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Year 1 NME > Clinical presentations of renal disease and interpretation of urinalysis > Flashcards

Clinical presentations of renal disease and interpretation of urinalysis Flashcards

1
Q

The blood vessels of the kidneys can cause disease of the kidneys. What are 2 common causes of blood vessel dysfunction that can lead to renal disease, and/or diseases anywhere in the body?

A

1 - atherosclerosis

2 - thromboembolic

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2
Q

Intrinsic kidneys can occur in 3 places in the kidneys. What are the 3 locations where this can occur?

A

1 - glomeruls

2 - tubulur interstium

3 - renal blood vessels

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3
Q

The ureters of the urinary tract can also cause renal disease. What are some of the most common causes?

A
  • renal stones
  • strictures
  • rare ureteric transitional cell carcinoma
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4
Q

Tmours in the kidney can occur, and can be benign or malignant. They can be primary or secondary, what does this mean?

A
  • pimrary = tumour began in the kidney
  • secondary = metastasised from somewhere else
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5
Q

What are the 2 most common causes of bladder disease?

A
  • stones blocking the bladder
  • cystitis (inflammation of the bladder)
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6
Q

Cystitis is inflammation of the bladder, which can commonly be caused by an infection. The parasitic infection Schistosomasis is an inflamamtion of the bladder due to parasitic infection, but can also increase the risk of what?

A
  • bladder carcinoma
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7
Q

Diseases of the prostate gland can be a potential csause of renal disease. What is prostatitis?

A
  • inflammation of the bladder
  • narrowing of the urethra is common
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8
Q

Diseases of the prostate gland can be a potential cause of renal disease. What is prostate hyperplasia?

A
  • abnormal growth of prostate cells
  • causes a narrowing of the urethra
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9
Q

Diseases of the prostate gland can be a potential csause of renal disease. What is prostate cancer?

A
  • malignant tumour growth in the prostate
  • causes a narrowing of the urethra
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10
Q

What is a nepheron?

A
  • functional unit of the kidney
  • includes the glomerula and tubules
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11
Q

What does vasa recta translate as?

A
  • vasa = vessels
  • recta = straight
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12
Q

What is the vasa recta?

A
  • straight blood vessels in the kidney
  • surround the tubules
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13
Q

What does IgA affect in the IgA Nepropathy?

A
  • abnormal IgA collect in the body
  • IgG anti-IgA antibodies are created
  • when they meet it forms antigen (IgA)-antibody (IgG) complexes
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14
Q

What causes IgA Nepropathy?

A
  • antigen (IgA)-antibodies (IgG) collect at melangial cells in glomerula
  • inflammation and damage to the glomerula follows
  • golmerula are damaged
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15
Q

In IgA Nephropathy abnormal IgA antibodies causes damage and inflammation. What can this lead to in the urine?

A
  • heamaturia (blood in urine) makes this a NEPHRITIC syndrome
  • proteinuria (protein in blood), can cause it to become foamy
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16
Q

In IgA Nephropathy, what generally causes an increase in abnormal IgA antibodies that can lead to further renal damage over a long time?

A
  • infection somewhere in the body but kidneys filter and they collect in the glomerulas
  • can be in lungs, GIT or in kidneys
  • more abnormal IgA antibodies are made to fight infection
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17
Q

In IgA Nephropathy, infections that can be in lungs, GIT, kidneys or anywhere mean more abnormal IgA antibodies are made to fight infection. Over prolonged periods of time this can lead to end stage renal failure. What can patients present with in relation to blood pressure and urine?

A
  • oliguria (reduced urine output)
  • increase H2O retention increases blood volume
  • increased blood volume causes hypertension
18
Q

In IgA Nephropathy, infections that can be in lungs, GIT, kidneys or anywhere mean more abnormal IgA antibodies are made to fight infection. Over prolonged periods of time this can lead to end stage renal failure, presenting with oliguria, which can contribute to hypertension and one other common clinical symptom, that is also made worse due to loss of proteins, specifically albumin, what is this?

A
  • oedema
  • flud retention and loss of albumin causes reduced osmotic pressure
  • fluid leaks into tissue
19
Q

In IgA Nephropathy, infections that can be in lungs, GIT, kidneys or anywhere mean more abnormal IgA antibodies are made to fight infection. Over prolonged periods of time this can lead to end stage renal failure. In time the abnormal IgA antibodies are then recognised by the immune system, which can then form what? In addition what type of hypersensitivity is this an example of?

A
  • immune complexes form
  • type 3 hypersensitivity
  • immune complexes further block and damage glomerulus
20
Q

In IgA Nephropathy, infections that can be in lungs, GIT, kidneys or anywhere mean more abnormal IgA antibodies are made to fight infection. Over prolonged periods of time this can lead to end stage renal failure. In time the abnormal IgA antibodies are then recognised by the immune system, forming immune complexes that can then block, damage and lead to what?

