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Clinical Pathology > diseases of the urinary tract 1 > Flashcards

diseases of the urinary tract 1 Flashcards

1
Q

what are the main functions of the kidney

A

eliminate metabolic waste, regulate fluid and electrolyte balance, acid base balance, production of some hormones (renin and EPO)

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2
Q

how to patients with renal disease present

A

acute renal failure- rapid rise in urea and creatinine

chronic renal failure- gradual declining function.

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3
Q

3 components of nephritic syndrome

A

oedema, proteinuria and haematuria.

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4
Q

3 conditions of nephrotic syndrome

A

oedema, proteinuria and hypoalbuimanemia.

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5
Q

what defines proteinuria

A

> 3g per 24 h

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6
Q

what 2 structures form the renal cortex

A

medulla is dark, cortex is light.

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7
Q

in what structure in the glomerulus found

A

Bowman’s capsule.

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8
Q

what structures are involved in filtration of the kidney

A

podocytes, foot processes, endothelial cells and basement membrane which allows filtration.

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9
Q

function of renal tubules

A

collects what you need and filters what you don’t need

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10
Q

how can the immune system damage the glomeruli

A

circulating immune complexes deposit in glomeruli
circulating antigen deposit in the glomeruli which complement antibodies of the basement membrane.
this causes damage via Complement activation, Neutrophil activation, Reactive oxygen species, Clotting factors.

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11
Q

what are non-immunological factors which cause damage to the glomeruli.

A

injury to endothelial vessels.
altered basement membrane due to hyperglycaemia in diabetes.
abnormal basememnt membrane or podocytes- inherited condition
deposition of abnormal proteins in the kidney e.g. amyloid.

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12
Q

how does schema cause tubular damage

A

hypotension- shock/ septic patients.
glomerular damage
damage to vessels within the kidney.

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13
Q

what toxic material can cause tubular damage

A

Direct toxins- X ray, heavy metal.
Hypersensitivity reactions e.g. to drugs
Deposition of crystals in tubules- gout uric acid crystals
Deposition of abnormal proteins in the tubules

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14
Q

define thrombotic microangioapthy (vascular damage) and what causes it to happen

A

thrombi in capillaries and small arterioles due to endothelial damage

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15
Q

causes of endothelial damage

A

bacteria, toxins, drugs, abnormal complement and clotting pathways.

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16
Q

define vasculitis

A

acute or chronic inflammation of the blood vessels.

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17
Q

what 3 factors cause renal damage

A

damage to tubules
damage to the glomerulus
damage to the blood vessels.

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18
Q

nephrotic syndrome damages which structure within the kidney

A

glomerulus.

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19
Q

what are the main complications of nephrotic syndrome

A

infections, thrombosis, pitting oedema.

20
Q

diagnosis of nephrotic syndromes

A

renal biposy

21
Q

what is the most common cause of nephrotic syndrome in adults

A

membranous nephropathy

22
Q

what is the most common cause of nephrotic syndrome in children

A

minimal change disease.

23
Q

other symptoms of nephrotic syndrome except the triad

A

hypertension and hyperlipidaemia.

24
Q

other symptoms of nephritic syndrome except the triad

A

Hypertension

Acute renal failure

25
Q

what is the most common cause of nephritic syndrome in adults and children

A

post infective glomerulonephritis.

26
Q

after what infection does post infective glomerulonephritis occur

A

Streptococcal throat infection.

27
Q

how is acute renal failure diagnosed

A

anuria/oliguria + raised creatinine and urea

28
Q

treatment for acute renal failure

A

short term dialysis.

29
Q

what are the pre-renal causes of acute renal failure

A

dehydration, hypotension

30
Q

what are the post renal causes of acute renal failure

A

tumours of the urinary tract, tumours of the pelvis, bladder stones, prostatic enlargement.

31
Q

what are the renal causes of acute renal failure in adults

A

vasculitis, acute interstitial nephritis (tubular damage with inflammation)

32
Q

what are the renal causes of acute renal failure in children

A

Henoch- Schmlein purpura
haemolytic uraemic syndrome
acute interstitial nephritis.

33
Q

what is Henoch-Schonlein purport and what age group is it common in

A

children

Specific type of IgA nephropathy

34
Q

define haemolyctic uraemic syndrome and what age group does is commonly affect

A

children

acute nephritis, haemolysis and thrombocytopenia,

35
Q

what are the complication of acute renal failure

A

cardiac failure, arrthymias (electrolyte imbalance), GI bleeding, Jaundice, Infections

36
Q

what are the 5 stages of chronic renal failure

A 
stage 1- kidney damage with normal of increased GFR
stage 2- mild reduction in GFR
stage 3-moderate reduction in GFR
stage 4-severe reduction in GFR
stage 5-kidney failure.
37
Q

what are the common causes of chronic renal failure in adults

A

diabetes, glomerulernephriris, reflux nephropathy

38
Q

what are the common causes of chronic renal failure in children

A

Developmental abnormalities/malformations
Reflux nephropathy
Glomerulonephritis

39
Q

why might bops not be helpful in diagnosis of chronic renal failure

A

Kidney shows severe scarring with loss of glomeruli and tubules
Similar changes are seen in end-stage renal disease due to any cause

40
Q

what the the effects of chronic renal failure

A

reduced excretion of water and electrolytes- oedema and hypertension.
reduced excretion of toxic metabolites
reduced production of EPO- anaemina
renal bone disease

41
Q

most common diagnosis of elderly patient with acute renal failure

A

Acute interstitial nephritis due to drug reactions.

myeloma- tumour of plasma cells which for immunoglobulins and circulate in the kidney

42
Q

most likely diagnose of male with haematuria and rash

A

Henoch-Schonlein purpura

43
Q

most likely diagnosis of Teenager/young adult with haematuria

A

Post-infective glomerulonephritis

IgA nephropathy.

44
Q

most likely diagnosis of Adult with acute renal failure, fever and myalgia

A

vasculitis.

45
Q

most likely diagnosis of Young woman with haematuria and facial rash

A

Lupus

Clinical Pathology (45 decks)

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