Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nayla patho > 3- Renal > Flashcards

3- Renal Flashcards

1
Q

What is nephrotic syndrome

A

when systemic diseases (diabetes, SLE, amyloidosis) cause direct injury to BM of glomeruli, making it more permeable so molecules can leak out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In Nephrotic syndrome, what are your abnormal labs

A

Proteinuria (up to 3.5g/day exits plasma into urine)
Hypoalbuminemia (less in blood, more in urine)
Edema (low plasma oncotic pressure and active RAS lets fluid escape into tissues
Hyperlipidemia/Lipiduria (liver makes more lipoproteins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Nephritic syndrome

A

Inflammatory damage to glomerular capillaries, with leukocytes and necrosis of glomeruli (acute post-strep glomerulonephritis) –>chronic renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are symptoms of Nephritic syndrome

A 
hematuria, proteinuria, RBC casts in urine
low GFR
high BUN/Cr
oliguria
mild edema
HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can you tell the difference between Nephrotic and Nephritic syndrome

A

Renal biopsy! for definitive diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is membranous GMN

A

immune mediated thickening f BM due to massive immune complex deposits-
WITHOUT inflammatory cells in glomeruli, or RBC in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most common cause of Nephrotic syndrome in adults

A

Membranous glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does membranous GMN show on EM

A

Thick BM due to immune deposits (very granular on IF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you treat membranous GMN

A

With progressive renal failure: corticosteroids
Spontaneous remission: 25%
Persistent proteinuria with stable renal function: 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is minimal change disease

A

Nephrotic syndrome with the fusion of podocytes

No glomerular changes OR Ig deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the MCC of nephritic syndrome in kids

A

Minimal change disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you diagnose Minimal change disease

A

EM to see podocyte fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you treat Minimal change disease

A

8 weeks corticosteroid therapy (complete remission of proteinuria in most kids and adults)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do calcium stones present

A

Calcium is hyper excreted leading to abnormal calcium metabolism, hyperparathyroidism, bone disease, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a Struvite stone

A

made of magnesium ammonia phosphate as a complication of UTI (Proteus converts urea to ammonia) creating Staghorn calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a uric acid stone

A

radiolucent stone that occurs along with gout or leukemia (rapid cell turnover d/t cancer tx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a Cysteine stone

A

inborn error of amino acid metabolism

appears with cystinosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you diagnose and treat renal stones

A

Biopsy for definitive Dx

Most are in renal pelvis or bladder and can be voided if small. If larger, surgery or lithotripsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are symptoms of all renal stones

A

hematuria and urinary colic (spasmodic pain due to ureter obstruction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Majority of urinary tract neoplasms are

A

Renal cell carcinoma (adenocarcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is RCC associated with

A

Men 55 y/o, cigarette smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do RCC look like on biopsy

A

yellow, boscillated, encapsulated

+/- extending through renal castle into fat, adrenals, or renal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do RCC look like grossly

A

sharply demarcated masses from upper or lower pole of kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are symptoms of RCC

A 
Hematuria
Flank pain
palpable mass
(non-specifically, wt loss, fever, HTN) 
(rarely, polycythemia, hyperalcemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is a transitional cell carcinoma

A

papillary neoplasm of the renal pelvis that looks like bladder carcinoma
Has good prognosis if grade 1/2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are symptoms of transitional cell carcinoma

A

Hematuria, renal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the most common renal tumor in kids and infants

A

Wilm’s tumor, present at birth but doesn’t manifest until 2-4 y/o

28
Q

What does Wilm’s tumor look like

A

solitary or multi nodular, palpable abdominal mass

-If malignant, will be composed of blastic or immature cells

29
Q

What is the pathology of Acute post-strep GMN

A
  • Our body has an antibody response to strep antigens (1-2 wks s/p GABHS throat or skin infx) leading to immune complex deposits in BM
  • In BM, Ig activates complement and inflammatory cells (PMN/monocytes)
  • Inflam. mediators cause hypercellularity of glomerulus
  • Leads to nephritic syndrome
30
Q

Who does Acute post-strep GMN affect

A

Usu. 6-10 y/o but is uncommon in U.S. d/t abx

Most kids recover (1-2% develop rapidly progressive, crescentic GMN)

31
Q

What does acute post-strep GMN look like on IF

A

Granular deposits (IgG and complement)

32
Q

What is the “classic case” related to acute post-strep GMN

A

Kid abruptly develops malaise, fever, nausea, oliguria, and hematuria (coca cola) 1-2 weeks after recovering from sore throat
-He has RBC casts in urine, proteinuria, periorbital edema, and mild HTN (nephritic syndrome)

33
Q

What is Good Pasteur’s

A

AI disease w/ antibodies that form against body’s own BM (collagen type 4)

34
Q

What is the pathophys of Good Pasteur’s

A
  • In glomeruli, abs rupture the BM
  • Macrophages exit and build up in urinary space (form crescents)
  • Crescents compress capillary loops no there is no blood flow, no GFR, and anuria
35
Q

