Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Senior - GU Test 1 > 7 - Glomerular Diseases > Flashcards

7 - Glomerular Diseases Flashcards

1
Q

Oliguria

A

Urine output <400 mL/day

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

Azotemia

A

Buildup of nitrogenous waste in blood, secondary to decreased renal function

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

Crescents

A

Proliferation of cells w/in bowmans capsule

  • response to glomerular rupture
  • marker of severe glomerular injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Oval fat bodies

A

Sloughed tubular epithelial cells that have reabsorbed some of the excess lipoproteins in the urine

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

Abnormalities of glomerular function cause damage to?

A

The major components of the glomerulus

  • epithelium (podocytes)
  • basement membrane
  • capillary endothelium
  • messangial cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is glomerular disease diagnosed?

A

Visualization of specific histologic patterns on biopsy

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

Glomerular disease classifications?

A

Nephritic syndrome

Nephrotic syndrome

They usually exhibit primarily nephritic or nephrotic but there is some overlap

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

Nephritic findings

A 
Ne phritic 
• Hematuria ± RBC casts 
• Mild proteinuria 
• ↓ GFR 
• Edema 
• HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nephrotic findings

A 
Nephrotic 
• Heavy proteinuria (>3.5
g/24h) 
• Hypoalbuminemia 
• Marked Edema 
• HLP (lipiduria)

Sweet pic on slide 9

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

Slide 10

A

Look at it

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

Nephrotic vs nephritic onset?

A

Nephrotic: insidious

Nephritic: acute

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

UA findings for nephrotic vs nephritic?

A

Nephrotic: proteinuria

Nephritic: hematuria; RBC casts

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

Edema w nephrotic and nephritic?

A

Nephrotic: ++++

Nephritic: ++

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

arterial BP and Central venous pressure for nephrotic vs nephritic?

A
  • Nephrotic: normal

- nephritic: increased

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

Nephritic specturm disorders range from?

A

Glomerular hematuria —> rapidly progressive glomerulonephritis (RPGN)

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

Where on the spectrum does nephritic syndrome land?

A

Somewhere in the middle

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

Nephritic syndrome is aka?

A

Acute glomerulonephtitis

Nephritis syndrome

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

Nephritic syndrome causes ___ of the glomeruli

A

Inflammation

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

Inflammatory response of nephritic syndrome is caused by?

A
  • due to immune response triggered by infection of other diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Essentials of diagnosis for nephritic syndrome

A 
Essentials of diagnosis
– Hematuria ± red cell casts
–Edema
–Hypertension (may be normotensive initially) 
–Subnephrotic Proteinuria (< 3 g/day) 
–↑ serum creatinine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

S/s of nephritic syndrome?

A

Dark, “cola colored” urine
• ± ↓ urine volume (oliguria)

Edema in regions of low tissue pressure
• Periorbital
• Scrotum

HTN, if present, is due to volume overload
• Due to ↓ GFR
• Check for JVD & adventitious lung sounds

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

Lab testing for nephritic syndrome?

A 
Testing:
– BUN, Creatinine, GFR
– UA:
    • Dark, “cola” colored • Hematuria:
– Dysmorphic RBCs
– RBC casts 
    • Subnephrotic proteinuria
– Renal biopsy
    • To definitively establish underlying cause
    • Not always necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

With nephritic syndrome you should also order?

A

Miscellaneous serologic markers based on presentation:

– Complement levels 
– Antinuclear antibodies (ANA) 
– Cryoglobulins 
– Hepatitis serologies 
– ANCA (antineutrophil cytoplasmic antibodies) 
– Anti-glomerular basement membrane (GBM) antibodies 
– Anti-streptolysin O (ASO) titers 
– C3 nephritic factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Nephritic UA and metabolic syndrome?

