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AUBF Lecture > Lesson 5: Renal Disease > Flashcards

Lesson 5: Renal Disease Flashcards

1
Q

It is a “sudden onset” of symptoms consistent with damage to the glomerular membrane

A

Acute glomerulonephritis (AGN)

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2
Q

This disease usually occurs after respiratory infection caused by certain strains of group A (Beta-hemolytic streptococci) that contains M protein in the cell wall

A

Acute poststreptococcal glomerulonephritis

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2
Q

Primarily urinalysis findings include:

marked hematuria
proteinuria
oliguria
RBC cast
dysmorphic RBC
hyaline, granular cast
WBC cast

A

Acute glomerulonephritis

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3
Q

What tests provide evidence that the glomerulonephritis is of streptococcal origin?

A

Positive anti-group A streptococcal enzyme test:
1. anti-streptolysin O (ASO)
2. antideoxyribonuclease-B antibody (anti-DNase B)

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3
Q

Technical Tip: RBC casts are a hallmark characteristic of acute glomerulonephritis

A

YIPPIE ESNUPI!

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4
Q

A more serious form of acute glomerular disease and has a much more poorer prognosis, often terminating in renal failure

A

Rapidly progressive (or crescentic) glomerulonephritis (RPGN)

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4
Q

Symptoms of this disease are initiated by deposition of “immune complexes in the glomerulus”, often as a complication of another form of glomerulonephritis or a disorder of the immune system such as, “SLE” or Systemic Lupus Erythematosus

A

Rapidly Progressive (Crescentic) Glomerulonephritis

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4
Q

A cytotoxic “autoantibody” can appear against the glomerular and alveolar basement membranes after viral respiratory infections

A

Goodpasture syndrome

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5
Q

Granulomatosis with polyangiitis (GPA) is formerly called as?

A

Wegener granulomatosis

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5
Q

It has morphological changes to the glomeruli resembling those in RPGN and seen in conjunction with autoimmune disorder termed as?

A

Goodpasture Syndrome

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6
Q

What antibody in the patient’s serum is a key diagnostic indication of Granulomatosis with Polyangiitis (GPA)?

A

Antineutrophilic cytoplasmic antibody (ANCA)

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6
Q

What antibody is related to Goodpasture Syndrome?

A

Anti-glomerular Basement Membrane Antibody

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6
Q

It causes a granuloma-producing inflammation of the small blood vessels, primarily of the kidney and respiratory system

A

Granulomatosis with polyangiitis (GPA)

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7
Q

ANCA is associated with what disease?

A

Granulomatosis with Polyangiitis

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8
Q

Testing for ANCA includes incubating the patient’s serum with either ________/________ and examining the preparation using indirect immunofixation to detect the serum antibodies attached to the neutrophils

A

Ethanol or Formalin/Formaldehyde-fixed neutrophils

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8
Q

ANCA binds with what WBCs located in the vascular walls that may initiate an immune response?

A

Neutrophils

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9
Q

When neutrophils are fixed with “ethanol”, the antibodies form a perinuclear pattern called?

A

p-ANCA

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9
Q

When neutrophils are fixed with “formalin/formaldehyde”, the pattern is granular throughout the cytoplasm and is referred to as?

A

c-ANCA

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9
Q

It is marked by different alteration in the cellularity of the glomerulus and peripheral capillaries

A

Membranoproliferative glomerulonephritis (MPGN)

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9
Q

Its initial symptoms include the appearance of raised, “red patches” on the skin

A

Henoch-Schonlein purpura

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10
Q

Complete recovery with normal renal function is seen more than ___ of patients in cases of Henoch-Schonlein Purpura

A

50%

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10
Q

Disorders associated with membranous glomerulonephritis development include?

A

SLE
Sjogren syndrome
Secondary syphilis
Hepatitis B
Gold and Mercury treatments
Malignancy

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10
Q

Type 1, Type 2, or Type 3 Membranoproliferative Glomerulonephritis (MPGN)

Also called as “dense deposit disease” and displays extremely dense deposits in the glomerular basement membrane, tubules, and Bowman capsule

A

Type 2 MPGN

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11
Q

This disorder is associated with a tendency towards “Thrombosis”

A

Membranous Glomerulonephritis

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11
Q

Predominant characteristic of this disease is a pronounced thickening of the glomerular basement membrane resulting from the deposition of “Immunoglobulin G” or IgG

A

Membranous Glomerulonephritis (MGN)

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11
Q

Type 1, Type 2, or Type 3 Membranoproliferative Glomerulonephritis (MPGN)

Displays increased cellularity in the subendothelial cells of the “mesangium” (interstitial area of Bowman capsule), causing thickening of the capillary walls

A

Type 1 MPGN

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12
Q

Type 1, Type 2, or Type 3 Membranoproliferative Glomerulonephritis (MPGN)

Characterized by “both” subepithelial and subendothelial deposits

A

Type 3 MPGN

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12
Q

Many patients are children, and the disease has a poor prognosis. Type 1 (MPGN) patients progress to what disease?