A
  • end stage renal failure
  • loss of glomerula
  • severe Proteinuria (>3.5g/day), hypoalbuminemia (<30 g/L), generalised oedem, hyperlipidaemia and increased risk of venous thromboembolism
21
Q

How can IgA neuropathy be diagnosed using urine and blood?

A
  • urine = increased RBCs and protein content
  • blood = low RBCs and increased creatinine
22
Q

What is the gold standard to confirm a diagnosis of IgA neuropathy?

A
  • kidney biopsy
  • IgA can be detected on microscopy
23
Q

What is glomerulonephritis?

A
  • glomerulonephritis refers to inflammation of the glomerula
  • inflammation and glumerula damage follows
24
Q

What is post infectious glomerulonephritis?

A
  • in infection that occurs somewhere else in the body
  • the infection can result in glomerulonephritis
25
Q

Post infectious glomerulonephritis occurs due to an infection occuring somewhere else in the body, but causes glomerulonephritis. What is the most common strain of bacteria that can cause this?

A
  • streptococci
26
Q

Post infectious glomerulonephritis occurs due to an infection occuring somewhere else in the body, but causes glomerulonephritis. Streptococci is the most common strain of bacteria that can cause this. What can the infection cause to accumulate in the kidneys?

A
  • antigen-immune complexes (type 3 hypersensitivity)
  • generally IgA or IgM
27
Q

Post infectious glomerulonephritis occurs due to an infection occuring somewhere else in the body, but causes glomerulonephritis. Streptococci is the most common strain of bacteria that can cause this. Antigen-antibody complexes can form that become trapped in the glomerula, specifcally where do they get trapped and what does this then cause?

A
  • accumulate in the glomerula basement membrane (GBM)
  • subepithelial (between GBM and podoctyes)
  • podocytes become damaged
28
Q

Post infectious glomerulonephritis occurs due to an infection occuring somewhere else in the body, but causes glomerulonephritis. Streptococci is the most common strain of bacteria that can cause this. Antigen-antibody complexes can form that become trapped in the glomerula, specifcally subepithelial (between glomerula basement membrane and podocytes) which causes inflammation and damage to podocytes, reducing their ability to filter effectively. What can this cause in the urine?

A
  • heamaturia making this a NEPHRITIC syndrome
  • proteinuria (<3.5g)
  • oligouria
29
Q

Post infectious glomerulonephritis occurs due to an infection occuring somewhere else in the body, but causes glomerulonephritis. Streptococci is the most common strain of bacteria that can cause this. Antigen-antibody complexes can form that become trapped in the glomerula, specifcally subepithelial (between glomerula basement membrane and podocytes) which causes inflammation and damage to podocytes, reducing their ability to filter effectively. What can be seen in patients blood sample?

A
  • hypoalbuminaemia
  • hyperlipidaemia
  • increased risk of thromboembolism
30
Q

Is post infectious glomerulonephritis more common in adults or children?

A
  • children
31
Q

What is Anti Neutrophil cytoplasmic antibody (ANCA)?

A
  • antibodies that are attacking neutrophils
  • this can lead to damage of small blood vessels and inflammation
  • small blood vessels in the glomerula are affected, called ANCA associated glomerulonephritis
32
Q

Patients can have allergic reaction to certain drugs. What are the most common drugs that can cause Tubulointerstitial disease?

A
  • NSAIDs
33
Q

Patients can have allergic reaction to certain drugs. What are the most common drugs antibiotics that can cause Tubulointerstitial disease?

A
  • gentamicin and vancomycin
34
Q

What is the most common cause of nephrotic syndrome in children?

A
  • minimal change disease
35
Q

What is minimal change disease?

A
  • disease that causes nephrotic syndrome
  • idiopathic, meaning we dont know the cause
  • linked with T cells, inflammartion and tissue damage
36
Q

Minimal change disease is a nephrotic syndrome, which an unknown cause. Why is it called minimal though?

A
  • due to not being able to be seen on a normal microscope
  • need a superpowerful microscope
37
Q

What are 2 risk factors for bladder cancer?

A

1 - smoking

2 - occupational risk factors. such as exposure to naphthylamine (rubber and paint factories)

38
Q

If a patient presents with odeama, what 3 organs and 1 condition do we need to consider?

A
  • liver
  • heart
  • kidneys
  • malnutrition
39
Q

If blood clots are seen in the urine, does this suggest a renal or post-renal disease?

A
  • post-renal
  • generally bladder
40
Q

Patients that present with painless hamaturia aged over 50 need to be screened for what?

A
  • bladder cancer

Year 1 NME (61 decks)

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