A

Slide 18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Goal of tx for nephritic syndrome?
Reduce the glomerular inflammation
26
Nephrtic syndrome treatment?
``` Admit - usually Nephrology referral Monitor - renal function - BP - edema - serum albumin - urine protein HTN and fluid overload reduction Corticosteroids ```
27
Nephritic syndrome prognosis?
Kids do better than adults
28
IgA nephropathy is aka?
Berger disease
29
IgA nephropathy is?
IgA deposition in the glomerular mesangium MC form of nephritic syndrome
30
MC pax for berger?
Most Common: young males >> females Common: Asians
31
MC presentation of IgA nephropathy?
Painless gross hematuria May present at any point on the nephritic spectrum - MC less sever end of spectrum
32
With IgA you need to look for?
URI | - freq associated w current URI “synpharyngitic hematuria”
33
IgA nephropathy labs?
Renal - UA - BUN - Cr - GFR Serum IgA - elevated
34
Confirm IgA nephropathy diagnosis?
Renal biopsy - Focal glomerulonephritis w/ diffuse mesangial IgA deposits & mesangial cell proliferation – Not always indicated
35
Tx of IgA nephroptathy?
ACE/ARB - target BP <125/75 Corticosteroids - if proteinuria persists > 3-6 mo REFERRAL to nephrology
36
ACE and ARB are titrated to? (IgA nephropathy)
Proteinuria < 1g/day
37
Most unfavorable prognostic indicator (IgA nephropathy)
Proteinuria > 1g/day
38
Postinfectious glomerulonephritis is due to?
Infection w - group A Beta-hemolytic streptocci - 7-10 days after pharyngitis/impetigo - get a good hx
39
S/s of postinfectious glomerulonephritis?
- coffee/cola urine - oliguria - edema - HTN (varies)
40
Labs for postinfectious glomerulonephritis?
``` – UA: • Urinary RBCs, red cell casts • Mild proteinuria – Throat culture – ASO titers may be elevated • May be WNL due to antibiotic treatment ```
41
postinfectious glomerulonephritis tx?
- tx infection - supportive - bed rest - anti-hypertension - diuretics (PRN) - nephrology consult
42
Prognosis for postinfectious glomerulonephritis?
Kids - full recover 2 months | Adults - progress to RPGN
43
IgA vs PSGN
Slide 29
44
Henoch-schonlein purpura is?
HSP Small vessel leukocytoclastic vasculitis - mediated by IgA (vasculitis)
45
HSP is not related to?
Unrelated to IgA nephropathy however pathophysiology and | histologic findings are the same.
46
HSP is MC in?
Young males | Post infection
47
HSP ask about?
Fever and hematuria
48
S/s of HSP?
``` – Palpable purpura (most often on legs) – Arthralgias – Abdominal symptoms (nausea, colic, melena) – ↓GFR – Hematuria ```
49
HSP tx?
``` – Usually self-limiting & most patients recover fully over several weeks • Bed rest • Hydration • Analgesics – +/- corticosteroids ```
50
HSP indications for inpatient
- cant maintain fluids - severe abd pain - sig gastrointestinal bleeding - mental status changes - severe joint involvement - renal insufficiency
51
Goodpasture syndrome is?
Anti-Glomerular Basement Membrane (anti-GBM) | Glomerulonephritis
52
Goodpasture syndrome is defined by?
- glomerulonephritis | - pulmonary hemorrhage
53
Goodpasture syndrome symptoms?
- hemoptysis - tachypnea - malaise - anorexia - HA - preceding URI (poss) Nephritic syndrome - HTN - Edema
54
Goodpasture syndrome prognosis?
Rapidly progressive and fatal
55
Labs for Goodpasture syndrome ?
– Gross or microscopic hematuria – Proteinuria – ↑ BUN/Creatinine – Anti-GBM antibodies
56
Goodpasture syndrome radiographs?
Pulmonary infiltrates due to pulmonary hemorrhage
57
Tx for Goodpasture syndrome ?
– ADMIT – Plasmapheresis → remove circulating anti GBM antibodies – Medications → inhibit formation of new antibodies: • Cortiocsteroids (i.e., Prednisone) • Cyclophosphamide
58
Nephrotic syndrome is characterized by?
``` – Heavy proteinuria – Hypoalbuminemia – Edema – Hyperlipidemia • Oval fat bodies in urine ```
59
Uncommon With nephrotic syndrome
HTN Hematuria Adults (usually its kids)
60
Essentials of diagnosis for nephrotic syndrome
– Urine protein > 3.5 g 24h – Hypoalbuminemia (albumin < 3 g/dL) – Rapid onset of peripheral edema • Typical presenting symptom
61
S/s of nephrotic syndrome?
Massive peripheral edema • When serum albumin is < 3 g/dL –> Due to loss of plasma oncotic pressure • Facial edema usually presenting symptom in children Dyspnea due to pulmonary edema, pleural effusions, and/or diaphragmatic compromise w/ ascites • Due to massive third spacing of fluid Pic on 41
62
Lab findings for nephrotic syndrome?
Heavy proteinuria (3+/4+) Hyperlipidemia (TG) - oval fat bodies in urine L serum albumin (<3g/dl)
63
Nephrotic syndrome cause profound?
Hypoalbuminemia - risk of VTE <2g/dL
64
What happens when the serum albumin is <2g/dL?
- H hepatic synthesis of clotting factors - h platelet activation - H serum viscosity (oncotic pressure) - L circulating —>antithrombin III, —>protein C/S
65
nephrotic syndrome definitive diagnosis?
