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ANURBF LEC > [2] LESSON 7: RENAL DISEASES > Flashcards

[2] LESSON 7: RENAL DISEASES Flashcards

1
Q

Kidney diseases are often classified into three types based on the morphologic component initially affected and susceptibility to disease varies with each other:

A

(1) Glomerular, (2) Tubular, and (3) Tubulointerstitial

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2
Q

: immune complex formation and deposition

A

Immunologic

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3
Q

: exposure to chemicals, toxins and amyloid materials

A

Non-immunologic

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4
Q

Deposition of immune complexes formed in response to Group A Streptococcal infection

A

Acute PostStreptococcal Glomerulonephritis

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5
Q

Marked by the sudden onset of symptoms consistent with glomerular membrane damage

A

Acute PostStreptococcal Glomerulonephritis

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6
Q

Signs and symptoms: edema, fever, fatigue, hypertension

A

Acute PostStreptococcal Glomerulonephritis

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7
Q

Urinalysis: gross hematuria, proteinuria, RBC casts, dysmorphic RBCs, hyaline and granular casts, WBC

A

Acute PostStreptococcal Glomerulonephritis

Rapidly Progressive/Crescentic Glomerulonephritis

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8
Q

Additional lab findings: increase BUN and ASO titer

A

Acute PostStreptococcal Glomerulonephritis

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9
Q

More serious form of acute glomerular disease that involves deposition of immune complexes from systemic immune disorders

A

Rapidly Progressive/Crescentic Glomerulonephritis

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10
Q

Damaged glomeruli allow release of cells and fibrin into the Bowman’s capsule leading to pressure changes

A

Rapidly Progressive/Crescentic Glomerulonephritis

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11
Q

Urinalysis: gross hematuria, proteinuria, RBC casts, dysmorphic RBCs, hyaline and granular casts, WBC

A

Acute PostStreptococcal Glomerulonephritis

Rapidly Progressive/Crescentic Glomerulonephritis

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12
Q

(+) Antiglomerular Basement Membrane Ab

A

Goodpasteur Syndrome

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13
Q

May lead to chronic glomerulonephritis and end-stage renal disease

A

Goodpasteur Syndrome

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14
Q

Signs and symptoms: hemoptysis and dyspnea

A

Goodpasteur Syndrome

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15
Q

(+) Antineutrophilic Cytoplasmic Antibody (ANCA) that targets neutrophils in the vascular walls initiating immune response and granuloma formation in the lungs and kidneys

A

Wegener’s Granulomatosis

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16
Q

Other lab findings:

increase serum BUN and creatinine

A

Wegener’s Granulomatosis

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17
Q

Allergic purpura that causes decrease in the number of platelets and affects vascular integrity

A

Henoch Schonlein Purpura

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18
Q

Signs and symptoms: red skin patches, blood in sputum and stool

A

HenochSchonlein Purpura

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19
Q

Urinalysis: proteinuria, hematuria, RBC casts

A

Goodpasteur Syndrome

Wegener’s Granulomatosis

HenochSchonlein Purpura

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20
Q

Involves IgG deposition on the glomerular membrane leading to pronounced thickening

A

Membranous Glomerulonephritis

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21
Q

Seen in SLE, Sjogren’s syndrome, secondary syphilis and hepatitis B infection

A

Membranous Glomerulonephritis

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22
Q

Urinalysis: hematuria and proteinuria

A

Membranous Glomerulonephritis

Membranoproliferative Glomerulonephritis

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23
Q

Cellular proliferation affecting capillary walls or the glomerular basement membrane

A

Membranoproliferative Glomerulonephritis

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24
Q

Other lab findings: decreased serum complement

A

Membranoproliferative Glomerulonephritis

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25
Q

Gradual worsening of symptoms leading to loss of kidney function

A

Chronic Glomerulonephritis

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26
Q

Signs and symptoms: fatigue, anemia, hypertension, edema and oliguria

A

Chronic Glomerulonephritis

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27
Q

Urinalysis: hematuria, proteinuria, glucosuria, isosthenuria and many casts

A

Chronic Glomerulonephritis

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28
Q

Other lab findings: increased BUN and creatinine, electrolyte imbalance

A

Chronic Glomerulonephritis

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29
Q

igA deposition on the glomerular membrane leading to thickening

A

IgA nephropathy/Berger’s Disease

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30
Q

most common cause of glomerulonephritis

A

IgA nephropathy/Berger’s Disease

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31
Q

Involves membrane damage and changes in the electrical charges of the basement membrane leading to the passage of high molecular weight proteins and lipids into the urine

A

Nephrotic Syndrome

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32
Q

Loss of albumin causes decrease in capillary oncotic pressure and edema

A

Nephrotic Syndrome

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33
Q

Urinalysis: massive proteinuria (>3.5 g/day), lipiduria (fat droplets, oval fat bodies, fatty and waxy casts), hematuria

