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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
Q

Hematuria and hemoptysis

A

Good-pastures

26
Q

Cryoglobulenemia

A

Hep C

RPGN hematuria

27
Q

Type I Cryoglobulenemia

A

Cancers of blood and immune system

28
Q

Type II and III Cryoglobulenemia

A

Autoimmune and Virus

29
Q

ACE inhibitor

A

Type I MPGN

Treat HTN and Proteinuria

30
Q

Type I MPGN

A

Tram tracking
C3 and C4 are low
Immune deposits everywhere
Hematuria and proteinuria

31
Q

Hep C

A 
Immune complex mediated MPGN (nephritic, type I)
Mixed Cryoglobulinemic GN (nephritic)
Membraneous Nephropathy (nephrotic)
32
Q

Type II MPGN

A

Dense Deposit Disease
Ribbon like deposits
Only C3 low

33
Q

methylprednisolone

A

proteinuria

34
Q

cyclophosphamide or mycophenolate mofetil

A

Decreased GFR

35
Q

APOL1 Gene

A

FSGS

36
Q

FSGS

A

Edema, HTN, oval fat bodies

Adult
AA

37
Q

Spike and dome

A

Membranous

38
Q

Lymphoma

A

Membranous

39
Q

Secondary Membranous

A

lymphoma, carcinoma,
penicillamine, gold, SLE, MCTD, thyroiditis, hepatitis B and C,
endocarditis, syphilis

Subepi IgG and C3

40
Q

PLA2R

A

Antigen in primary membranous

41
Q

Renal vein thrombosis

A

B/L enlargement

Pain, nausea, vomiting

42
Q

Nephropathy and thrombosis

A

Increase risk

Leak out antithrombin

43
Q

CRF and glomerular nephrotic disease

A

Amyloidosis
Diabetic sclerosis
HIV collapsing

44
Q

Chronic tubulointerstitial disease

A 
isosthenuria with polyuria 
moderate proteinuria     
very few cells 
type I, II or IV RTA 
broad waxy casts 
small kidneys
45
Q

Cause of Chronic Tubulointerstitial disease

A 
Proud American Veterans Love GM
     Prostate (obstructive uropathy)  
     Analgesics (NSAIDs)
     VU reflux
     Lead (heavy metals)
     Gout
     Myeloma
46
Q

Triad for MM

A

Back pain, weight loss, immunoglobins

47
Q

Type IV RTA

A

High potassium

48
Q

Type I RTA

A

High pH

49
Q

Type II RTA

A

Low pH and low bicarb

50
Q

Advanced renal failure

A

Anion gap

51
Q

Type I RTA

A

Amphoteracin B,
HyperparaT,
Sjogrens syndrome

52
Q

Type II RTA

A

Myeloma

Drugs

53
Q

Type IV RTA

A

Diabetics, ACE inhibitors,
K sparing diuretics,
Obstruction, Interstitial
Nephritis, HIV, NSAIDs

54
Q

Cl and Bicarb not equally opposite?

A

Hyperchloremic Metabolic acidosis and occult metabolic alkalosis

55
Q

Bence Jones protein

A

Bicarb leaking

56
Q

Renal disease of myeloma

A 
“Myeloma kidney”
Hypercalcemia
Hyperuricemia
Amyloidosis
B cell infiltration
Hyperviscosity

Type II RTA - main one

RENAL II Exam 3 (12 decks)

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