A

Nephrotic syndrome

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13
Q

Many patients are children, and the disease has a poor prognosis. Type 2 (MPGN) patients progress to what disease?

A

Chronic Glomerulonephritis

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14
Q

Acute glomerular disease may progress into (2)?

A

Chronic Glomerulonephritis (CGN)
End-Stage Renal Disease (ESRD)

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14
Q

Technical Tip: The presence of broad casts is often seen in chronic glomerulonephritis that progresses to ESRD

A

YEEEEEEEEEEEEEEEEEEEEEEEE

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15
Q

Immune complexes containing IgA are deposited on the glomerular membrane, and is the most common common cause of glomerulonephritis

A

IgA nephropathy

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15
Q

IgA nephropathy is also known as?

A

Berger disease

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15
Q

A patient with IgA nephropathy may remain essentially asymptomatic for how many years?

A

20 years or more

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16
Q

This disorder is seen most frequently in children and young adults

A

Immunoglobulin A nephropathy

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16
Q

What is damaged in cases of Nephrotic Syndrome that causes the passage of high-molecular-weight proteins and lipids and negatively charged albumin into the urine.

A

Damaged shield of negativity and podocytes that produces a barrier

16
Q

In nephrotic syndrome, what is the primary protein depleted from the circulation?

A

Albumin

16
Q

Minimal Change Disease (MCD) is also known as?

A

Lipid nephrosis or nil disease

16
Q

This is a disease marked by:

massive proteinuria (>3.5 g/day)
low levels of serum albumin
high levels of serum lipids
pronounced “edema”

A

Nephrotic Syndrome

16
Q

Primary disorder associated with damage to the renal tubules?

A

Acute Tubular Necrosis (ATN)

16
Q

Since both tubular and glomerular damage occurs, nephrotic syndrome may progress to?

A

Chronic Renal Failure

17
Q

Produces little cellular change in the glomerulus, except for some damage to the podocytes and shield of negativity, allowing for increased protein filtration

A

Minimal Change Disease

17
Q

What antigen is associated with Minimal Change Disease (MCD)?

A

Human leukocyte antigen-B12 (HLA-B12)

18
Q

Patients of this disease are usually:

Children who present with edema
Heavy proteinuria
Transient hematuria
Normal BUN and Creatinine

A

Minimal Change Disease (MCD)

18
Q

It is the most common cause of nephrotic syndrome in children (85-95%)

But only (10-15%) in adults

A

Minimal Change Disease (MCD)

19
Q

It is a disorder of T cells, which release a cytokine that injures the glomerular epithelial foot processes.

A

Minimal Change Disease (MCD)

20
Q

Minimal Change Disease (MCD) is usually treated with?

A

Corticosteroids

20
Q

It is one of the most common causes of primary glomerular disease in adults

It affects only certain numbers and area of glomeruli and the others remain normal

A

Focal Segmented Glomerulosclerosis (FSGS)

20
Q

A disease seen in association with abuse of “heroin” and “analgesics” and with HIV and Hepatitis virus

A

FSGS (Focal Segmental Glomerulosclerosis)

21
Q

Immune deposits, primarily immunoglobulin M (IgM) and C3, are a frequent finding and can be seen in undamaged glomeruli

A

Focal Segmental Glomerulosclerosis (FSGS)

22
Q

Damage to the RTE cells may be produced by decreased blood flow that causes a lack of oxygen presentation to the tubules in Acute Tubular Necrosis which is called?

A

Ischemia

22
Q

Exposure to substances like:

Aminoglycoside antibiotics
Antifungal agents (amphotericin B)
Cyclosporine
Radiographic dye
Ethylene glycol
Heavy metals
Toxic mushrooms

These are substances that are considered as?

A

Nephrotoxic agents

23
Q

This disorder may be inherited in association “Cystinosis” and “Hartnup Disease”, acquired through exposure to toxic agents, including heavy metals and outdated tetracycline, or seen as a complication of multiple myeloma or renal transplant

A

Fanconi Syndrome

23
Q

It is a general term indicating a severe condition that decreases the flow of blood throughout the body

A

Shock

23
Q

It is a glycoprotein and is the only protein produced by the kidney (in the PCT and DCT)

A

Uromodulin

23
Q

It is an inherited disorder of “collagen production” affecting the glomerular basement membrane.

Can be sex-linked or autosomal genetic disorder.

A

Alport Syndrome

23
Q

This disease shows abnormalities in hearing and vision.

A

Alport syndrome

24
Q

This disorder associated with tubular dysfunction most frequently is?

A

Fanconi syndrome

24
Q

The syndrome consists of a generalized failure of tubular reabsorption in the PCT.