Do patients usually recover from Good Pasteur’s

A

No, they need dialysis of transplant

unlike Acute post-strep GMN which most kids recover from

36
Q

What is Adult PKD

A

Autosomal dominant condition in which body forms multiple serous or purulent cysts (larger) that destroy the entire parenchyma, bilaterally
-Cysts derived from obstructed tubules d/t atrophic lining in nephron

37
Q

What are early vs late signs of adult PKD

A
  • Early: dull, aching pain in abdomen or back (pressure of expanding cysts)
  • After rupture, hematuria
  • Long term, renal failure and HTN
38
Q

What is childhood PKD

A

Autosomal recessive disorder with enlarged bilateral kidneys that don’t function from birth
Cysts are in cortex and medulla causing renal failure after birth (smaller but plentiful)

39
Q

What is acute cystitis

A

When bacteria reach the urinary tract by ascending infection s/p sex, urinary cath, or surgery (usually no obvious cause)
W>M

40
Q

What are RF for acute cystitis

A 
Pregnancy (estrogen dilates the urethra and uterus)
DM
Immunosuppression
tumors
BPH
41
Q

What is pyelonephritis

A

Suppurative infection of kidneys with abscesses that can invade the kidney and fill the renal pelvis
Resolves on its own if healthy, but may need abx

42
Q

What do pyelonephritis cysts look like

A

round, yellow, raised abscesses on the renal surface surrounded by areas of congestion

43
Q

What usually causes pyelonephritis

A

E. coli (and many gram - rods)

Staph and strep are NOT common

44
Q

What are symptoms of pyelonephritis

A

sudden onset sharp pain in CVA, chills, fever, malaise

45
Q

What is the most common urinary tract neoplasm

A

Urinary bladder cancer (2x more common than RCC, but 1/2 the deaths!)

46
Q

What are RF for urinary bladder cancer

A

Male, 60-80 years old
SMOKING (proportionate to # smoked)
Industrial carcinogens (Azo dye, rubber, textile chemicals)
Schistosome eggs (Egypt)

47
Q

What is urinary bladder cancers

A

Tumor usually made of transitional cells that can extend into muscle or adjacent pelvic organs

48
Q

What are symptoms of urinary bladder cancer

A

hematuria, dysuria, lower abdominal pain

49
Q

What is the prognosis of urinary bladder cancer

A

Excellent if Stage 1 (98%) poor if Grade D (15%)
early mets go to pelvis lymph nodes first
Treat with surgical resection and chemotherapy

50
Q

What is horseshoe kidney

A

when the kidney fees at the midline during fetal development. Doesn’t cause a problem unless it obstructs renal flow

51
Q

What is the most common renal development disorder

A

Renal cystic dysplasia

52
Q

What is renal cystic dysplasia

A

Abnormal differentiation of renal structures during embryonic period
Unilateral
-Kidneys don’t function but NO association with malignancy

53
Q

What does renal cystic dysplasia look like histologically

A

tube like structures enclosed by mesenchyme
foci of cartilage
immature glomeruli and tubules

54
Q

What is renal papillary necrosis

A

complication of papillary necrosis seen in diabetics

-Ischemia and grey-white Necrosis at the tips of renal pyramids

55
Q

What is the #1 complication of renal papillary necrosis

A

Obstruction from a necrotic pyramid tip breaking off and lodging in ureter

56
Q

What is the hallmark of chronic pyelonephritis

A

Scarring in the pelvis or calyces causing papillary blunting

57
Q

What does chronic pyelonephritis look like histologically

A

Dilated glossy tubules that look like thyroid tissue (thyroidization)

58
Q

What is a common cause of acute renal failure

A

Acute tubular necrosis (s/p MI, cardiac arrest, or hypotensive shock)

59
Q

What is acute tubular necrosis

A

reduced renal blood flow in cortex and tubules

60
Q

What are Tamm Horsfall proteins

A

Proteins released by renal tubule cells that lodge in distal tubules and collecting ducts, due to acute tubular necrosis

61
Q

What is Kimmelstiel Wilson disease

A

Nodular glomerulosclerosis d/t diabetic neuropathy

62
Q

What renal changes occur in diabetics

A
  1. Vascular: thick walls and narrow vessels d/t hyaline in arteriole leading to ischemia and tubular atrophy
  2. Interstitial changes: kidneys prone to bacterial infections causing peel. If recurrent, destroys kidneys
63
Q

What is “lumpy bumpy” pattern

A

acute post-strep GMN and Membranous GMN

-It is due to Immune complexes that give the lumpy bumpy appearance on IF

64
Q

What is “linear” pattern

A

Good Pasteur’s has antibodies, but no immune complexes so it is more linear

65
Q

Where are urinary tract obstructions usually

A

Below the level of glomeruli

66
Q

What do all urinary tract obstructions usually lead to

A

ESRD

Nayla patho (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions