Glomerular, Polycystic, Nephrolithiasis Flashcards

1
Q

Damage of the renal glomeruli by deposition of inflammatory proteins in the glomerular membranes as the result of an immunologic response

A

Glomerulonephritis

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2
Q

60% of glomerulonephritis cases are in what age group

A

children ages 2-12

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3
Q

Causes of GN are divided into 2 groups:

A

Focal (less than 1/2 glomeruli affected)

Diffuse (affects most glomeruli)

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4
Q

Clinical features of GN

A

Hematuria

Oliguria / anuria

Edema of face and eyes in AM,
edema of feet and ankles PM

HTN is common

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5
Q

Causes of FOCAL (< 1/2 glomeruli) GN in children

A

Benign hematuria

Henoch-Schonlein purpura

Mild postinfectious GN

IgA nephropathy

Hereditary nephritis

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6
Q

Causes of FOCAL (<1/2) GN in adults

A

IgA nephropathy

Hereditary nephritis

SLE

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7
Q

Causes of DIFFUSE GN in children

A

Postinfectious GN

Membranoproliferative GN

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8
Q

Causes of DIFFUSE GN in adults

A

SLE

Membranoproliferative GN

Rapidly Progressive GN

Postinfectious GN

Vasculitis

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9
Q

Henoch-Schonlein purpura

A

Focal GN found in children

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10
Q

IgA nephropathy

A

Focal GN found in both children and adults

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11
Q

Hereditary nephritis

A

Focal GN found in both children and adults

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12
Q

SLE

A

causes focal GN in adults

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13
Q

Membranoproliferative GN

A

causes DIFFUSE GN in children and adults

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14
Q

RPGN

A

causes DIFFUSE GN in adults

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15
Q

Vasculitis

A

causes DIFFUSE GN in adults

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16
Q

Lab that detects post infectious GN 60-80% of the time

A

Antistreptolysin - O

17
Q

Urinalysis in GN

A

Hematuria / Acanthocytes

RBC casts

Proteinuria

18
Q

Other diagnostic lab value found in GN

A

Serum complement (C3) levels are often decreased

19
Q

Excretion of > 3.5g protein in 24 hrs.

A

Nephrotic syndrome

20
Q

Characteristics of nephrotic syndrome

A

Proteinuria (3.5g +)

Hypoalbuminemia

Lipiduria

Hypercholesterolemia

Edema

21
Q

Why are patients with nephrotic syndrome at risk of thrombosis?

A

Due to loss of proteins S and C and antithrombin III

22
Q

Symptoms of nephrotic syndrome

A
Malaise
Abdominal distension
Anorexia
Facial edema
Oliguria
Scrotal swelling
SOB
Weight gain
23
Q

Signs of nephrotic syndrome

A

Ascites
Edema
Hypertension
Orthostatic Hypotension

Retinal sheen ?

Skin striae

24
Q

Tx nephrotic syndrome

A

ACE-I, early in course of disease

Diuretics for edema

Anticoagulants, if needed

Steroids, esp in children, if indicated. Stronger immunosuppressants if relapse (cyclo’s, etc)

25
Q

ADPKD

A

Most common form of PKD

Bilateral

Symptoms develop during 4th decade of life

26
Q

ARPKD

A

Less common

Begins in utero

can lead to fetal / neonatal death

surviving infants > short life, renal/hepatic failure

27
Q

ACKD

A

Acquired cystic kidney disease

occurs in ppl w long term renal disease

more common in African American men

28
Q

ADPKD, clinical features

A

back and flank pain

headaches (risk of aneurysm)

nocturia

Hematuria, HTN, UTI’s, weight loss

Renal colic, N/V

29
Q

ADPKD urinalysis

A

Proteinuria, hematuria, pyruria, bacteruria

30
Q

ADPKD diagnostic method of choice

A

Ultrasonography (fluid filled cysts)

31
Q

3 anatomical points at which kidney stones can lodge

A
  1. Ureteropelvic junction (UPJ stones)
  2. Uretervesicular junction (UVJ BLADDER stones)
  3. Ureter at levels of iliac vessels
32
Q

4 major types of stones

A

Calcium (75-85%)

Uric acid (5-8%)

Cystine (<1%) - genetic

33
Q

Pain from a stone in the upper ureter radiates

A

to anterior abdomen

34
Q

pain from a stone in the lower ureter radiates

A

ipsilateral groin, testicle or labia

35
Q

Pain from a stone in the UVJ radiates

A

lower pelvic pain

urinary frequency / urgency

36
Q

Imaging modality of choice for kidney stones

A

Helical CT

no contrast needed

ultrasound for pregs and kids

37
Q

Gold standard Tx for large kidney stone (>10 mm)

A

Ureteral stent or percutaneous nephrostomy

38
Q

Medications for calcium stones

A

Hydrochlorothiazede, to decrease urine calcium excretion

39
Q

Medication for uric acid stones

A

Allopurinol to decrease uric acid excretion