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Clinical Pathology > Diseases of the Renal System 1 > Flashcards

Diseases of the Renal System 1 Flashcards

1
Q

What are the 4 main functions of the kidney

A

Eliminate metabolic waste products
Regulate fluid and electrolyte balance
Acid-base balance
Produce some hormones (renin, erythropoietin)

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2
Q

What are the 2 main types of mechanisms of glomerular damage?

A

Immunological

Non-immunological

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3
Q

Give 4 conditions whcih cause damage to the glomerulus by immune complexes being deposited in the glomerulus

A

Lupus
IgA nephropathy
Henoch Schonlein Purpura
Membranous purpura

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4
Q

Give 2 examples of conditions that cause damage to the basement membrane through the deposition of antibodies

A

Anti glomerular basement membrane disease (goodpasture’s syndrome)
Post infective glomerulonephritis

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5
Q

5 mechanisms of vascular damage in the kidneys

A 
Thrombotic microangiopathy
Vasculitis
Hypertension
Diabetes
Atheroma e.g. renal artery stenosis
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6
Q

Thrombi in capillaries and small arterioles, due to damaged endothelium (bacterial toxins, drugs) or abnormalities in clotting e.g haemolytic uraemic syndrome

A

Thrombotic microangiopathy

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7
Q

Give an example of vasculitis that can affect the kidney

A

Wegener’s granulomatosis

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8
Q

Nephrotic syndrome is due to damage of what part of the renal system?

A

Glomerulus

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9
Q

What are the signs of nephrotic syndrome

A 
Hypoalbuminaemia
Proteinuria
Oedema
\+/-hypertension
\+/-hyperlipidaemia
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10
Q

Complciations of nephrotic syndrome

A

Infections, thrombosis

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11
Q

4 causes of nephrotic syndrome

A

Membranous neuropathy
Focal segmental glomerulosclerosis (FSGS)
Minimal change disease
Diabetes, lupus nephritis, amyloid

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12
Q

Most common cause of nephrotic syndrome

A

Membranous neuropathy

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13
Q

Primary glomerular disorder of unknown cause. 30-60yrs, 20-30% progress to end stage renal failure

A

Membranous neuropathy

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14
Q

A pattern of kidney damage affecting the podocytes, with various possible causes (idiopathic, genetic, heroin use, HIV)

A

Focal segmental glomerulosclerosis

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15
Q

Which causes of nephrotic syndrome are more common in males than females?

A

Membranous neuropathy

Focal segmental glomerulosclerosis

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16
Q

In children, what are the most common causes of nephrotic syndrome?

A

Minimal change disease, or FSGS (less common)

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17
Q

What are the 5 signs of acute nephritis

A 
Oedema
Proteinuria
Acute renal failure
Haematuria
Hypertension

Both nephrotic syndrome and nephritis OPAHH

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18
Q

4 main causes of acute nephritis

A

Post infective glomerulonephritis
IgA nephropathy
Vasculitis
Lupus

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19
Q

Typically occurs a few weeks after streptococcoal throat infection; common cause of acute nephritis

A

post infective glomerulonephritis

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20
Q

Most common primary glomerular disease- teenagers and young adults iwth haematuria

A

IgA nephropathy

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21
Q

What proportion of people with IgA nephropathy will progress to renal failure over 20 years

A

20-50%

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22
Q

Cause of nephritic syndrome; presents with fever, generally unwell, rash, myalgia, arthralgia

A

Vasculitis

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23
Q

Autoimmune disease commonly affecting women, that can be a cause of acute nephritis

A

Lupus

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24
Q

What are the 3 most common causes of nephritis in children?

A

Post infective glomerulonephritis
IgA nephropathy
hencoch-schonlein purpura
haemolytic-uraemic syndrome

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25
Q

A specific type of IgA nephropathy that is more common in males than females- arthralgia ,abdo pain, rash and haematuria and acute renal failure

A

Henoch schonlein purpura

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26
Q

Typically affects children with E.coli 0157 enteritis

A

Haemolytic uraemic syndrome

27
Q

What are the 3 signs of haemolytic uraemic syndrome

A

Acute nephritis, haemolysis and thrombocytopenia

28
Q

What 3 things must be present for a diagnosis of acute renal failure

A

Anuria/oliguria
High plasma creatinine levels
High plasma Urea

29
Q

What are the 3 classes of causes for acute renal failure

A

pre-renal
renal
post-renal

30
Q

Give 2 examples of pre renal causes of acute kidney failure

A

Severe dehydration

Hypotension e.g. bleeding, septic shock, LV failure

31
Q

Give 3 examples of post renal causes of acute kidney failure

A

Tumours
bladder stones
prostatic enlargement

32
Q

Give 4 examples of renal causes of acute renal failure

A

Vasculitis

Acute interstitial nephritis

33
Q

Give 3 examples of renal causes of acute renal failure in children

A

Henoch schonlein purpura
Hameolytic uraemic syndrome
acute interstitial nephritis