Renal biopsy - adults: get one - kids: not usually done
66
Tx for nephrotic syndrome?
Based on symptoms ``` Protein loss - ACE/ARB Edema - Na restriction - loop diuretic Hyperlipidemia - exercise/diet - statins Pt education on H infection risk ```
67
nephrotic syndrome infection risk?
Increased pneumonia and peritonitis etc
68
Tx for nephrotic syndrome specific to serum albumin <2g/dL?
IV albumin Long term anticoagulation therapy - warfarin
69
nephrotic syndrome admit if?
- renal failure - refractory edema - complications
70
nephrotic syndrome complications that lead to admission?
``` Sepsis Peritonitis Pneumonia Thromboembolic problem Failure to thrive ```
71
What causes adults to get nephrotic syndrome?
1/3 comes from systemic disease - DM - amyloidosis - SLE The rest have primary renal disease
72
MC primary nephrotic syndromes?
1. Minimal change disease 2. Membranous nephropathy 3. Focal segmental glomerulosclerosis
73
MC cause of primary nephrotic syndrome in kids?
Minimal change disease | 80%
74
Most minimal change disease is?
Idiopathic Can also be - S/P viral URI - Tumors - hodgkins - meds (lithium) - hypersensitivity reactions (NSAIDS, bee)
75
Minimal change s/s?
Sudden swelling in child Nephrotic syndrome manifestations
76
Biopsy for mcd?
Reserved for steroid tx failures | - electron microscopy shows effacement of podocyte foot process
77
MCD tx?
Prednisone (90% respond) - 4-8 wks in kids - 16 wks in adults Continue several weeks after remission
78
Prognosis for MCD?
Many relapse and require subsequent steroid tx Progression to ESRD is rare (adults > kids)
79
MC cause of primary nephrotic syndrome in adults?
Membranous nephropathy | - adults 40s or 50s
80
Membranous nephropathy is sometimes secondary to?
Carcinoma Infections (HBV, HCV, syphilis) Autoimmune disease
81
Menbranous nephropathy s/s?
Nephrotic syndrome manifestations VTE (high incidence) - renal vein thrombosis - high PE risk
82
Membranous nephropathy tx?
R/o secondary causes Tx renal progression Biopsy (maybe) Meds: - ace/arb - statin - immunosuppression (steroids/cytotoxic) Renal transplant
83
Focal segment glomerulosclerosis is associated with?
Renal inj - podocyte damage Nephrotic syndrome manifestations - proteinuria
84
Focal segment glomerulosclerosis diagnosis?
Biopsy | - fusion of epithelia foot processes
85
Focal segment glomerulosclerosis tx?
Steroids Ace/arb Statins
86
Systemic diseases that adversly affect the glomeruli?
Secondary renal disease - DM (DM nephropathy) - Hep C - SLE - SCD - HIV (HIV associated nephropathy) - renal amyloidosis - alport syndrome (hereditary nephritis)
87
MC cause of ESRD in US?
The big DM | - type 1 more likely to develop ESRD
88
Why does DM1 get more ESRD?
DM1 lives longer so they can develop ESRD, | - DM2 folks die faster
89
When does diabetic nephropathy present?
10 yrs after DM onset | - may be at diagnosis for DM2
90
MC lesion in diabetic nephropathy?
Diffuse glomerulosclerosis
91
Diabetic nephropathy pathogenesis?
Glomerular HTN -> glomerular hyperfiltration -> sclerosis
92
DM pts must be screened for?
Microalbuminuria | - earliest detector
93
Diabetic nephropathy tx?
Strict glycemic control Aggressive HTN control - ACE/ARB PT education Avoid contrast material - acute renal failure
94
Hep C nephritic and nephrotic features?
– Membranoproliferative glomerulonephritis – Cryoglobulinemic glomerulonephritis – Membranous nephropathy
95
Hep c glomerular disease typically has?
Hematuria Proteinuria HTN Anemia
96
SLE pts need?
Routine UA - hematuria - proteinuria
97
SLE has what glomerular lesions?
Wide spectrum of lesions | - 6 lupus nephritis classification based on biopsy results
98
SLE renal is?
Aggressive | - 50% + greater loss of renal function w/in weeks/months
99
SCD renal problems?
RBC sickling - renal medula - renal dysfunction Hematuria and flank pain Congestion and stasis - hemorrhage - interstitial inflammation - papillary infarcts Glomerular involvement - proteinuria and progressive GFR disease
100
SCD nephropathy leads to?
ESRD
101
HIV pts get?
Nephrotic syndrome w/ decreased GFR Leads to secondary focal segmental glomerulosceroisis - sever tubulointerstitial damage may present
102
Renal amyloidosis leads to?
Extracelular amyloid deposition Glomeruli are filled w/ amorphous deposits
103
Primary emyloidosis leads to?
ESRD in 2-3 yrs
104
Alport syndrome is aka?
Hereditary nephritis | - X linked
105
Alport syndrome is?
Type IV coallegen defects of kidneys, ears and eyes - microscopic hematuria (birth) - progressive proteinuria - nephritic syndrome - hearing loss
106
Alport syndrome leads to?
Progressive glomerulosclerosis and interstitial scarring develop -> ESRD
107
What do testicles and prostates have in common?
Not much, there is a vas deference between them

Senior - GU Test 1 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions