MSN 570 Advanced Pathophysiology Exam Graded A

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.