Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary (Semester 3) > Glomerular Injury > Flashcards

Glomerular Injury Flashcards

1
Q

What is the difference between a primary and secondary glomerular injury?

A

Primary: just affecting the glomerulus

Secondary: a systemic disease that has, in turn, damaged the glomerulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 sites of glomerular injury?

A
  1. subepithelial: anything that affects podocytes side of glomerular BM
  2. Within glomerular basement
  3. Subendothelial: inside the BM
  4. Mesangial/paramesangial: supporting capillary loop
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pathology of proteinuria?

A

Protein in the urine is caused by podocyte damage and widening of the fenestration slits, causing protein to leak out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What defines nephrotic syndrome? What is the likely site of injury?

A

> 3.5g of protein filtered in 24 hours. Oncotic pressure reduces, giving rise to edema. Podocyte and subepithelial damage is likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name 3 primary causes of proteinuria/nephrotic syndrome

A
  1. Minimal change glomerulonephritis (GN)
  2. Focal segmental glomerulosclerosis (FSGS)
  3. Membranous glomerulonephritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define glomerulonephritis and 6 stimuli

A

Damage/inflammation of the glomerular BM resulting in altered function

  1. virus
  2. post-infective
  3. bacteria
  4. parasites
  5. drugs
  6. hereditary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How might a patient present with nephrotic/nephritic syndrome?

A

Nephrotic: low albumin, oedema, frothy urine

Nephritic: Increased BP, coca-cola urine, decreased urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name 6 things you could do to investigate a patient who may have a glomerular disease

A
  1. Urine dip
  2. Urine microscopy
  3. BP
  4. Blood
  5. Biopsy
  6. Microscopy: light and electron
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When does minimal change glomerulonephritis usually present? What is a good investigation to do?

A

Childhood - adolescence

Do a renal biopsy and electron microscopy to see podocyte damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When does focal segmental glomerulosclerosis typically present?
What is the significance of the ‘sclerosis’
What might you see under electron microscopy?

A

Adulthood:
Podocytes undergo damage and scar (sclerosis)
May see a thickened BM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When/how does membranous glomerulonephritis typically occur?

What histological features might be noticed?

A

It is the most common cause of nephrotic syndrome in adults, and is caused by immune complex deposits in the sub-epithelial space (probably an autoimmune basis against podocytes)

Histology: ‘speckly BM’ and thickened capillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is IgA nephropathy?

How does it classically present?

A

The commonest glomerular nephropathy, occuring at any age and characterised by deposition of IgA antibody in the glomerulus. Classically presents with visible/invisible hematuria and normal C3 complement levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name the 2 hereditary nephropathies

A

Anti GBM BM and Alport syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 2 common secondary causes of proteinuria/nephrotic syndrome?

A
  1. Diabetes mellitus

2. Amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is goodpasture syndrome? What investigations could you do and what might you see?

A

Very rapidly progressing glomerular nephritis, caused by an autoantibody to collagen IV in BM (but only affects kidney)

Could do chest x-ray: see pulmonary infiltrates and microscopy to see depositions of IgG along the glomerular BM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is vasculitis?

A

Inflammation of blood vessels when glomerulus is attacked by ANCA

17
Q

What is HSP Henoch Schonlein Purpur? How and when can it commonly present?

A

IgA and IgG interact to produce complexes that activate an immune response.

3-10 years old, more common in boys. Skin rash, fever, edema, abdominal pain, hematuria

18
Q

What is post strep syndrome? What is a typical history and presentation?

A

Group A hemolytic streptococcus, history of throat infection and skin infection

Presents: coke cola urine, swollen ankles or puffy eyes

19
Q

What kind of general management would you offer to a patient with glomerular disease?

A
  1. BP control
  2. Fluid/hydration
  3. Immunosuppressive drugs
  4. Diuretics: fluid overload
  5. Control of hyperkalemia, uremia
  6. Dialysis
  7. ACE inhibitor
  8. Thrombosis/infection
20
Q

What does PHAROH stand for?

