Glomerular and Tubulointerstitial Disease Lecture Powerpoint

Question 1

BUN will have increased concentration if…

Answer 1

…there is decreased blood flow to kidney

Question 2

Creatinine will only increase if there is….

Answer 2

…significant kidney damage

Question 3

Azotemia definition

Answer 3

Presence of elevated BUN

Question 4

Uremia definition

Answer 4

Advancing azotemia with increased BUN and Cr, indicates renal failure

Question 5

Vasopressor definition

Answer 5

The name of the local paracrine factor secreted by macula densa cells to communicate with juxtaglomerular cells thru mesangial cells indicating the JG cells need to release renin

Question 6

When blood pressure is too high, macula densa cells can secrete ___ that inhibit ___ release from JG cells

Answer 6

Paracrine factors, renin

Question 7

Nephrotic syndrome results from injury to the ___ (cells) while nephritic syndrome is ____ based, involving ____

Answer 7

Podoctyes, inflammation, blood in the urine

Question 8

Most nephrotic syndromes have a ___basis

Answer 8

Immunologic

Question 9

Does antibiotic treatment prevent glomerular disease in post strep glomerulonephritis?

Answer 9

Nope, immune mediated doesn’t have to do when treatment was sought after

Question 10

A strep infection often goes on to cause either ____ or ____ but rarely both

Answer 10

rheumatic fever, acute glomerulonephritis

Question 11

Treatment of post strep glomerulonephritis (3)

Answer 11

• supportive diuretics
• control hypertension
• dialysis in extreme cases

Question 12

Prognosis of post strep glomerulonephritis

Answer 12

Very good, see recovery often within 2 months

Question 13

Goodpasture’s syndrome definition

Answer 13

A type II hypersensitivity invoolving antibody formation against the glomerular basement membrane, rapidly progressive to renal failure

Question 14

Most common glomerular cause of hematuria

Answer 14

IgA nephropathy/berger’s disease

Question 15

IgA nephropathy/berger’s disease definition

Answer 15

Attacks of hematuria following nonspecific illness, exercise, or immunization that is benign and result of excessive IgA antigen complex formation

Question 16

IgA nephropathy/berger’s disease treatment (2)

Answer 16

• supportive care of hypertension

- steroids if progressive to suppress immune response

Question 17

Rapidly progressive glomerulonephritis (RPGN) definition

Answer 17

Acute glomerulonephritis marked by rapid loss of renal function >50% over a period of 3 months with renal crescents upon biopsy

Question 18

75-80% of all nephrotic syndromes in kids and 20% in adults is from…

Answer 18

…minimal change disease

Question 19

Minimal change disease definition

Answer 19

Nondamaging cause of proteinuria leading to nephrotic syndrome, sometimes seen with allergies, malignancies, or certain drugs

Question 20

Minimal change disease presents as ___onset of nephrotic syndrome

Answer 20

abrupt

Question 21

Focal segmental glmoerulosclerosis definition

Answer 21

Scarring of some of the glomeruli of the kidney either idiopathic or due to infection, or drug, or a disease

Question 22

Focal segmental glmoerulosclerosis prognosis

Answer 22

Poor

Question 23

Most common primary cause of nephrotic syndrome in adults is…

Answer 23

…membranous glomerular disease

Question 24

Captopril drug class

Answer 24

ACEI

Question 25

Causes of membranous glomerular disease are typically ___ and include (3), how does it present (3)?

Answer 25

Autoimmune

• nephrotic syndrome
• cancers
• Hep B

Presents with proteinuria and sometimes hematuria or malaise

P

Question 26

Membranoproliferative glomerulonephritis (MPGN) results in ___ GFR and ____ mesangial cellularity

Answer 26

decreased, increased

Question 27

Mostcommon cause of end stage renal disease in US

Answer 27

Diabetes

Question 28

Kimmelsteil Wilson lesion definition

Answer 28

Hallmark change seen in kidney from mesangial matrix expansion, nodular appearance indicative of glomerulonephropathy from diabetes

Question 29

Cortical nephrons focus on controlling ____ while medullary ones are focused on ____

Answer 29

BP, reabsorption

Question 30

Acute interstitial nephritis definition, what 3 things does it lack compared to glomerular disease?

Answer 30

Acute decline in renal function due to inflammation of the nephron, lacks HTN, proteinuria, or edema unlike glomerulonephritis

Question 31

Acute interstitial nephritis triad

Answer 31

• fever
• skin rash
• peripheral eosinophilia

Question 32

Acute interstitial nephritis can present as TINU syndrome, which is…

Answer 32

…tubulointerstitial nephritis and uveitis syndrome

Question 33

Acute interstitial nephritis urine appears…

Answer 33

…coke colored

Question 34

Causes of acute interstitial nephritis (4)

Answer 34

• antibiotis
• NSAIDS
• systemic infections
• autoimmune

Question 35

Chronic tubulointerstitial nephropathy definition, what does it frequently present with?

Answer 35

Disease of the nephron tubule, frequently presents with hyperkalemia

Question 36

Sequelae of chronic tubulointerstitial nephropathy

Answer 36

Fanconi syndrome

Question 37

Fanconi syndrome definition

Answer 37

dysfunction of proximal tubules of kidney resulting in renal glycosuria, water and bicarb loss, and metabolic acidosis