Therefore, substances affected most noticeably include glucose, amino acids, phosphorous, sodium, potassium, bicarbonate, and water

A

Fanconi Syndrome

25
Q

Technical Tip: RTE cell casts and the presence of RTE cells in the urine sediment are characteristic for ATN

A

Strasingpurrrrr!!

25
Q

Technical Tip: Uromodulin forms the matrix of urinary casts seen in many renal disorders. The defective gene is not associated with other renal disorders

A

FWAEHHH!

26
Q

It is primarily an inherited disorder caused by an autosomal mutation in the “gene that produces uromodulin”

Decreased production of normal uromodulin and replaced with abnormal form

A

Uromodulin-Associated Kidney Disease

27
Q

It is the most common cause of ESRD (End-Stage Renal Disease)

A

Diabetic Nephropathy

27
Q

Nephrogenic Diabetes Insipidus can be acquired from medication of?

A

Lithium and Amphotericin B

27
Q

Early monitoring of people diagnosed with diabetes mellitus for the presence of __________ is important to detect the onset of diabetic nephropathy

A

Microalbuminuria

28
Q

Polycystic kidney disease and sickle cell anemia are complications seen in?

A

Nephrogenic Diabetes Insipidus

29
Q

Most frequently encountered UTI is the infection of the?

A

Bladder (Cystitis) (Lower UTI)

29
Q

What is the difference in reabsorption function between Fanconi Syndrome and Renal Glycosuria?

A

Fanconi Syndrome = Generalized failure to reabsorb substances from the Glomerular Filtrate

Renal Glycosuria = Affects only reabsorption of Glucose

29
Q

Upper urinary tract infections affect the ____, ______, and _____

A

renal pelvis, tubules, and interstitium

30
Q

Considering the close proximity between renal tubules and the renal interstitium, disorders affecting the interstitium also affect the tubules, resulting in the condition called as?

A

Tubulointerstitial Disease

30
Q

Most common renal disease

A

UTI (Urinary Tract Infection)

31
Q

Lower urinary tract infections affect the _____ and _______

A

urethra and bladder

32
Q

Infection of the Upper Urinary Tract, including both the tubules and interstitium is termed as?

A

Pyelonephritis

33
Q

It is associated primarily with an allergic reaction to medications that occurs within the renal interstitium, possibly caused by the medication binding to the interstitial protein

A

Acute Interstitial Nephritis (AIN)

34
Q

It occurs most frequently as a result of ascending movement of bacteria from a lower UTI into the renal tubules and interstitium

A

Acute Pyelonephritis

35
Q

Congenital urinary structural defects producing reflux nephropathy are the most frequent cause of?

A

Chronic Pyelonephritis

35
Q

Reflux of urine from the bladder back into the ureters is termed as?

A

Vesicoureteral reflux (VUR)

36
Q

Technical Tip: The presence of WBC casts is significant for differentiating between cystitis and pyelonephritis

A

LEZGOOO!

36
Q

Which is reversible, Acute Renal Failure or Chronic Renal Failure?

A

Acute Renal Failure

36
Q

Primary causes of Acute Renal Failure

Prerenal: sudden decrease in blood flow to the kidney
Renal: Acute glomerular and tubular disease
Postrenal: Renal calculi or tumor obstructions

A

YAY!!!

36
Q

It is marked by the inflammation of the renal interstitium followed by inflammation of the renal tubules

A

Acute Interstitial Nephritis (AIN)

37
Q

Medications commonly associated with AIN include:

Penicillin
Methicillin
Ampicillin
Cephalosporins
Rifampin
Sulfonamides
NSAIDs
Thiazide diuretics
Indinavir
Proton pump inhibitors
Allopurinol
5-aminosalicylates
Diuretics
Cimetidine

A

YIPPIE ESNUPI!

37
Q

The progression to ESRD is characterized as follows:

  • Marked decrease in the glomerular filtration rate (less than 25 mL/min)
  • Steadily rising serum BUN and creatinine values (azotemia)
  • Electrolyte imbalance
  • Lack of renal concentrating ability, producing an isosthenuric urine
  • Proteinuria
  • Renal glycosuria
  • Abundance of granular, waxy, and broad casts, often referred to as a telescoped urine sediment
A

Thanks for the info!

37
Q

Technical Tip: The presence of eosinophil casts and eosinophils in the urine sediment are characteristic for AIN (Acute interstitial nephritis)

A

ESNUPIIIII!

38
Q

These may form in the calyces and pelvis of the kidney, ureters, and bladder. They vary in size from barely visible to large.

A

Renal calculi

39
Q

Technical Tip: Broad casts are often referred to as “Renal Failure Casts”

A

LAMAOW!

40
Q

These are renal calculi resembling the shape of the renal pelvis and smooth, round bladder stones with diameters of 2 or more inches

A

Staghorn calculi

41
Q

A procedure using high-energy shock waves, can be used to break stones located in the upper urinary tract into pieces that then can be passed in the urine

A

Lithotripsy

AUBF Lecture (7 decks)

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