A

Nephrotic Syndrome

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34
Q

Other lab findings: decreased serum albumin, increased serum lipids

A

Nephrotic Syndrome

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35
Q

Acute onset may occur as a result of circulatory disruption causing systemic shock and decrease in blood pressure

A

Nephrotic Syndrome

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36
Q

Urinalysis: hematuria

A

Alport Syndrome

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37
Q

Inherited disease that affects the glomerular basement membrane (lamellated appearance with areas of thinning)

A

Alport Syndrome

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38
Q

Disruption of podocytes occurring primarily in children following allergic reactions and immunizations

A

Minimal Change Disease

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39
Q

Associated with heroin and analgesic abuse, and AIDS

A

Focal Segmental Glomerulosclerosis

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40
Q

Disruption of the podocytes in certain areas of the glomerulus

A

Focal Segmental Glomerulosclerosis

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41
Q

Most common cause of end-stage renal disease

A

Diabetic Nephropathy/Kimmelstiel-Wilson

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42
Q

Glomerular damage may be due capillary thickening, increase proliferation of the mesangial cells, increase deposition of cellular and non-cellular materials

A

Diabetic Nephropathy/Kimmelstiel-Wilson

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43
Q

Most common cause of end-stage renal disease

A
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44
Q

A. GLOMERULAR DISEASE

A
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45
Q

B. TUBULAR DISEASES

A
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46
Q

C. TUBULOINTERSTITIAL DISEASES

A
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47
Q

D. OTHER RENAL DISORDERS

A
48
Q

 May be due to actual tubule damage, and metabolic or hereditary disorders

A

TUBULAR DISEASES

49
Q

 Damage to the renal tubular epithelial cells due to ischemia and nephrotoxic agents

A

Acute Tubular Necrosis

50
Q

 Urinalysis: hematuria, RTE cells, RTE casts, other casts

A

Acute Tubular Necrosis

51
Q

Failure of tubular reabsorption in the PCT (glucose, amino acids, phosphorus, sodium, potassium, bicarbonate and water)

A

Fanconi’s Syndrome

52
Q

 Urinalysis: glycosuria, possible mild proteinuria

A

Fanconi’s Syndrome

53
Q

Inherited defect of tubular response to ADH or acquired from medications

A

Nephrogenic Diabetes Insipidus

54
Q

Disorders affecting the interstitium also affects the tubules due to their close proximity

A

TUBULOINTERSTITIAL DISEASES

55
Q

Majority of these disorders involve infections and inflammatory conditions

A

TUBULOINTERSTITIAL DISEASES

56
Q

 Most common renal disease that involves the lower urinary tract (urethra and bladder) or the upper urinary tract (renal pelvis, tubules and interstitium)

A

Urinary Tract Infection

57
Q

 Signs include frequent and burning urination

A

Urinary Tract Infection

58
Q

 Bacterial culture performed to determine the causative agent

A

Urinary Tract Infection

59
Q

: most frequently encountered infection that may ascend to the upper urinary tract

A

Cystitis

60
Q

: affects the renal tubules and interstitium

A

Pyelonephritis

61
Q

Urinalysis: WBC, bacteria, mild proteinuria, microscopic hematuria and increased pH

A

Cystitis

62
Q

Allergic inflammation of the renal interstitium in response to certain medications

A

Acute Interstitial Nephritis

63
Q

Formation of stones in the renal calyces, renal pelvis, ureters and bladder

A

Renal Calculi/Lithiasis

64
Q

May be passed in the urine and obstruct the urinary tract

A

Renal Calculi/Lithiasis

65
Q

: may be due to metabolic disorders or diet

A

Calcium oxalate/phosphate (~75%)

66
Q

: frequently accompanied by UTI involving urea-splitting bacteria

A

Magnesium ammonium phosphate

67
Q

: associated with increased intake of foods with high purine content

A

Uric acid

68
Q

: seen in conjunction with hereditary disorders of cysteine metabolism

A

Cystine

69
Q

Removal: surgery or high-energy shock waves

A

Primary Calculi Constituents

70
Q

May be acute or chronic

A

Renal Failure

71
Q

Chronic form may result from the gradual progression of original disorder which eventually leads to end-stage renal disease

A

Renal Failure

72
Q

Renal Failure

Progression to end-stage renal disease is characterized by:
 Marked decrease in GFR (?)
 Steadily rising azotemia (?)
 (?) imbalance
 (?) urine
 Proteinuria
 Renal (?)
 Telescoped (?)

