Glomerular Disease 1- Pathology Flashcards
Be able to map out the flow of blood from renal artery to renal vein.
What is the vasodilator for afferent arteriolar blood flow?
PGE2
What is the vasconstrictor for efferent arteriolar blood flow?
AT II
What are some components of the basement membrane?
collagen IV
Laminin
polyanionic proteoglycan
fibronectin
entactin
etc
Another name for visceral epithelium?
podocyte
What is the function of the glomerular barrier?
to discriminate among various protein molecules depending on their size and charge
What is the glomerular barrier maintained by?
visceral epithelial cells
Describe pathology of Goodpastures.
The ag to which ab are directed are present on the NC1 domain of alpha chain
Describe pathology of Alports.
a mutation in the alpha 5 chain in T4 collagen (col IV A5 mutation)
How many different types of collagen chains are there?
6 types of alpha chains and it takes 3 to form structure
Be able to reproduce this chart on the pathology affecting the different parts of the nephron.
Reproduce chart.
Be able to reproduce chart on presentations in renal disease.
Reproduce chart.
Be able to chart out the localization of the pathology related to kidneys based on the presentation.
Reproduce this chart
What are normal levels of serum BUN?
normal: 7-18mg/dl
What are factors that may affect BUN?
Depends on GFR, protein content in diet, PCT function, status of urea cycle
In what conditions is BUN usually increased?
CCF, acute GN, Acute & chronic renal failure, urinary tract obstruction, cirrhosis
What is normal serum creatinine?
normal: 0.6 -1.2 mg/dl
What is normal serum BUN: Creatinine ratio?
normal = 15
If BUN/Cr ration is > 15, what may this indicate?
Prerenal & post renal azotemia
If BUN/Cr ratio is ≤ 15, what may this indicate?
renal azotemia
What is normal creatinine clearance?
100-137 ml/min
What does creatinine clearance depend on?
GFR
If creatinine clearance is < 10ml/min what may this indicate?
renal failure
Is this definition descriptive of nephrotic or nephritic syndrome?
Heavy proteinuria (more than 3.5 gm/day), hypoalbuminemia, generalised edema, hyperlipidemia, and lipiduria
Nephrotic syndrome
List some complications caused by nephrotic syndrome and pathogenesis related to them.
List conditions and pathology associated.
Which syndrome nephrotic or nephritic, will present as inflamed glomerulus which compromises BF and filtration.
nephritic syndrome
Nephritic syndrome is the classic presentation of what other condition?
post streptococcal glomeruleonephritis
Another name for Frank Severe asymptomatic hematuria?
IgA nephropathy/Intravascular hemolytic anemia
What are the 4 stages of progression in chronic renal failure?
- diminished renal reserve
- renal insufficiency
- renal failure
- end-stage renal disease
Describe diminished renal reserve. (GFR and other characteristics)
GFR is about 50% of normal. Serum BUN & creatinine values – normal
Describe renal insufficiency.(GFR and other characteristics)
GFR is 20% to 50% azotemia +, usually associated with anemia & hypertension ; Polyuria and nocturia can occur
Describe renal failure (GFR and other characteristics)
GFR is less than 20% to 25% of normal ;
Edema, metabolic acidosis, and hypocalcemia;
develop features of uremia
Describe end-stage renal disease and other defining features
GFR is less than 5% of normal; this is the terminal stage of uremia.
