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RENAL II Exam 3 > Chronic Renal Failure > Flashcards

Chronic Renal Failure Flashcards

1
Q

Acute

A

Sudden increase in BUN and creatinine
Oliguria, hypovolemia, or hypervolemia
Nausea vomiting, malaise
Azotemia with confusion, asterixis, pericardial effusion, etc.
Hyperkalemia, acidosis (type depends on GFR), hyperphosphatemia
Bleeding and clotting (platelet dysfunction)

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2
Q

State 3 for 3 mo

A

CRF

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3
Q

70% of CRF

A

DM or HTN

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4
Q

Other causes of CRF

A

GN, cystic, obstruction, and tubulointerstitial

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5
Q

Hallmarks of CRF

A 
Bone disease
Anemia
Broad waxy casts
Paresthesias
B/L small kidneys
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6
Q

HTN, CHF, Edema + CRF

A

Increase sodium and water retention

Sympathetics and RAAS

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7
Q

Increase PTH with CRF

A

Decrease GFR -> increase phosphate -> decrease calcium -> increase PTH - but it can’t work on kidney so it activates osteoclasts by activating RANKL production from osteoblasts

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8
Q

Vit D and CRF

A

Decrease
Bad for bones
Increase PTH even more

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9
Q

Anemia and CRF

A

No erythropoieten

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10
Q

Broad waxy casts

A

Tubular destruction

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11
Q

Acidosis and hyperkalemia

A

Both acute and chronic

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12
Q

Paresthesias

A

Uremic toxins

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13
Q

Glomerular disease

A

Proteinuria

Hematuria

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14
Q

Nephritic disease

A 
Postinfectious Glomerulonephritis(GN)
IgA nephropathy
Henoch-Schönlein
Pauci-immune GN
Anti-glomerular Basement membrane GN
Cryoglobulin-Associated GN
Membranoproliferative GN
Hepatitis C Infection
SLE
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15
Q

Low complement

A

Antigen binding

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16
Q

IgA

A

Synpharyngitic
Associated with URI or GI infection
Alternative complement -> serum complement normal
Mesangial cells proliferate

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17
Q

IgA nephropathy assoc with

A 
Henoch Sholein purpura
Celiac
CMV
HIV
Liver cirrhosis
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18
Q

Treatment for IgA progressing to CRF

A

ACEI
Steroids
Cyclophosphamide and azathioprine

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19
Q

IgA vasculitis

A

Immune deposits in small vessels

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20
Q

P-ANCA GN

A

Churg Strauss (eosinophilia) or Microscopic polyangitis

Not granuloma formation and not UR tract involvement

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21
Q

C-ANCA GN

A

Wegener

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22
Q

ANCA GN

A

Fever, weight loss, hematuria

RBC casts on UA

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23
Q

Priming proteins for ANCA

A

PR3 - p-ANCA

MPO - c-ANCA

24
Q

Anti-GBM

A

NC1 domain of collagen IV

25
Hematuria and hemoptysis
Good-pastures
26
Cryoglobulenemia
Hep C | RPGN hematuria
27
Type I Cryoglobulenemia
Cancers of blood and immune system
28
Type II and III Cryoglobulenemia
Autoimmune and Virus
29
ACE inhibitor
Type I MPGN Treat HTN and Proteinuria
30
Type I MPGN
Tram tracking C3 and C4 are low Immune deposits everywhere Hematuria and proteinuria
31
Hep C
``` Immune complex mediated MPGN (nephritic, type I) Mixed Cryoglobulinemic GN (nephritic) Membraneous Nephropathy (nephrotic) ```
32
Type II MPGN
Dense Deposit Disease Ribbon like deposits Only C3 low
33
methylprednisolone
proteinuria
34
cyclophosphamide or mycophenolate mofetil
Decreased GFR
35
APOL1 Gene
FSGS
36
FSGS
Edema, HTN, oval fat bodies Adult AA
37
Spike and dome
Membranous
38
Lymphoma
Membranous
39
Secondary Membranous
lymphoma, carcinoma, penicillamine, gold, SLE, MCTD, thyroiditis, hepatitis B and C, endocarditis, syphilis Subepi IgG and C3
40
PLA2R
Antigen in primary membranous
41
Renal vein thrombosis
B/L enlargement | Pain, nausea, vomiting
42
Nephropathy and thrombosis
Increase risk | Leak out antithrombin
43
CRF and glomerular nephrotic disease
Amyloidosis Diabetic sclerosis HIV collapsing
44
Chronic tubulointerstitial disease
``` isosthenuria with polyuria moderate proteinuria very few cells type I, II or IV RTA broad waxy casts small kidneys ```
45
Cause of Chronic Tubulointerstitial disease
``` Proud American Veterans Love GM Prostate (obstructive uropathy) Analgesics (NSAIDs) VU reflux Lead (heavy metals) Gout Myeloma ```
46
Triad for MM
Back pain, weight loss, immunoglobins
47
Type IV RTA
High potassium
48
Type I RTA
High pH
49
Type II RTA
Low pH and low bicarb
50
Advanced renal failure
Anion gap
51
Type I RTA
Amphoteracin B, HyperparaT, Sjogrens syndrome
52
Type II RTA
Myeloma | Drugs
53
Type IV RTA
Diabetics, ACE inhibitors, K sparing diuretics, Obstruction, Interstitial Nephritis, HIV, NSAIDs
54
Cl and Bicarb not equally opposite?
Hyperchloremic Metabolic acidosis and occult metabolic alkalosis
55
Bence Jones protein
Bicarb leaking
56
Renal disease of myeloma
``` “Myeloma kidney” Hypercalcemia Hyperuricemia Amyloidosis B cell infiltration Hyperviscosity ``` Type II RTA - main one

RENAL II Exam 3 (12 decks)

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