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Nephrology > Intro to Glomerulonephritis > Flashcards

Intro to Glomerulonephritis Flashcards

1
Q

What three potential causes of Renal Dz (location wise)?

A
  1. Prerenal
  2. Postrenal
  3. Renal
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2
Q

Where is the glomerulus located?

A

Cortex

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3
Q

Two different causes of most broadly generalized by problems in?

A
  1. Tubular

2. Glomerular

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4
Q

This type of cell lines the capillary and provides antithrobotic functions.

A

Endothelial Cell

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5
Q

This type of cell largely controls filtration of solute and protein.

A

Podocyte (Epithelial Cell)

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6
Q

This type of cell can control the capillary loop diameter.

A

Mesangial Cell

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7
Q

This type of cell produced the matriz that supports the capillary loop and has some macrophage-like functions.

A

Mesangial Cell

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8
Q

Two most important aspects of a patient visit to suspect glomerulonephritis?

A
  1. History and Physical

2. Labs

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9
Q

Signs of Glomeulonephritis based on Physical Exam?

A
  1. Abdominal Pain
  2. Rash
  3. Neuropathy
  4. Recent Illness
  5. Recent Medications
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10
Q

Single most important lab in the evaluation of glomerulonephritis

A

Urine Analysis with Microscopic Exam

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11
Q

When the filter of the glomerulus breaks, what will happen?

A

Loss of Protein and RBCs

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12
Q

UA Results of 2+ Protein, 60 RBC would narrow the differential to?

A

Glomerulonephritis
UTI
RBC from mass lesion in bladder or stone.

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13
Q

Two specific finds for glomerulonephritis

A
  1. Dysmorphic RBCs (Acanthocytes)

2. RBC Casts

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14
Q

What would you find clinically in nephrOtic Syndrome?

A

Problem with the glomerulus causing leakage of very large amounts of protein

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15
Q

What would you find clinically in nephrItic Syndrome?

A

Problem with the glomerulus causing leakage of some RBC and less protein

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16
Q

Characteristics of Nephrotic Syndrome

A
  1. > 3.5 protinurea/day
  2. Hypoalbuminemia
  3. Edema
  4. Hyperlipidemia
  5. Hypercoaguability

*** Not lots of RBSa or RBC casts in urine

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17
Q

Characteristics of Nephrutic Syndrome

A
  1. RBCs and RBC Cast in urine
  2. Proteinurea (but not massive)
  3. HTN
  4. Possible renal impairments
  5. Possibly more acute
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18
Q

Most important diagnostic testing for nephritic syndrome

A

Renal Biopsy via Renal Consult

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19
Q

Primary causes of nephritic syndrome

A
  1. Post-infectious glomerulonephritis
  2. IgA Nephropathy
  3. Rapidly progressive glomerulonephritis
  4. Rapidly progressive glomerulonephritis (Anti-GBM, Idiopathic)
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20
Q

Systemic Dz Causes of Nephritic Syndrome

A
  1. Lupus
  2. Goodpasture’s Dz (Vasculitis)
  3. Pauci-Immune Glomerulonephritis’s Dz (Vasculitis)
  4. Henoch- Schonlein Purpura
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21
Q

Most common infection that can lead to post-infectious glomerulonephritis?

A

Streptococcal (Throat or Skin infection)

***Must be a nephrotoxic strain to cause this

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22
Q

After a nephrotoxic strain of strep infection, how soon will you see glomerulonephritis onset?

A

2-3 weeks

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23
Q

Which cause of Nephritic Syndrome is the most common in children 2-14 years old?

A

Post-Infectious Glomerulonephritis

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24
Q

Is post-infectious glomerulonephritis common these days?

A

Nope, not at all. We are all about antibiotics these days, so this doesn’t phase us.

25
Q

Presentation of Post-infectious glomerulonephritis Nephritic Syndrome

A
  1. Tea colored urine
  2. Leg Swelling
  3. Sore throat that was untreated
  4. HTN
26
Q

Lab results of someone with post-infectious glomerulonephritis

A
  1. Protein in urine
    • Antistreptolysin O
  3. Low C3 level
  4. Elevated BUN and Creatinine
  5. RBCs in urine (low?)
27
Q

Pathogenesis of Post-infectious Glomerulonephritis

A

Immune complex deposits in the glomerulus

28
Q

Treatment of Post-infectious Glomerulonephritis

A
  1. Supportive (Hugs)

2. Antibiotics (with more hugs)

29
Q

What is the most common type of glomerulonephritis?

A

IgA Nephropathy!

Most common in Asia

30
Q

Presentation of IgA Nephropathy

A

Usually slow and progressive.
Often asymptomatic
Can present as microscopic or gross hematuria (+mild proteinuria)
Flares during infections

31
Q

Over 20 years, about 25% of pts with IgA Nephropathy develops ___________.

A

End Stage Renal Disease

32
Q

Over 20 years, about 20% of pts with IgA Nephropathy develops ___________.

A

Chronic Kidney Disease

33
Q

Etiology of IgA Nephropathy

A
  1. Host production of slightly abnormal IgA
  2. Abnormal Bone Marrow Response
  3. Abnormal mucosal immune system
34
Q

IgA Nephropahy leads to

A

Deposition of IgA in the kidney

35
Q

Treatment of IgA Nephropathy

A
  1. Control BP with ACE Inhibitor and ARB

2. Fish oil?

36
Q

This type of glomerulonephritis progresses rapidly over days to weeks and has a non-specific etiology.

A

Rapidly Progressive Glomerulonephritis

37
Q

On a biopsy, what will Rapidly Progresive Glomerulonephritis appear like?

A

Crescents!

38
Q

Due to the crescent shapes on a histological smear of this diseases, what is also called “Crescentic Glomerulonephritis?”

A

Rapidly Progressive Glomerulonephritis

39
Q

This is an autoimmune disorder that is characterized by rash, photosensitivity, arthritis, hematologic disorders, and anti-nuclear antibodies.

A

Lupus

40
Q

True/False

Lupus can cause rapidly progressive acute renal failure as well as asymptomatic urinary findings.

A

True! Lupus is a varying dz.

41
Q

A patient with Lupus Nephritis will present in a lab finding with:

A
  1. Abnormal UA (RBC and Protein)
  2. Positive ANA (antinuclear antibodies)
  3. Positive dsDNA
  4. Low complement
  5. Elevated BUN and Creatinine
42
Q

Pathogenesis of Lupus Nephritis

A

Immune complexes deposited in the kidney.

43
Q

Treatment of Lupus Nephritis

A

Immunosuppression

44
Q

True/False:

Any patient with lupus and unexplained protein, RBC, or WBC in the urine is considered normal.

A

False! They should be referred to nephrology and get a biopsy!

45
Q

This is an autoimmune disorder where the body makes antibodies against the glomerular basement membrane

A

Goodpasture’s Dz

46
Q

In addition to affecting the glomerular basement membrane, Goodpasture’s Dz will also affect the membranes of what organ?

A

Lungs! Can lead to pulmonary hemorrhage

47
Q

Goodpasture’s Dz is more common in what types of individuals?

A

Men, Smokers, people with lung damage from hydrocarbons.

48
Q

Lab Findings of Goodpasture’s Dz?

A
  1. Elevated BUN Creatinine

2. UA with RBCs and Protein

49
Q

Histologically, what will you see in Goodpasture’s Dz vs. Normal Kidney?

A

Atrophy of the GBM! Looks like an outline around the glomerulus

50
Q

Treatment of Goodpasture’s Dz

A
  1. Plasmapheresis
  2. Immunosuppression
  3. Supportive (Dialysis and Hugs)
51
Q

What are three rare diseases that can cause Pauci-immune Glomerulonephritis?

A
  1. Wegner’s Granulomatosis
  2. Microscopic Polyangitis
  3. Chrug-Strauss Syndrome
52
Q

Pauci-Immune Glomerulonephritis is a group of diseases that all affect:

A

Vasculature (Vasculitis)

53
Q

Pauci-Immune Glomerulonephritis is associated with:

A

Anti-nuclear cytoplasmic antibodies (ANCA)

54
Q

Pauci-Immune Glomerulonephritis is most common in which sex?

A

Vaginal Humans! (Females)

55
Q

Two most important factors in identifying Pauci-immune glomerulonephritis

A
  1. Positive ANCA

2. No Immune findings on IF

56
Q

Light Microscopy of Pauci-Immune Glomerulonephritis

A

Crescent Imaging

57
Q

Fluorescent Microscopy of Pauci-Immune Glomerulonephritis

A

Nothing will fluoresce

58
Q

Treatment of Pauci-Immune Glomerulonephtitis

A
  1. Immunosuppression

2. Supportive (Hugs)

Nephrology (6 decks)

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