34
Q

5 complications of acute kidney disease

A 
Cardiac failure
Arrythmias
GI bleeding
Jaundice
Infection
35
Q

Which might cardiac failure results from acute kidney failure?

A

Fluid overload

36
Q

Treatment for acute kidney disease

A

Short term dialysis

Treat underlying cause

37
Q

Permanently decreased GFR and less nephrons

A

Chronic renal failure

38
Q

Briefly outline the stages of chronic renal failure

A

1-2 no treatment
3-moderate reduction in GFR
4- severe reduction in GFR
5-end stage kidney failure

39
Q

3 causes of chronic renal failure

A

Diabetes
Glomerulonephritis
Reflux nephropathy

40
Q

Chronic reflux of urine up the ureter leading to repeated infections and scarring

A

Reflux nephropathy

41
Q

What does a renal biopsy tell you in chronic renal failure?

A

Scarring, no evidence of initial cause

42
Q

4 effects of chronic renal failure

A

Decreased excretion of water and electrolytes-oedema and hypertension
decreased excretion of toxic metabolites
decreased production of erythropoietin- anaemia
renal bone disease

43
Q

elderly patient with acute renal failure

A

acute interstitial nephritis (drug reactions)

myeloma-tumour of the plasma cells, secrete immunoglobulins

44
Q

Young male with haematuria and rash

A

Henoch Schonlein Purpura

45
Q

Teenager/young adult with haematuria

A

Post infective glomerulonephritis

IgA nephropathy

46
Q

Adult with acute renal failure, fever and myalgia

A

Vasculitis

47
Q

Young woman with haematuria and facial butterfly rash

A

Lupus

48
Q

Adult with nephrotic syndrome

A

Membranous neuropathy

49
Q

Child with nephrotic syndrome

A

Minimal change

50
Q

Imaging of the urinary tract

A

Cytoscopy

51
Q

Causes of isolated haematuria

A

IgA nephropathy
Thin basemement membrane disease
Alport type hereidtary nephropathy

52
Q

Inherited abnormalities of collagen type 4 causing abnormal basement membrane in the glomerulus- renal failure +/- deafness +/-occular problems May be autosomal or X linked

A

Alport type hereditary nephropathy

53
Q

Commonest 3 causes of isolated proteinuria in adults

A

FSGS
Diabetes
Lupus

54
Q

Commonest 2 causes of isolated proteinuria in children

A

Henoch Schonlein purpura

FSGS

55
Q

Causes of acute pyelonephritis

A

Diabetes

Structural abnormalities of urinary tract

56
Q

Complications of pyelonephritis

A

Abscess formation

57
Q

What is the cause of chronic pyelonephritis

A

Associated iwth obstruction of urinary tract and reflux of urine up reter, leading to scarring of the kidney and can lead to renal failure

58
Q

Complications of chronic pyelonephritis

A

Scarring of kidney

Chronic renal failure

59
Q

What is the result of renal artery stenosis

A

Ischemia of affected kidney

Activation of renin-angiotensin-aldosterone system leads to hypertension

60
Q

Thrombus blocks the capillary within the glomerulus. Inflammatory cells surround an artery which has fibrin in the wall indicating damage

A

Vasculitis

61
Q

How does hypertension cause damage to the kidney

A

Thickening of vessel walls-decrease in size of the lumen-chronic hypoxia-loss of renal tubules-decrease in renal function, decreased blood flow activates RAA system

62
Q

Commonest cause of end stage renal failure?

A

Diabetes

63
Q

How does diabetes affect the kidney?

A

hyperglycaemia damages the basement membrane- becomes thicker, glomerulus produces excess extracellular matrix which forms nodules. Also affects small vessels leading to ischaemia and damage to renal tubules

64
Q

What tumour is made of plasma cells which produce excess immunoglobulins-deposit in the tubules- inflammation and fibrosis, decreased kidney function, usually irreversible

A

Myeloma

Clinical Pathology (53 decks)

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