A

Acronym for nephritic syndrome:
P: Proteinuria
H: Hematuria
A; Azotemia: increased creatinine and urea
R: RBC casts (RBC gets a tubular skinny shape from squeezing through the kidney tubles)
O: Oliguria: abnormally small amounts of urine
H: Hypertension

21
Q

Where can a urinary tract malignancy occur?

A
  1. Bladder
  2. Prostate
  3. Urethra and penis
22
Q

Name 5 risk factors and 5 red flags for UT malignancies?

A

5 risk factors:

  1. Occupational; dyes
  2. genetic
  3. age
  4. sex: male
  5. Smoking + alcohol

5 red flags:

  1. Bone pain
  2. abdominal pain
  3. appetite or weight loss
  4. Hematuria
  5. ED
23
Q

How common is renal adenocarcinoma? What are some causes and risks?

What is the ‘Triad’ Signs/symptoms?

A

95% of all upper urinary tract tumours.

Smoking, obesity, more common in males, poor prognosis

Triad: Have Fun Memorising…

  1. Hematuria
  2. Flank pain
  3. palpable flank mass
24
Q

How would you diagnose renal adenocarcinoma and what are some treatments?

A

MRI
Partial nephrectomy: removing the part of the kidney with a disease or tumour in it

Radical nephrectomy: removing the whole kidney, the fatty part around it and a portion of the ureter

25
Q

What is the cause of Wilm’s tumour? When/How do patient’s typically present?

A

A mutation on chromosome 11.

Typically 2-5 years old, with large abdominal mass + pain, anemia, hypertension, hematuria, weight loss

26
Q

What is the prevalence, risk factors, diagnosis and treatment for ureteric (urothelial cancer)?

A

Uncommon

Smoking, dyes and chemicals in leather goods, Hereditary non-polyposis colorectal cancer

Diagnosis: Ultrasound, ureteroscopy, biopsy, etc

Treatment: nephro-ureterectomy; removing a patient’s renal pelvis, ureter, kidney and bladder cuff

27
Q

What are the 3 main risk factors for bladder cancer? What is the prognosis and recurrence rate?

A
  1. Smoking
  2. Chemicals in dye making ‘aromatic amines’
  3. Caucasians: 2X more likely

Prognosis:
Recurrence rate of bladder cancer is 50-75% so people who have had bladder cancer have a higher chance of getting another UT tumour. Prognosis is low as most females get diagnosed at advanced stages

28
Q

How could you diagnose and treat bladder cancer?

A

Investigations: urine culture and cytology with biopsy

Treat: transurethral resection of bladder tumour, radical cystectomy, radiotherapy

29
Q

What is the incidence and what are the risk factors for prostate cancer?

A

Incidence: most common type of cancer in men, going up

Risk factors:
>50, black, genetics, obesity, FH,

30
Q

What is PSA Testing and how can it be used? Is it reliable?

A

PSA is a protein produced by normal and cancerous prostate cells into prostatic fluid.

Not always reliable:

  1. Cancer can be present without raised PSA levels
  2. There are non-cancer causes of a raised PSA like a urine infection, vigorous exercise, ejaculation, anal sex, prostate biopsy and DRE
31
Q

What is a major issue with diagnosing prostate cancer ?

A

No national screening, only do DRE (digital rectal exam) if someone is presenting with symptoms

Prostate biopsies also find <50% of clinically significant prostate cancers that MRI scans miss

32
Q

What is one complication that can result from a biopsy?

A

Sepsis

33
Q

What might you find on investigations of nephritic/nephrotic syndrome?

A

Urine: blood, frothy, protein

Blood: clotting will increase, reduced albumin, infections, lipids

34
Q

How does prostate cancer typically present?

A

Mostly asymptomatic, may have difficulty urinating, bone pain and hematuria means advanced

Urinary (Semester 3) (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions