Glomerular Disease 1- Pathology

Question 1

Be able to map out the flow of blood from renal artery to renal vein.

Answer 1

Question 2

What is the vasodilator for afferent arteriolar blood flow?

Answer 2

PGE2

Question 3

What is the vasconstrictor for efferent arteriolar blood flow?

Answer 3

AT II

Question 4

What are some components of the basement membrane?

Answer 4

collagen IV
Laminin
polyanionic proteoglycan
fibronectin
entactin
etc

Question 5

Another name for visceral epithelium?

Answer 5

podocyte

Question 6

What is the function of the glomerular barrier?

Answer 6

to discriminate among various protein molecules depending on their size and charge

Question 7

What is the glomerular barrier maintained by?

Answer 7

visceral epithelial cells

Question 8

Describe pathology of Goodpastures.

Answer 8

The ag to which ab are directed are present on the NC1 domain of alpha chain

Question 9

Describe pathology of Alports.

Answer 9

a mutation in the alpha 5 chain in T4 collagen (col IV A5 mutation)

Question 10

How many different types of collagen chains are there?

Answer 10

6 types of alpha chains and it takes 3 to form structure

Question 11

Be able to reproduce this chart on the pathology affecting the different parts of the nephron.

Answer 11

Reproduce chart.

Question 12

Be able to reproduce chart on presentations in renal disease.

Answer 12

Reproduce chart.

Question 13

Be able to chart out the localization of the pathology related to kidneys based on the presentation.

Answer 13

Reproduce this chart

Question 14

What are normal levels of serum BUN?

Answer 14

normal: 7-18mg/dl

Question 15

What are factors that may affect BUN?

Answer 15

Depends on GFR, protein content in diet, PCT function, status of urea cycle

Question 16

In what conditions is BUN usually increased?

Answer 16

CCF, acute GN, Acute & chronic renal failure, urinary tract obstruction, cirrhosis

Question 17

What is normal serum creatinine?

Answer 17

normal: 0.6 -1.2 mg/dl

Question 18

What is normal serum BUN: Creatinine ratio?

Answer 18

normal = 15

Question 19

If BUN/Cr ration is > 15, what may this indicate?

Answer 19

Prerenal & post renal azotemia

Question 20

If BUN/Cr ratio is ≤ 15, what may this indicate?

Answer 20

renal azotemia

Question 21

What is normal creatinine clearance?

Answer 21

100-137 ml/min

Question 22

What does creatinine clearance depend on?

Answer 22

GFR

Question 23

If creatinine clearance is < 10ml/min what may this indicate?

Answer 23

renal failure

Question 24

Is this definition descriptive of nephrotic or nephritic syndrome?

Heavy proteinuria (more than 3.5 gm/day), hypoalbuminemia, generalised edema, hyperlipidemia, and lipiduria

Answer 24

Nephrotic syndrome

Question 25

List some complications caused by nephrotic syndrome and pathogenesis related to them.

Answer 25

List conditions and pathology associated.

Question 26

Which syndrome nephrotic or nephritic, will present as inflamed glomerulus which compromises BF and filtration.

Answer 26

nephritic syndrome

Question 27

Nephritic syndrome is the classic presentation of what other condition?

Answer 27

post streptococcal glomeruleonephritis

Question 28

Another name for Frank Severe asymptomatic hematuria?

Answer 28

IgA nephropathy/Intravascular hemolytic anemia

Question 29

What are the 4 stages of progression in chronic renal failure?

Answer 29

1. diminished renal reserve
2. renal insufficiency
3. renal failure
4. end-stage renal disease

Question 30

Describe diminished renal reserve. (GFR and other characteristics)

Answer 30

GFR is about 50% of normal. Serum BUN & creatinine values – normal

Question 31

Describe renal insufficiency.(GFR and other characteristics)

Answer 31

GFR is 20% to 50% azotemia +, usually associated with anemia & hypertension ; Polyuria and nocturia can occur

Question 32

Describe renal failure (GFR and other characteristics)

Answer 32

GFR is less than 20% to 25% of normal ;
Edema, metabolic acidosis, and hypocalcemia;
develop features of uremia

Question 33

Describe end-stage renal disease and other defining features

Answer 33

GFR is less than 5% of normal; this is the terminal stage of uremia.