ADVANCED PATHO 611 EXAM 4
QUESTIONS & CORRECT ANSWERS
Urinary Tract Infections - correct answer ✔✔clinical manifestations of these in older adults are
confusion and poorly localized abdominal discomfort. Can be difficult to diagnoses d/t vague
symptoms
RAAS, (Renin-angiotensin-aldosterone system) - correct answer ✔✔Is activated by the reduced
perfusion (kidneys require at least 20-25% cardiac output - MAP) of the affected kidney and
activates this ___, which causes constriction of peripheral arterioles.
Calcium oxalate - correct answer ✔✔The most common type of renal stone
Passage of kidney stones - correct answer ✔✔Can be extremely painful and may produce
"referred pain" to the umbilicus area.
the 10th thoracic nerve roots - correct answer ✔✔pain from the passage of kidney stones is d/t
the sensory innervation of the upper part of the ureter arising from this area.
Pyelonephritis - correct answer ✔✔an infection of one or both upper urinary tracts (ureter,
renal pelvis, and kidney interstitium)
Vesicoureteral reflux - correct answer ✔✔reflux of urine from the bladder
pyelonephritis - correct answer ✔✔urinary obstruction and Vesicoureteral reflux are the most
common risk factors for this ___
,E.Coli, Proteus, or Pseudomonas - correct answer ✔✔organisms usually associated with acute
pyelonephritis. These microorganisms split urea into ammonia, making alkaline urine that
increases the risk of stone formation
Painful bladder syndrome/ interstitial cystitis (PBS/IC) - correct answer ✔✔a condition that
includes nonbacterial infectious cystitis (viral, mycobacterial, chlamydial, fungal) and
noninfectious cystitis (radiation, chemical, autoimmune, hypersensitivity)
Differentiating between cystitis and pyelonephritis - correct answer ✔✔done by urine culture,
urinalysis, and clinical signs and symptoms.
Urge Incontinence (most common in older adults) - correct answer ✔✔involuntary loss of urine
associated with an abrupt and strong desire to void. Often associated with involuntary
contractions of the detrusor. May be associated with decreased bladder wall compliance.
Stress incontinence (most common in women younger than 60 years and men who have had
prostate surgery) - correct answer ✔✔involuntary loss of urine during coughing, sneezing,
laughing, or other physical activity associated with increased abdominal pressure.
Overflow incontinence - correct answer ✔✔involuntary loss of urine with overdistention of the
bladder. Associated with neurologic lesions below S1, polyneuropathies, and urethral
obstruction (i.e. enlarged prostate)
Functional incontinence - correct answer ✔✔involuntary loss of urine caused by dementia or
immobility
Glomerular disorder - correct answer ✔✔reduced GFR during this disorder is evidenced by
elevated plasma urea, creatinine concentration, or reduced renal creatinine clearance.
, Acute glomerulonephritis - correct answer ✔✔includes renal diseases in which glomerular
inflammation is caused by immune mechanisms that damage the glomerular capillary filtration
membrane including the endothelium, basement membrane, and epithelium (podocytes).
Signs and symptoms of acute glomerulonephritis - correct answer ✔✔sudden onset of
hematuria, including red blood cell casts and proteinuria (milder than nephrotic syndrome). if
more severe s/sx include edema, HTN, and impaired renal function.
Nephrotic syndrome - correct answer ✔✔the excretion of 3.0 g of more of protein in the urine
per day (Massive proteinuria) and peripheral edema. It is characteristic of glomerular injury.
Primary cause of nephrotic syndrome - correct answer ✔✔include minimal change disease
(lipoid nephrosis) membranous glomerulonephritis, and focal segmental glomerulonephrosis
Secondary forms of nephrotic syndrome - correct answer ✔✔occur in systemic diseases
including DM, amyloidosis, and systemic lupus erythematous. Also seen with certain drugs,
infections, malignancies, and vascular disorders
Acute kidney injury - correct answer ✔✔may be acute and rapidly progressive (within hours)
and the process may be reversible.
Renal insufficiency - correct answer ✔✔refers to the decline in renal function to about 25% of
normal or a GFR of 25 to 30 ml/min. Levels of serum creatinine and urea are mildly elevated,
occurring when more than 50% of glomerular filtration is lost and are often delayed by more
than 24 hours.
Oliguria mechanisms - correct answer ✔✔alterations in renal blood flow and tubular
obstruction
QUESTIONS & CORRECT ANSWERS
Urinary Tract Infections - correct answer ✔✔clinical manifestations of these in older adults are
confusion and poorly localized abdominal discomfort. Can be difficult to diagnoses d/t vague
symptoms
RAAS, (Renin-angiotensin-aldosterone system) - correct answer ✔✔Is activated by the reduced
perfusion (kidneys require at least 20-25% cardiac output - MAP) of the affected kidney and
activates this ___, which causes constriction of peripheral arterioles.
Calcium oxalate - correct answer ✔✔The most common type of renal stone
Passage of kidney stones - correct answer ✔✔Can be extremely painful and may produce
"referred pain" to the umbilicus area.
the 10th thoracic nerve roots - correct answer ✔✔pain from the passage of kidney stones is d/t
the sensory innervation of the upper part of the ureter arising from this area.
Pyelonephritis - correct answer ✔✔an infection of one or both upper urinary tracts (ureter,
renal pelvis, and kidney interstitium)
Vesicoureteral reflux - correct answer ✔✔reflux of urine from the bladder
pyelonephritis - correct answer ✔✔urinary obstruction and Vesicoureteral reflux are the most
common risk factors for this ___
,E.Coli, Proteus, or Pseudomonas - correct answer ✔✔organisms usually associated with acute
pyelonephritis. These microorganisms split urea into ammonia, making alkaline urine that
increases the risk of stone formation
Painful bladder syndrome/ interstitial cystitis (PBS/IC) - correct answer ✔✔a condition that
includes nonbacterial infectious cystitis (viral, mycobacterial, chlamydial, fungal) and
noninfectious cystitis (radiation, chemical, autoimmune, hypersensitivity)
Differentiating between cystitis and pyelonephritis - correct answer ✔✔done by urine culture,
urinalysis, and clinical signs and symptoms.
Urge Incontinence (most common in older adults) - correct answer ✔✔involuntary loss of urine
associated with an abrupt and strong desire to void. Often associated with involuntary
contractions of the detrusor. May be associated with decreased bladder wall compliance.
Stress incontinence (most common in women younger than 60 years and men who have had
prostate surgery) - correct answer ✔✔involuntary loss of urine during coughing, sneezing,
laughing, or other physical activity associated with increased abdominal pressure.
Overflow incontinence - correct answer ✔✔involuntary loss of urine with overdistention of the
bladder. Associated with neurologic lesions below S1, polyneuropathies, and urethral
obstruction (i.e. enlarged prostate)
Functional incontinence - correct answer ✔✔involuntary loss of urine caused by dementia or
immobility
Glomerular disorder - correct answer ✔✔reduced GFR during this disorder is evidenced by
elevated plasma urea, creatinine concentration, or reduced renal creatinine clearance.
, Acute glomerulonephritis - correct answer ✔✔includes renal diseases in which glomerular
inflammation is caused by immune mechanisms that damage the glomerular capillary filtration
membrane including the endothelium, basement membrane, and epithelium (podocytes).
Signs and symptoms of acute glomerulonephritis - correct answer ✔✔sudden onset of
hematuria, including red blood cell casts and proteinuria (milder than nephrotic syndrome). if
more severe s/sx include edema, HTN, and impaired renal function.
Nephrotic syndrome - correct answer ✔✔the excretion of 3.0 g of more of protein in the urine
per day (Massive proteinuria) and peripheral edema. It is characteristic of glomerular injury.
Primary cause of nephrotic syndrome - correct answer ✔✔include minimal change disease
(lipoid nephrosis) membranous glomerulonephritis, and focal segmental glomerulonephrosis
Secondary forms of nephrotic syndrome - correct answer ✔✔occur in systemic diseases
including DM, amyloidosis, and systemic lupus erythematous. Also seen with certain drugs,
infections, malignancies, and vascular disorders
Acute kidney injury - correct answer ✔✔may be acute and rapidly progressive (within hours)
and the process may be reversible.
Renal insufficiency - correct answer ✔✔refers to the decline in renal function to about 25% of
normal or a GFR of 25 to 30 ml/min. Levels of serum creatinine and urea are mildly elevated,
occurring when more than 50% of glomerular filtration is lost and are often delayed by more
than 24 hours.
Oliguria mechanisms - correct answer ✔✔alterations in renal blood flow and tubular
obstruction
