NURS 611 ADVANCED PATHOPHYSIOLOGY EXAM (WITH VERIFIED Q&A) -100% PASS

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NURS 611 ADVANCED PATHOPHYSIOLOGY
EXAM (WITH VERIFIED Q&A) -100% PASS


1. Acute .unilateral .renal .obstruction .and .hypertension.

a. What .amount .of .cardiac .output .to .kidneys . require?

i. at .least .20-25% .cardiac .output .– .MAP

b. What .does .reduced .perfusion .of .kidneys .cause? .(2)

i. Activation .of .the .renin-angiotensin-aldosterone .system .(RAAS)

ii. constriction .of .peripheral .arterioles

c. What .is .the .most .common .type .of .renal .stone?

i. Calcium .oxalate

d. Passage .of .kidney .stones .can .be .extremely .painful . - .what .may .they .produce? .Why?

i. ―referred .pain‖ .to .umbilicus .area

ii. due .to .the .sensory .innervation .of .the .upper .part .of .the .ureter .arising .from .the .10th
. thoracic .nerve .roots.

2. Urinary .tract .infections:

a. What .are .the .two .common .clinical .manifestations .of .a .urinary .tract .infection .in .an
.older .adult?

i. confusion .and .poorly .localized .abdominal .discomfort

b. Why .can .they .be .very .difficult .to . diagnose?

i. due .to .vague .symptoms.

3. Pyelonephritis

a. What .is .pyelonephritis?

i. An .infection .of .one .or .both .upper .urinary .tracts .(ureter, .renal .pelvis, .and
.kidney .interstitium)

b. What .are .the .two .most .common .underlying .risk .factors .to .pyleonphritis?

i. Urinary .obstruction .and .reflux .of .urine .from .the .bladder .(vesicoureteral .reflux)

c. Name .3 .microorganisms .usually .associated .with .acute .pyelonephritis:

i. E. .coli

ii. Proteus




NURS .611 .ADVANCED .PATHOPHYSIOLOGY .EXAM .(WITH .VERIFIED .Q&A) .-100%
.PASS

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iii. Pseudomonas

d. How .do .pyelonephritis .associated .microorganisms .increase .the .risk .of .stone .formation?

i. They .split .urea .into .ammonia, .making .alkaline . urine

4. Painful .bladder .syndrome/interstitial .cystitis

a. What .does .PBS/IC .include?

i. nonbacterial .infectious .cystitis .(viral, .mycobacterial, .chlamydial, .fungal)

ii. noninfectious .cystitis .(radiation, .chemical, .autoimmune, .hypersensitivity)

b. What .is .the .cause .of .PBS/IC?

i. The .exact .cause .is .unknown, .but .an .autoimmune .reaction .may .be .responsible
.for .the .inflammatory .response

c. What .4 .autoimmune .reactions .are . included .in .the .inflammatory .response .in .PBS/IC?

i. Mast .cell .activation

ii. altered .epithelial .permeability

iii. Neuroinflammation

iv. increased .sensory .nerve .sensitivity.



d. What .is .difficult .when .looking .at .s/s .of .cystitis .and . pyelonephritis?

i. Differentiating .symptoms .by .clinical .assessment .alone

e. How .is .the .specific .diagnosis .is .established?

i. urine .culture

ii. Urinalysis

iii. Clinical .signs .and .symptoms

f. urine ?
What .indicates .pyelonephritis, .but .are .not .always .present .in .the

i. White .blood .cell .casts

5. Glomerular .disorders

a. What .is .reduced .GFR .during .glomerular .disease .is .evidenced .by? .(3)

i. elevated .plasma .urea

ii. creatinine .concentration

iii. reduced .renal .creatinine .clearance




NURS .611 .ADVANCED .PATHOPHYSIOLOGY .EXAM .(WITH .VERIFIED .Q&A) .-100%
.PASS

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6. Acute .glomerulonephritis

a. What .does .acute .glomerulonephritis .include?

