MSN 570 Advanced Pathophysiology
Exam Questions and Answers
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
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.
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