A

<25 ml/min

BUN and creatinine

Electrolyte

Isosthenuric

glycosuria

sediment

73
Q

infection of the renal tubules and tissue

A
74
Q

inability to respond to ADH

A
75
Q

granulomatosis with (+)ANCA

A
76
Q

most common cause of glomerulonephritis

A
77
Q

most common UTI

A
78
Q

marked decrease in GFR & isosthenuria

A
79
Q

lamellated glomerular basement membrane

A
80
Q

autoimmune disorder causing pronounced glomerular membrane thickening

A
81
Q

aka rapidly progressive glomerulonephritis

A
82
Q

streptococcus that may cause glomerulonephritis sequelae

A
83
Q

hallmark urine sediment in glomerulonephritis

A
84
Q

(+)antiglomerular basement membrane antibody

A
85
Q

characterized by lipiduria

A
86
Q

inherited disorder of the renal tubules

A
87
Q

cell to which ANCA is directed

A
88
Q

A patient who tested positive for HIV exhibits mild symptoms resembling the nephrotic syndrome.

A
89
Q

A 40-year-old patient diagnosed with SLE develops macroscopic hematuria, proteinuria, and the presence of RBC casts in the urine sediment.

A
90
Q

A 50-year-old patient diagnosed with SLE exhibits symptoms of gradually declining renal function and increasing proteinuria.

A
91
Q

A patient who has taken outdated tetracycline develops glycosuria and a generalized aminoaciduria.

A
92
Q

A patient known to form renal calculi develops oliguria, edema and azotemia.

A
93
Q

A patient has a normal blood glucose and glucosuria (2 disorders)

A
94
Q

A 6-year-old boy with respiratory syncytial virus has macroscopic hematuria.

A
95
Q

A patient with severe lower back pain and microscopic hematuria is scheduled for lithotripsy.

A
96
Q

The patient positive for ANCA exhibits pulmonary and renal symptoms.

A
97
Q

POINTS to PONDER…..
A 22-year-old female BMLS student performs a urinalysis on her own urine as part of a lab class. Significant results include: Color: yellow Appearance: Cloudy pH: 7.5 Nitrite: positive Leukocyte esterase: 2+ 20-40 WBC/hpf 0-3 RBC/hpf 2-5 squamous epithelial cell/lpf Moderate bacteria All other results were normal. What do these findings suggest? Is/Are there any of these results which is/are not consistent with the others? Why do you say so?

A
98
Q

The term [?] describes a series of screening tests that are capable of detecting a variety of renal, urinary tract, and systemic diseases.

A

“routine urinalysis”

99
Q

Urine specimen has been referred to as a [?] of the urinary tract, which is painlessly obtained. It also yields a great deal of information quickly and economically.

A

liquid tissue biopsy

100
Q

Disorders in the body can affects renal function considering that the major function of the kidney is filtration of the blood to remove waste products.

A
101
Q

The kidneys are consistently exposed to potentially damaging substances.

A
102
Q

Renal disorders are classified according to the anatomical structures affected. These can be glomerular, tubular or tubulointerstitial in nature.

A
103
Q

Glomerular disorders may present as nephritic or nephrotic syndromes.

A
104
Q

The hallmarks of nephritic glomerular disorders are grossly visible hematuria and mild to moderate proteinuria.

A
105
Q

They may be immune or non-immune mediated.

A
106
Q

Nephrotic glomerular disorders on the other presents with heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia leading to hyperlipiduria.

A
107
Q

Examples of nephritic disorders include acute proststreptococcal glomerulonephritis, rapidly progressive glomerulonephritis, Goodpasteur syndrome, Wegener’s granulomatosis, membranous glomerulonephritis, membranoproliferative glomerulomephritis, Berger’s disease and chronic glomerulonephritis.

A
108
Q

Tubular disorders are those that primarily affects the renal tubules resulting to dysnfunctional reabsorption of substances. These include acute tubular necrosis, Fanconi syndrome and nephrogenic diabetes insipidus.

A
109
Q

Tubulointerstitial disorders initially affects the renal interstitium and progresses to cause tubular damage. These disorders are often caused by infection such as urinary tract infection or inflammation such as acute interstitial nephritis.

A
110
Q

Other disorders of the urinary system include the formation of calculi or lithiasis in the kidneys (pelvis and calyces), ureters and bladder.

A
111
Q

Calculi formation is brought about by the precipitation of urine crystals, the most common of which is calcium oxalate or calcium phosphate.

A
112
Q

Renal failure often results from the gradual progression of another disorder which may eventually lead to end-stage renal disease.

A
113
Q

which is cytotoxic to collagen leading to complement activation and capillary destruction

A

(+) Antiglomerular Basement Membrane Ab

114
Q

targets neutrophils in the vascular walls initiating immune response and granuloma formation in the lungs and kidneys

A

(+) Antineutrophilic Cytoplasmic Antibody (ANCA)

115
Q

Acute onset may occur as a result of circulatory disruption causing systemic shock and decrease in blood pressure

A

Nephrotic syndrome

ANURBF LEC (9 decks)

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