i. renal .diseases .in .which .glomerular .inflammation .is .caused .by .immune .mechanisms
.that .damage .the .glomerular .capillary .filtration .membrane
b. What .parts .of .the .glomerular .capillary .filtration .membrane .can .be .damaged .in
.acute .glomerulonephritis?

i. Endothelium

ii. basement .membrane

iii. epithelium .(podocytes)

c. What .are .the .classic .symptoms .of .acute .glomerulonephritis?

i. Sudden .onset .of .hematuria .including .red .blood .cell .casts .and .proteinuria .(milder
.than .nephrotic .syndrome

ii. In .more .severe .cases, .these .symptoms .are .also .accompanied .by .edema,
.hypertension, .and .impaired .renal .function.
7. Nephrotic .syndrome

a. What .is .seen .in .nephrotic .system? .(4)

i. a) .in the .urine .per .day
The .excretion .of .3.0 .g .or .more .of .protein .(massive .proteinuri

ii. hypoalbuminemia .(less .than .3.0 .g/dl)

iii. Hyperlipidemia

iv. peripheral .edema

b. What .is .nephrotic .syndrome .the .characteristic .of?

i. glomerular .injury

c. What .are .the .[rimary .causes .of .nephrotic .syndrome?

i. minimal .change .disease .(lipoid .nephrosis)

ii. membranous .glomerulonephritis

iii. focal .segmental .glomerulosclerosis

d. Where .do .secondary .forms .of .nephrotic .syndrome .occur? .(3)

i. systemic .diseases .including .diabetes .mellitus, .amyloidosis, .and .systemic
.lupus .erythematosus
e. Where .is .Nephrotic .syndrome .also .is .seen .with? .(4)

i. certain .drugs, .infections, .malignancies, .and .vascular .disorders.

8. Acute .Kidney .injury

a. What .do .we .know .about .the .progression .of .AKI? .(2)

i. Can .be .acute .and .rapidly .progressive .(within .hours)

ii. the .process .may .be .reversible


NURS .611 .ADVANCED .PATHOPHYSIOLOGY .EXAM .(WITH .VERIFIED .Q&A) .-100%
.PASS

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b. What .do .we .know .about .chronic .kidney .failure?

i. Can .progress .slowly .into .end-stage .kidney .failure .over .a .period .of .months .or .years

c. What .does .Renal .insufficiency .refers .to?

i. a .decline .in .renal .function .to .about .25% .of .normal .or .an .eGFR .of .25 .to .30 . ml/minute.

d. What .is .eGFR .is .extremely .useful .in?

i. Determining .improvement .or .decline .in .kidney .function!!)

e. What .do . you .see .(lab .wise) .in .renal .insufficiency?

i. Levels .of .serum .creatinine .and .urea .are .mildly .elevated.

f. Changes .in .serum .creatinine .level .occur .only .if .more .than % .of .glomerular .filtration
.is .lost .and .are .often .delayed .by .more .than . hours?
i. 50 .,24

g. What .does .diagnostic .delays .make .more .difficult? .What .does .this .contribute .to . (2)?

i. The .implementation .of .early .therapy .- .contributing .to .disease .progression .and .mortality.

h. What .are .renal .insufficiency .patients .prone .to? .(4)

i. Hyperkalemia

ii. metabolic .acidosis

iii. Hyperphosphatemia

iv. Fluid .retention .which .may .cause .edema

i. What .may .you .see .with .those .in .cardiac .disease .r/t .renal .insufficiency?

i. Symptoms .of .congestive .heart .failure .develop .in .persons .with .cardiac .disease.
.Nausea, .vomiting, .and .fatigue .accompany .uremia .and .electrolyte .imbalances.
.Wound .healing .is .delayed, .and .the .risk .of .infection, .particularly .pneumonia, .is
.greater.

j. What .does .AKI .commonly .result .from?

i. extracellular .volume .depletion .and .decreased .renal .blood .flow

ii. toxic/inflammatory .injury .to .kidney .cells .that .result .in .alterations .in .renal .function .that
.may .be .minimal .or .severe




NURS .611 .ADVANCED .PATHOPHYSIOLOGY .EXAM .(WITH .VERIFIED .Q&A) .-100%
.PASS