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Med Path Fall 2020 > Kidney > Flashcards

Kidney Flashcards

1
Q

3 forms of urinalysis and common contaminants

A

Visual analysis
Test sticks
Microscopic

Common: 
Leukocytes 
Blood
Ketone
Glucose
Protein
Bilirubin
pH 
Transitional cells
Bacteria
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2
Q

Renal function tests (3) to determine GFR- Glomerular filtration rate. Volume of fluid filtered by glomeruli.

A
  1. Inulin. Gold standard. Give IV infusion of plant starch. Completely filtered by glomerulus. Can get accurate GFR.
  2. Creatinine clearance rate. Compare blood levels to urine. Will slightly overestimate GFR
  3. Blood urea nitrogen (BUN) protein and DNA breakdown byproduct.
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3
Q

Azotemia

A

No clinical signs of renal failure present.
Only labs are abnormal- decreased GFR, increased BUN, increased blood creatinine.
Usually discovered on accident.

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4
Q

Uremia

A

Azotemia + clinical signs and symptoms of renal failure

Ex: HTN, anemia, edema, oliguria

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5
Q

Oliguria

A

Low GFR= reduced ability to produce urine.

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6
Q

Renal disease is #__ cause of death

A

9

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7
Q

Nephritic vs nephrotic

A

Nephritic: Blood in urine. Hematuria.
Nephrotic: Proteins in urine. Proteinuria.

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8
Q

Nephrotic syndromes

A 
Diabetic nephropathy (50%) 
Minimal change disease

Proteinuria - foamy urine from albumin.
No hematuria

May resolve completely or progress to ESRD.

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9
Q

Which is more severe? Nephritic or nephrotic?

A

Nephrotic.

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10
Q

Diabetic nephropathy (nephrotic syndrome)

  • Most common cause of __
  • Leading cause of death in ___
  • MOA
  • Characterized by
  • Risk factors
A

Most common cause of renal disease
Leading cause of death in T1 DM
MOA: Endothelial glycation = basement membrane damage

Characterized by nephrotic syndrome, diffuse glomerulosclerosis.

Risk: Type 1 DM, HTN, smoking, Race (AA, hispanic)

Tx: Dialysis, DM treatment

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11
Q

Minimal change disease (nephrotic syndrome)

  • Most common cause of nephrotic syndrome in __
  • Cause?
  • First symptom/sign
  • How to visualize pathology
  • Treat with what
A

Most common cause of nephrotic syndrome in children. 80-90% children, 10-20% adults

70-90% idiopathic cause.

Edema of face is first sign

Pathology visible with electron microscopy- podocytes, microvilli, vacuoles.

Treat with steroids- 95% recover

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12
Q

Acute tubular necrosis

  • What is it
  • Most common cause of what
  • Two types
A
  • Extensive necrosis of tubular epithelial cells.
  • Most common cause of ACUTE renal failure.
  • Glomeruli are spared.
  • Ischemic (50%), toxic (25%)
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13
Q

Most common cause of acute renal failure

A

Acute tubular necrosis

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14
Q

Most common cause of nephrotic syndrome in children

A

Minimal change disease

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15
Q

Most common cause of renal disease

A

Diabetic nephropathy due to T1 DM

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16
Q

Leading cause of death in T1 DM

A

Diabetic nephropathy

17
Q

What causes ischemic acute tubular necrosis?(50%)

What causes toxic acute tubular necrosis? (25%)

A

Ischemic: Vascular collapse due to shock/hypotension. Or pre-renal vessel occlusion due to HTN, DM.

Toxic: Intravenous use of x ray contrast media or other drugs.

18
Q

Hypertensive nephropathy

  • MOA
  • 2nd most common cause of ___
  • Duration and severity of ___ plays a role
  • Two types
  • Tx
A

Sclerosis of renal arteries and glomeruli due to HTN.
2nd most common cause of ESRD, behind DM.
HTN plays big role

  1. Benign nephrosclerosis (55%)
    - 1 to 5% progress to renal failure.
  2. Malignant nephrosclerosis (45%
    - Diastolic over 130 mmHg.
    - 33% progress to renal failure.

Tx: BP control.

19
Q

Two types of HTN nephropathy

A
  1. Benign nephrosclerosis (55%)
    - 1 to 5% progress to renal failure.
  2. Malignant nephrosclerosis (45%
    - Diastolic over 130 mmHg.
    - 33% progress to renal failure.
20
Q

ESRD #1 #2 and #3causes

A

1: DM (40%)
2: HTN nephropathy (30%)
3: Glomerulonephritis (8%)

21
Q

GFR of what signals ESRD

A

15 or less.

10% normal renal function.

22
Q

ESRD 3 tx options

A

Dialysis
Transplantation
Death from uremia.

23
Q

3 main signs of chronic renal failure

A

Oliguria: Low GFR= reduced ability to produce urine.
Azotemia/uremia (abnormal labs and clinical signs)
Fatigue

24
Q

Ophthalmic manifestations of renal disease

A

Band keratopathy
Posterior subcapsular cataract
Renal retinopathy due to HTN. As kidneys fail, it leads to HTN that can affect eye.

25
Q

80-90% of kidney cancers are ____

A

Renal cell carcinoma.

26
Q

Renal cell carcinoma

  • Risk factors
  • Symptoms
  • more in men or women
A

Smoking, family history (VHL)
Hematuria- blood in urine.
Men > women

27
Q

Nephroblastoma aka Wilms tumor

  • most common kidney cancer in ___
  • Unilateral vs bilateral chance of progressing to ESRD
  • Risk factors
  • Signs
A

Most common kidney cancer in children
Dx between 3-4 years old.

95% are unilateral and have 40% of developing ESRD.
If bilateral, have 90% change to develop ESRD.

AA>Caucasian> asian
F> M
Family Hx

Palpable abdominal mass
Eyes = aniridia (25-30% of cases)

28
Q

Most common kidney cancer in kids

A

Wilms tumor/nephroblastoma. Aniridia.

29
Q

98% of bladder cancers

A

Transitional cell carcinoma

  • Usually 65+
  • Men > women
30
Q

Transitional cell carcinoma

  • Risk factors
  • Main sign
A

Smoking (50%) and occupational exposures (30%)

Signs- hematuria blood in urine

31
Q

Main cause of UTI

A

E coli (70-90%) or stasis or urine flow.

32
Q

Nephrolithiasis (kidney stones)

  • Risk factors
  • Types of stones
A

Men > women
White > AA

Calcium is most common type of stone

Tx with hydration and pain meds

33
Q

Kidney dysfunction. What 2 tests are elevated and which 2 are reduced

A

Elevated: Blood urea nitrogen (BUN) and blood creatinine.

Reduced: Urine Creatinine and GFR

Med Path Fall 2020 (20 decks)

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