteroid therapy
, Cell proliferation in glomeruli, WBC infiltration, inflammation - ANS Cellular causes of nephritic
syndrome
IgA (Berger Disease) - ANS What antibody can cause nephritic syndrome?
Autoimmune or post strep disorder - ANS Causes of acute glomerulonephritis (AGN)
Group A Strep antibodies attack glomeruli - ANS How does post-strep GN occur?
Berger Disease - ANS Most common cause of primary GN. Usually occurs after URI or GI infection
Type IV collagen - ANS Hereditary nephritis GMB gene mutation affects what?
Type I CrGN (Cresentic) - ANS Anti-GBM Antibody (12%)
Goodpasture Syndrome - autoantibodies against COL4A3 in GBM and alveolar capillary BM
Type II CrGN - ANS Immune-Complex Mediated (44%)
Complication of Post-Streptococcal GN, SLE, IgA Nephropathy
Type III CrGN - ANS Pauci-Immune (44%)
Anti-neutrophil cytoplasmic antibodies in serum
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