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Renal SOH > Kidneys in systemic disease > Flashcards

Kidneys in systemic disease Flashcards

1
Q

Diabetic nephropathy is a MICRO/MACRO -vascular complication of diabetes?

A

Microvascular

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2
Q

Diabetic nephropathy - the afferent arteriole CONSTRICTS/DILATES and the efferent arteriole CONSTRICTS/DILATES ?

A

Afferent - dilates
Efferent - constricts
This is due to the RAAS system

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3
Q

Diabetic nephropathy - pathogenesis

A

Glomerular hypertension
Pressure goes up in the glomerulus which causes proteins to leak out
Renal hypertrophy
- nodule formation and diffuse glomerulosclerosis
Inflammation
- causes damage to filtering unit

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4
Q

Diabetic nephropathy - it is common to get proteinuria. True or false?

A

True

- due to the podocyte dysfunction

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5
Q

Diabetic nephropathy - investigations

A 
GFR - should be normal 
Urinalysis
- microalbuminuria/proteinuria
Renal biopsy 
- only if haematuria present
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6
Q

What is the earliest sign of diabetic nephropathy?

A

Microalbuminuria / proteinuria

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7
Q

Diabetic nephropathy - management

A 
Maintain tight glycaemic control
Reduce proteinuria 
- ACE inhibitor 
- ARB 
Statin 
RRT (if severe)
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8
Q

Diabetic nephropathy - why are ACE inhibitors good to use?

A

Reduce proteinuria

Dilate the efferent arteriole by blocking the RAAS system

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9
Q

Transplantation in diabetic nephropathy can cure diabetic nephropathy AND diabetes. True or false?

A

True

  • simultaneous kidney-pancreas transplant
  • only works for type 1 diabetes
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10
Q

Renovascular disease(RVD) - name some examples

A

Hypertension
Cardio-renal syndrome
Ischaemic nephropathy
Renal artery stenosis

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11
Q

RVD - ischaemic nephropathy - definition

A

Reducred GF associated with reduced renal blood flow beyond the level of auto-regulatory compensation

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12
Q

A reduction in renal perfusion pressure ACTIVATES/DEACTIVATES a series of hormonal and neuronal responses that RAISE/DROP systemic arterial BP?

A

Activates

Raise

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13
Q

Who gets essential hypertension?

A

Elderly patients

Poorly controlled hypertension

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14
Q

Who gets secondary hypertension?

A

Younger hypertensive patients

Renal artery stenosis pts

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15
Q

What is renal artery stenosis?

A

Blockage of the major blood supply to the kidney

Severe narrowing of the renal artery

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16
Q

Renal artery stenosis - who gets it?

A

Elderly
Males
Those with risk factors of generalised atherosclerosis

17
Q

Renal artery stenosis is usually unilateral/bilateral?

A

Unilateral

18
Q

Renal artery stenosis - clinical features

A

Renovascular hypertension
Atherosclerosis elsewhere
Flash pulmonary oedema

19
Q

Renal artery stenosis - examination findings

A

Abdominal bruit

20
Q

Renal artery stenosis - investigations

A 
Imaging
- Discrepancy in kidney size 
US
Renal artery duplex studies 
CT angiography 
MRI angiography
21
Q

Renal artery stenosis - management

A

Statin
Anti-platelet
ACE inhibitor
Angioplasty +/- stent

22
Q

When are ACE inhibitors contra-indicated in renal artery stenosis?

A

In BILATERAL renal artery stenosis

23
Q

Cardio-renal syndrome - definition

A

Kidneys are trying to hold on to salt and water to keep them functioning
Heart muscle gets overloaded and is more stressed

24
Q

Small vessel vasculitis - types

A

GPA
EGPA
Microscopic polyangitis

25
Q

Which of the following do NOT have granulomas?

  • GPA
  • EGPA
  • MPA
A

Microscopic polyangitis

26
Q

Small vessel vasculitis - investigations

A 
Urinalysis
Bloods 
- raised inflammatory markers
Immunology
- ANCA 
Renal biopsy
27
Q

cANCA + anti-PR3 suggests which small vessel vasculitis?

A

GPA

28
Q

pANCA + anti-MPO + NO granulomas suggests which small vessel vasculitis?

A

Microscopic polyangitis

29
Q

pANCA + anti-MPO + granulomas suggests which small vessel vasculitis?

A

EGPA

30
Q

Small vessel vasculitis - management

A

Steroids + cyclophosphamide

Plasma exchange

31
Q

Lupus nephritis - investigations

A

Urinalysis
- proteinuria
Renal biopsy

Renal SOH (25 decks)

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