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MHD V: Renal > 10.27: Renal I > Flashcards

10.27: Renal I Flashcards

1
Q

2 main categories of kidney disease?

A
  1. NephrOTIC: proteinuria > 3-3.5g/day

2. NephrITIC: hematuria

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2
Q

Which form of kidney disease is hematuria a hallmark of?

A

Nephritic

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3
Q

What is frothy urine characteristic of?

A

Proteinuria (nephrotic syndrome)

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4
Q

Some causes of hematuria?

A
  1. Glomerulonephritis
  2. Carcinoma
  3. Trauma
  4. Infarct
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5
Q

Characteristics of nephritic syndrome?

A
  1. Hematuria w/ dysmorphic cells and RBC casts
  2. Some degree of oliguria and azotemia
  3. Htn.
  4. Active urinary sediment
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6
Q

What does active urinary sediment mean?

A

Dysmorphic RBCs or RBC casts in urine

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7
Q

What is acute postinfectious glomerulonephritis? presentation?

A 
- Usually presents in children
"Acute nephritic syndrome"
1. Hematuria
2. Edema
3. Htn. 
4. Renal failure
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8
Q

Normal cause for acute postinfectious glomerulonephritis? and pathology?

A
  • 1 - 4 weeks post pharyngitis from group A Beta hemolytic strep
  • These bacteria have M protein virulence factor
  • Antigen + IgG immune complexes deposit in renal capillaries activating complement C5a
  • Neutrophils are attracted causing damage
  • Damage to tissue allows RBCs to pass through leading to hematuria
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9
Q

What characteristic of immune complex is unique to postinfectious glomerulonephritis?

A
  • In situ formation of immune complex leading to subepithelial “humps”
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10
Q

What is subepithelial humps of immune complex characteristic of?

A

Post infectious glomerulonephritis

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11
Q

What are trilobed cells?

A

Usually neutrophils

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12
Q

Laboratory tests indicative of post infectious glom.?

A
  1. Tea color, smoke, coca cola urine
  2. Hematuria w/ mild proteinuria
  3. Increased ASO titer (antistrep)
  4. Decreased complement levels
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13
Q

Prognosis in acute postinfectious glomerulonephritis?

A
  1. 95% recover in children
  2. Adults can become chronic glomerulonephritis
  3. Small subset of children with gross hematuria can develop severe acute syndrome with renal failure
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14
Q

When is renal biopsy needed in acute post infectious glom.?

A
  • Only if the course is a typical

- Not if the course is typical

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15
Q

What is the main Ig in the body?

A
  • IgG

- IgA is main Ig in secretions and mucosal immunity

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16
Q

What is Berger Disease?

A

IgA nephropathy

17
Q

Clinical presentation of IgA nephropathy?

A
  • RECURRENT hematuria
  • PAINLESS
  • Sometimes after upper respiratory tract infection
  • Last for days recurring every few months
18
Q

What is recurrent, painless hematuria characteristic of?

A

IgA nephropathy

19
Q

Pathogenisis of IgA nephropathy?

A
  • Mucosal infection leading to IgA production

- IgA immune complex deposits in mesangium

20
Q

How do complement levels present in IgA nephropathy?

A
  • IgA actives complex system at slow rate so we do not see drop
  • Drop in immune complex levels are seen in post infectious
21
Q

What is hematuria with normal complement levels characteristic of?

A

IgA nephropathy

22
Q

What is necessary for definitive diagnosis in IgA Nephropathy?

A

Kidney needle biopsy

23
Q

What is hereditary nephritis?

A
  • Mutations in glomerular basement membrane proteins
  • Often in collagen type IV
  • Alport syndrome is best known type
24
Q

Where is type IV collagen found?

A
  1. Glomerular basement membrane
  2. Eyes
  3. Ears
25
Q

Triad of symptoms in alport syndrome?

A
  1. Nephritis
  2. Nerve deafness: hearing abnormalities
  3. Eye disorders such as early cataracts
26
Q

What is Alport syndrome?

A
  • Most common form of hereditary nephritis
  • X linked
  • Triad of symptoms
27
Q

What is lamina densa splitting and basket weave lamination characteristic of?

A
  • Hereditary nephritis

- Alport syndrome

28
Q

Prognosis of hereditary nephritis?

A
  • Kidney failure at 2 - 50 years of age

- Genetic testing needed for diagnosis

29
Q

What is atypical postinfectious glomerulonephritis?

A
  • Normally we would see pharyngitis 2 weeks before

- In “A typical” this is not the case

MHD V: Renal (28 decks)

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