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2 - CPR (renal) > 20-5 (Vascular Diseases) > Flashcards

20-5 (Vascular Diseases) Flashcards

1
Q

What is Nephrosclerosis?

A

Sclerosis of renal arterioles and small arteries

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2
Q

Sclerosis of renal arterioles and small arteries

A

Nephrosclerosis

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3
Q

What is Nephrosclerosis strongly associated with?

– It can cause this or be a result of this –

A

Hypertension

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4
Q

What are the 2 steps in the pathogenesis of Nephrosclerosis?

A
  1. Medial and intimal thickening

2. Hyalinization of arteriolar walls

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5
Q

What are the 2 steps in the pathogenesis of Nephrosclerosis?

A
  1. Medial and intimal thickening

2. Hyalinization of arteriolar walls

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6
Q

With nephrosclerosis there are narrowed lumens of the vessels affected. What does that result in?

A

Ischemia and loss of renal mass

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7
Q

How do the kidneys look (size) with Nephrosclerosis and why?

A

Normal or small due to cortical scarring and shrinking

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8
Q

Why are kidneys small with nephrosclerosis?

A

Cortical scarring and shrinking

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9
Q

How does the surface of the kidneys look with nephrosclerosis?

A

Granular (grain leather)

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10
Q

What 3 populations of people are more at risk for renal failure from nephrosclerosis?

A

Blacks
Diabetics
HTN

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11
Q

How does Renal A. Stenosis cause HTN?

A

Increased renin production from the ischemic kidney

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12
Q

How does Renal A. Stenosis cause HTN?

A

Increased renin production from the ischemic kidney

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13
Q

The magnitude of the HTN from Renal A. Stenosis is proportional to the?

A

Narrowing

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14
Q

With Renal A. Stenosis, renin is released. What happens next and what is a possible treatment for resulting HTN?

A

Renin –> Angiotensin 2 –> vasoconstriction

– Treatment = block angiotensin 2

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15
Q

In males with Renal A. Stenosis, what is the most common cause?

A

Narrowing due to atheromatous plaque

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16
Q

In females with Renal A. Stenosis, what is the most common cause?

A

Fibromuscular Dysplasia (medial type)

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17
Q

How does Fibromuscular Dysplasia look?

A

String of beads – alternating narrow and wide areas

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18
Q

With renal a. stenosis, you need an arteriography to localize the lesion. What is a possible sound that can be heard on auscultation of the renal arteries?

A

Bruit

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19
Q

Thrombotic Microangiopathies are syndromes that lead to ___ in many places including the kidney

A

Thrombi

20
Q

What are 2 Thrombotic Microangiopathies?

A

Hemolytic Uremic Syndrome

Thrombotic Thrombocytopenic Purpura

21
Q

Typical HUS is acquired how?

A

Ingesting food that is contaminated with certain bacteria that produce shiga-like toxin

22
Q

Which bacteria are commonly to blame for Typical HUS?

A

E.coli strain 0157 that produces shiga-like toxin

23
Q

What populations are usually affected by Typical HUS?

A

Children or elderly

24
Q

Describe the symptoms seen with Typical HUS

A
  • Diarrheal symptoms
  • Sudden onset of GI bleeding symptoms
  • Oliguria and possibly HTN
25
Q

Describe the symptoms seen with Typical HUS

A
  • Diarrheal symptoms
  • Sudden onset of GI bleeding symptoms
  • Oliguria and possibly HTN
26
Q

What can restore the renal function lost with Typical HUS?

A

Dialysis

27
Q

Atypical HUS is usually due to?

A

Inherited genetic abnormalities/autoantibodies

28
Q

Atypical HUS involves dysregulation of the _____

A

Complement system

29
Q

Atypical HUS can involves deficiencies in complement proteins like?

A

Factor H, Factor I, CD46

30
Q

Atypical HUS can involve deficiencies in complement proteins that normally do what?

A

(-) activation of the complement

== Without them the complement is activated too much

31
Q

What is the main pathogenesis mechanism for HUS?

A

Endothelial activation

32
Q

What is the main pathogenesis mechanism for TTP?

A

Platelet aggregation

33
Q

Things like antiphospholipid syndrome, post-partum renal failure, kidney vascular diseases, certain drugs and irradiation can all cause acquired autoantibodies and thus?

A

Atypical HUS

34
Q

TTP is usually due to

A

Acquired autoantibodies

35
Q

What deficiency is present with TTP?

A

ADAMTS13

36
Q

What is the job of ADAMTS13?

A

Cleaves long multimers of vWF

37
Q

TTP involves an ADAMTS13 deficiency and thus long multimers of vWF arise. What is the pentad of symptoms in younger patients < 40?

A
  1. Fever
  2. Neuro sx
  3. Microangiopathic hemolytic anemia
  4. Thrombocytopenia
  5. Renal failure
38
Q

What are the pentad of symptoms with TTP?

A
  1. Fever
  2. Neuro sx
  3. Microangiopathic hemolytic anemia
  4. Thrombocytopenia
  5. Renal failure
39
Q

What is the treatment for TTP?

A

Plasma exchange to remove autoantibodies and give ADAMTS13

40
Q

Where is the necrosis seen with the thrombotic microangiopathies?

A

Cortical necrosis

41
Q

What causes Atheroembolic Renal Disease?

A

Embolization of fragments of atheromatous plaques from the aorta/renal arteries –> intrarenal vessels

42
Q

In what patients is Atheroembolic Renal Disease usually seen?

A

Older patients with severe atherosclerosis after surgery on the aorta

43
Q

What are the (3) symptoms of Sickle Cell Nephropathy?

A

Hematuria
Diminished concentrating of urine
Patchy papillary necrosis

44
Q

What are the (3) symptoms of Sickle Cell Nephropathy?

A

Hematuria
Diminished concentrating of urine
Patchy papillary necrosis

45
Q

What are the (3) symptoms of Sickle Cell Nephropathy?

A

Hematuria
Diminished concentrating of urine
Patchy papillary necrosis

2 - CPR (renal) (27 decks)

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