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Block 19 Module 3 > Approach to Proteinuria and Hematuria > Flashcards

Approach to Proteinuria and Hematuria Flashcards

1
Q

Normal protein flow thru renal arteries

A

121,000g/day

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2
Q

Normal protein flow thru GLOMERULUS

A

1-2g/day

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3
Q

Normal protein excretion in urine

A

<150mg/day and (-) on dipstick

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4
Q

Usual first sign of renal complication

A

Microalbuminuria

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5
Q

Only protein detected on dipstick

A

Albumin

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6
Q

% of Tamm-Horsfall protein in Urine

A

60-80%

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7
Q

% Albumin in urine

A

20-40

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8
Q

550mg of protein in urine is considered

A

Moderate
Mild: <500 mg
Moderate: 500mg-2g
Severe: >2g

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9
Q

Most common cause of proteinuria

A

DM

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10
Q

Etiology of Protenuria is classified into

A

Overflow
Tubular
Glomerular

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11
Q

TorF: Tubulointerstitial disease would cause high molecular weight proteinuria

A

False. LOW bsta tubular kag overfLOW ky LOW

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12
Q

Disease that would cause high mol wt proteinuria

A

GN

Orthostatic proteinuria

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13
Q

Type of proteinuria which resolves with resolution of underlying dse

A

Transient proteinuria

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14
Q

Secondary causes of Tubulointerstitial disease

A

Uric acid nephropathy
Heavy Metal and drug toxicity
Sickle Cell Dse

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15
Q

Proteinuria while upright or after prolonged standing but normal when supine

A

Orthostatic proteinuria

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16
Q

Diagnostic methods for orthostatic proteinuria

A

Split urine collection

Spot protein creatinine ratio of 1st AM and mid afternoon void

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17
Q

T or F: More patients have secondary causes than primary glomerular disease

A

False: 75% primary

25% secondary

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18
Q

kidney disesase as a result

of the progression of symptoms diabetes mellitus

A

Diabetic Kidney disease

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19
Q

kidney disease as a direct

result of increased blood glucose

A

Diabetic nephropathy

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20
Q

How many yrs does microalbuminuria develop in Diabetic nephropathy/DKD

A

5 yrs, proteinuria 11-20 yrs

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21
Q

Why are young population prone to CKD

A

Due to fast food and salty diet (nan sigeha nyu ah)

22
Q

What to look for in fundoscopy that would suggest DM

A

Retinopathy

23
Q

Low C3 would suggest

A

Post strep

24
Q

Normal C3 would suggest

A

Glomerulonephritis

25
Q

Lab exam that you would request to detect chronicity and activity of renal lesions

A

Renal biopsy

26
Q

T or F: atleast 1 kidney should be functional before doing biopsy

A

False: BOTH kidneys must be functioning

27
Q

T or F: in adults pulse therapy is attempted before biopsy

A

False: it’s for pedia since pediatric Neo are more responsive. (adults:biopsy b4 treatment)

28
Q

T or F: aurine dipstick analysis is most sensitive to albumin and least sensitive to low mol wt proteins

A

True

29
Q

Turbidimetric assay based on protein precipitation;

A

Sulfosalicylic assay (SSA)

30
Q

Type of protein measured by SSA

A

All proteins

31
Q

Define Hematuria

A

> 3 RBC/hpf in centrifuged urine

32
Q

Presence of clots may indicate

A

Ureteral or bladder origin

33
Q

Origin of primary hematuria

A

Renal

34
Q

Most common form of hematuria

A

Primary

35
Q

Lab test that gives us an idea of what section of the urinary tract is involved in hematuria

A

Three-glass test

36
Q

In the 3-glass tetst urine is collected during 3 stages, what are these

A

Urethral involvement
Bladder neck or triangle
Bladder or upper UT

37
Q

If all urine samples in the 3-glass test have RBC which stage is this

A

Bladder or upper UT

38
Q

(3glass tets) If the RBCs are only from near end of micturition which stage is this

A

Bladder neck or triangle

39
Q

(3 glass test) if the RBCs are only from the START of micturition which stage

A

Urethral involevemtn

40
Q

NO clots usually indicate which origin

A

Upper UT or glomerular origin

41
Q

Test that distinguish btn glomerular from post-glomerular origin of hematuria

A

Phase contrast microscopy

42
Q

Dysmorphic RBCs indicate which origin

A

Glomerular

43
Q

Normal size and shape RBCs indicate which origin

A

Post glomerular

44
Q

If the accompanying symptom is dysuria, micturition pause or straining this indicates

A

Bladder or urethral stone

45
Q

If the hematuria is accompanied with symptoms like high spiking fever, chills, loin pain and positive kidney punch test this is a diagnosis of

A

Pyelonephritis

46
Q

Hematuria plus urgency only

A

Cystitis

47
Q

Hematuria plus edema and hypertension

A

GN

Hypertensive nephropathy

48
Q

Hematuria plus chyluria

A

Filariasis

49
Q

Painful gross hematuria without clots indicate

A

RCC

50
Q

This test is best in evaluating hematuria

A

Renal biopsy

51
Q

3wks pta px develop sore throat, positive ASO, (+) hematuria this is

A

Post strep GN

52
Q

Eosinophiluria indicates

A

Allergic interstitial nephritis

Block 19 Module 3 (9 decks)

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