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AUBF > MIDTERM- RENAL DISEASE > Flashcards

MIDTERM- RENAL DISEASE Flashcards

1
Q

disruption of the electrical membrane charges as occurs in the
____ syndrome.

A

nephrotic syndrome

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2
Q

The term ___ refers to a sterile, inflammatory process that affects the glomerulus and
is associated with the finding of blood, protein, and
casts in the urine

A

glomerulonephritis

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3
Q

what are the components we can found in the urine of a patient with glomerulonephritis?

A

protein, blood, and cast

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4
Q

___is a
disease marked by the sudden onset of symptoms consistent
with damage to the glomerular membrane.

A

acute glomerulonephritis (AGN)

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5
Q

signs and symptoms for acute poststreptococcal glomerulonephritis

A

These may include
fever, edema (most noticeably around the eyes), fatigue,
hypertension, oliguria, and hematuria.

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6
Q

which bacteria or strains can be associated with acute poststreptococcal glomerulonephritis?

A

group a streptococcus with M protein

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7
Q

what is the primary urinalyss findings for acute post-streptococcal glumeronephritis

A

Primary urinalysis findings include marked

hematuria,
proteinuria, and oliguria, accompanied by red blood cell (RBC)
casts, dysmorphic RBCs, hyaline and granular casts, and white
blood cells (WBCs).

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8
Q

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

A

rapid progressive (or crescentic) glomerulonephritis

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9
Q

Symptoms
are initiated by deposition of immune complexes in the glomerulus, often as a complication of another form of glomerulonephritis or an immune systemic disorder such as systemic lupus
erythematosus (SLE).

A

Rapidly Progressive (Crescentic) Glomerulonephritis

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10
Q

Damage by macrophages to the capillary
walls releases cells and plasma into Bowman’s space, and the
production of CRESCENTIC FORMATION containing macrophages, fibroblasts, and polymerized fibrin, causes permanent damage to
the capillary tufts.

A

Rapidly Progressive (Crescentic) Glomerulonephritis

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11
Q

Morphologic changes to the glomeruli resembling those in rap
idly progressive glomerular nephritis are seen in conjunction
with the autoimmune disorder termed ___

A

Goodpasture syndrome

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12
Q

A cytotoxic autoantibody can appear against the glomerular
and alveolar basement membranes after

A

viral respiratory infections.

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13
Q

Attachment of autoantibody to the basement membrane, followed by complement activation, produces the
capillary destruction. Referred to as ___ , the autoantibody can be detected in
patient serum.

A

antiglomerular basement membrane antibody

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14
Q

what are the initial pulmonary complains for Goodpasture syndrome

A

hemoptysis and dyspnea

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15
Q

urinary results commonly for Goodpasture syndrom

A

results include proteinuria, hematuria, and the presence of
RBC casts.

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16
Q

Wegener granulomatosis causes a ___of the small blood vessels primarily of the kidney
and respiratory system.

A

granuloma-producing INFLAMMATION

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17
Q

Key to the diagnosis of Wegener
granulomatosis is the demonstration of ____in the patient’s serum.

A

antineutrophilic
cytoplasmic antibody (ANCA)

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18
Q

In ANCAor anti-neutrophilic cytoplasmic antibody testing,

we fix the serum in either ethanol or formalin/formaldehyde ad examine it through immunofixation.

If the neutrophils are fixed in ethanol, the antibodies form a perinuclear pattern called ___

A

p-ANCA

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19
Q

In ANCAor anti-neutrophilic cytoplasmic antibody testing,

we fix the serum in either ethanol or formalin/formaldehyde ad examine it through immunofixation.

When the neutrophils are
fixed with formalin/formaldehyde, the pattern is granular throughout the cytoplasm called ___

A

c-ANCA.

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20
Q

fixating serum for testing anti-neutrophilic cytoplasmic antibody for the detection of wegener granulomatosis

ethanol vs formalin

A

ethanol: perinuclear pattern - p anca
formalin: granular patter - c anca

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21
Q

___ disease occurs primarily in children after upper respiratory infections. As its name implies,
initial symptoms include the appearance of raised, red patches
on the skin

A

Henoch-Schönlein purpura

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22
Q

In Henoch-Schonlein Purpura, what is the most serious complication of the disorder

A

Renal involvement, may range from mild to heavy proteinuria and hematuria
with RBC casts.

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23
Q

few of the symptoms for this type of Glomerulonephritis

Respiratory and gastrointestinal symptoms, including blood in the sputum and stools, may be present

A

Henoch-Schönlein Purpura

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24
Q

The predominant characteristic of ___ is a pronounced thickening of the glomerular
basement membrane resulting from the deposition of a specific immunoglobulin immune complexes

A

membranous glomerulonephritis

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25
Q

membranous glomerulonephritis’s distinct clinical manifestation is the thickening of the glomerular basement membrane resulting from the deposition of what immunoglobulin immune complexes?

A

immunoglobulin G immune complexes

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26
Q

Disorders associated
with membranous glomerulonephritis development include ____

A

Systemic lupus erythematosus, Sjögren syndrome
secondary syphilis
hepatitis B,
gold and mercury treatments
malignancy.

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27
Q

a glomerulonephritis which has a rule of

the disease progresses SLOWLY, with possible
REMISSION; however, nephrotic syndrome symptoms frequently develop.

A

membranous glomerulonephritis

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28
Q

a glomerulonephritis that is marked
by two different alterations in the cellularity of the glomerulus
and peripheral capillaries

A

Membranoproliferative glomerulonephritis (MPGN)

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29
Q

what are the 2 different alterations in the cellularity of the glomerulus and peripheral capillaries

A

Type 1 displays increased cellularity in the subendothelial cells of the mesangium (interstitial area of Bowman’s capsule)

type 2 displays extremely dense deposits in the
glomerular basement membrane. M

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30
Q

which type of membranoproliferative glomerulonephritis is has the possibility of developing a necrotic syndrome

A

Type 1

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31
Q

which type of membranoproliferative glomerulonephritis can experience the symptoms of chronic glomerulonephritis

A

type 2

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32
Q

laboratory findings for membranoproliferative glomerulonephritis

A

The laboratory findings vary, but hematuria, proteinuria, and decreased
serum complement levels are usual findings.

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33
Q

a type of glomerulonephritis that has tendency toward THROMBOSIS

A

Membranous Glomerulonephritis

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34
Q

laboratory findings for chronic glomerulonephritis

A

Examination of the urine reveals hematuria, proteinuria,
glucosuria as a result of tubular dysfunction, and many varieties of casts, including broad casts.

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35
Q

Gradually worsening symptoms for chronic glomerulonephritis are

A

fatigue, anemia, hypertension, edema, and oliguria

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36
Q

A markedly decreased
glomerular filtration rate is present in conjunction with increased BUN and creatinine levels and electrolyte imbalance

this significant changes is an indication of what renal disease?

A

Chronic Glomerulonephritis

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37
Q

Also known as Berger disease

A

Immunoglobulin A Nephropathy

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38
Q

IgA nephropathy, in which
___are deposited on the
glomerular membrane, is the most common cause of glomerulonephritis

A

immune complexes containing IgA

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39
Q

IgA nephropathy, Patients have increased serum levels of IgA, which
may be a result of a ___infection

A

mucosal

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40
Q

Immunoglobulin A Nephropathy disorders are frequently seen in what ages?

A

The disorder is most
frequently seen in children and young adults.

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41
Q

The ___ is marked by massive proteinuria (greater than 3.5 g/day), low levels of serum
albumin, high levels of serum lipids, and pronounced edema.

A

nephrotic syndrome

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42
Q

in order to be classified as a nephrotic syndrome, a patient must have proteinuria of around ____ g/day

A

3.5 g per day

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43
Q

Acute onset of the disorder can
occur in instances of circulatory disruption producing SYSTEMIC SHOCK that decrease the pressure and flow of blood to
the kidney.

A

chronic glomerulonephritis

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44
Q

___is the primary protein depleted from the circulation

A

Albumin

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45
Q

In chronic glomerulonephritis

Urinalysis observations include marked

A

proteinuria; urinary fat droplets; oval fat bodies; renal tubular epithelial (RTE)
cells; epithelial, fatty, and waxy casts; and microscopic hematuria

46
Q

minimal change disease (also known as
____)

A

lipid nephrosis

47
Q

Although the etiology is unknown at this
time, allergic reactions, recent immunization, and possession
of the human leukocyte antigen-B12 (HLA-B12) antigen have
been associated with this disease

A

Minimal Change Disease

48
Q

Minimal Change Disease responds well
to ____, and prognosis is generally good, with
frequent complete remissions.

A

corticosteroids

49
Q

this glomerulonephritis___ affects only certain numbers and areas of glomeruli, and the others remain normal. S

A

focal segmental glomerulosclerosis (FSGS)

50
Q

Symptoms may be similar to the nephrotic syndrome
and minimal change disease owing to damaged podocytes

A

focal segmental glomerulosclerosis (FSGS)

51
Q

In focal segmental glomerulosclerosis, Immune deposits, primarily ___, are
a frequent finding and can be seen in undamaged glomeruli

A

immunoglobulin M and C3

52
Q

focal segmental glomerulonephritis is often seen in association with abuse of _

A

heroin and
analgesics and with AIDS.

53
Q

glomerulonephritis disorders

A
  1. Acute Poststreptococcal Glomerulonephritis
  2. Rapidly Progressive (Crescentic) Glomerulonephritis
  3. Goodpasture Syndrome
  4. Wegener Granulomatosis
  5. Henoch-Schönlein Purpura
  6. Membranous Glomerulonephritis
  7. Membranoproliferative Glomerulonephritis
  8. Chronic Glomerulonephritis
  9. Immunoglobulin A Nephropathy
54
Q

disorders under nephrotic syndrome

A
  1. Minimal change disease
  2. focal segmental glomerulosclerosis
55
Q

The primary disorder associated with damage to the
renal tubules is ___

A

acute tubular necrosis (ATN).

56
Q

Damage to the RTE cells may be produced by decreased blood flow that causes a lack of oxygen presentation to the tubules (______) or the presence of toxic
substances in the urinary filtrate.

A

ischemia

57
Q

“____”
is a general term indicating a severe condition that decreases
the flow of blood throughout the body

A

Shock

58
Q

Examples of conditions
that may cause shock are ___

A

cardiac failures, sepsis involving toxigenic bacteria, anaphylaxis, massive hemorrhage, and contact
with high-voltage electricity.

59
Q

aside from ischemia what is the other reason for having a damage RTE cells

A

Exposure to a variety of nephrotoxic agents

60
Q

what are the example of nephrotoxic agents that can damage the RTE cells

A

Substances include
aminoglycoside antibiotics, the antifungal agent amphotericin
B, cyclosporine, radiographic dye, organic solvents such as ethylene glycol, heavy metals, and toxic mushrooms.

61
Q

aside from the chemicals and substances, what are the example of a naturally occuring component in the body that is as well nephrotoxic

A

filtration of large amounts of hemoglobin and
myoglobin is also nephrotoxic.

62
Q

list down the Hereditary and Metabolic Tubular
Disorders

A

Fanconi Syndrome
Alport Syndrome
Uromodulin-Associated Kidney Disease
Diabetic Nephropathy
Nephrogenic Diabetes Insipidus
Renal Glycosuria

63
Q

The disorder most frequently associated with tubular dysfunction is

A

Fanconi syndrome

64
Q

The syndrome consists of a generalized failure of tubular reabsorption in the PROXIMAL CONVOLUTED TUBE

A

Fanconi Syndrome

65
Q

In fanconi syndrome, since the one affected is the proximal convoluted tube, the substances that are most noticeably affected includes the

A

glucose, amino acids, phosphorous, sodium,
potassium, bicarbonate, and water

66
Q

Tubular reabsorption may
be affected by the 3, what are they?

A

dysfunction of the transport of filtered substances across the tubular membranes,

disruption of cellular
energy needed for transport,

changes in the tubular membrane permeability.

67
Q

Fanconi syndrome may be inherited in association with
___ disease, acquired
through exposure to toxic agents, including heavy metals and
outdated tetracycline, or seen as a complication of multiple
myeloma and renal transplant

A

cystinosis and Hartnup disease

68
Q

hereditary and metabolic tubular disorder

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

A

Alport syndrome

69
Q

The syndrome can be inherited as a ___ and ___

A

sex-linked or autosomal genetic
disorder.

70
Q

in alport syndrome,

During
respiratory infections, males younger than age ___ years may exhibit macroscopic hematuria and continue to exhibit microscopic hematuria. Abnormalities in hearing and vision may also
develop

A

6 yrs old

71
Q

The glomerular basement membrane has a lamellated appearance with areas of thinning

A

Alport Syndrome

72
Q

__is a glycoprotein and is the only protein produced
by the kidney. I

A

Uromodulin

73
Q

is primarily an
inherited disorder caused by an autosomal mutation in the
GENE that produces uromodulin

A

Uromodulin-associated kidney disease

74
Q

a hereditary tubular disorder that is about The mutation which causes a decrease in the production of normal uromodulin that is replaced
by the abnormal form

A

Uromodulin-associated kidney disease

75
Q

in uromodulin-associated kidney disease.

The mutation also causes an increase in serum uric acid,
resulting in persons developing ___as early as the teenage
years before the onset of detectable renal disease.

A

gout

76
Q

is currently the most common cause of end-stage renal disease.

A

Diabetic nephropathy

77
Q

diabetic nephropathy,

Damage to the glomerular membrane
occurs not only as a result of glomerular membrane thickening
but also because of the increased proliferation of ___
and increased deposition of cellular and noncellular material
within the glomerular matrix, resulting in accumulation of solid
substances around the capillary tufts.

A

mesangial cells

78
Q

Diabetic Nephropathy

This glomerular damage
is believed to be associated with deposition of ____ resulting from poorly controlled blood glucose levels.

A

glycosylated proteins

79
Q

Diabetic Nephropathy

The
vascular structure of the glomerulus also develops __

A

sclerosis

80
Q

early monitoring of persons diagnosed with diabetes mellitus for the presence of ___ is important to detect the onset of diabetic
nephropathy.

A

microalbuminuria

81
Q

___can be inherited as a sex-linked recessive
gene or acquired from medications, including lithium and am
photericin B

A

Nephrogenic DI

82
Q

the disorder related to the action of ADH which is disrupted either by
the inability of the renal tubules to respond to ADH or failure of the hypothalamus to produce ADH

A

Nephrogenic Diabetes Insipidus

83
Q

a disorder that affects only the reabsorption of glucose

A

Renal Glycosuria

84
Q

renal glucosuria, The disorder is inherited as an __

A

autosomal recessive trait.

85
Q

In inherited renal glucosuria either the number of glucose
transporters in the tubules is decreased or the affinity of the
transporters for glucose is decreased.

true or false

A

true

86
Q

Considering the close proximity between the renal tubules and the renal interstitium, disorders affecting the interstitium also affect the tubules, resulting in the condition commonly called ___ disease

A

tubulointerstitial

87
Q

The most common renal disease for tubulointerstitial disease

A

urinary tract infection or UTI

88
Q

for interstitial disease, Most frequently encountered is infection of the bladder (____), which can progress to a more serious upper UTI if left untreated.

A

cystitis

89
Q

Infection of the upper urinary tract, including both the
tubules and interstitium, is termed __and can
occur in both acute and chronic forms

A

pyelonephritis

90
Q

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

A

Acute pyelonephritis

91
Q

reflux of urine
from the bladder back into the ureters (___).

A

vesicoureteral reflux

92
Q

____ producing reflux
nephropathy are the most frequent cause of chronic
pyelonephritis

A

Congenital urinary structural defects

93
Q

The presence of WBC casts is significant
for differentiating between ___ and ___

A

cystitis and pyelonephritis

94
Q

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

A

Acute interstitial nephritis (AIN)

95
Q

Patients present
with a rapid onset of symptoms relating to renal dys
function, including oliguria, edema, decreased renal concen
trating ability, and a possible decrease in the glomerular
filtration rate.

A

Acute Interstitial Nephritis

96
Q

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

A

AIN Acute interstitial nephritis

97
Q

Medications commonly associated with AIN include ___

A

penicillin, methicillin, ampicillin, cephalosporins, sulfon
amides, NSAIDs, and thiazide diuretics.

98
Q

The progression to _____ is
characterized by a marked decrease in the glomerular filtration
rate (less than 25 mL/min); steadily rising serum BUN and cre
atinine values (azotemia); electrolyte imbalance; lack of renal
concentrating ability producing an isosthenuric urine; protein
uria; renal glycosuria; and an abundance of granular, waxy, and
broad casts, often referred to as a telescoped urine sediment

A

end-stage renal disease

99
Q

___, in contrast to chronic renal
failure, exhibits a sudden loss of renal function and is frequently REVERSIBLE

A

Acute renal failure (ARF)

100
Q

renal calculi or kidney stones will form in what part of the kidney?

A

calyces and pelvis of the kidney, ureters, and bladder.

101
Q

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

A

Lithotripsy

102
Q

Conditions favoring the formation of renal calculi are similar to those favoring formation of urinary crystals,
including __, __, ___

A

pH, chemical concentration, and urinary stasis

103
Q

Approximately
75% of the renal calculi are composed of what crystal?

A

calcium oxalate or calcium phosphate

104
Q

__, __, and ___ are the other primary calculi constituents.

A

Magnesium ammonium phosphate (struvite),
uric acid, and cystine

105
Q

which calculi are are frequently associated with metabolic calcium
and phosphate disorders and occasionally diet.

A

Calcium calculi

106
Q

which calculi are frequently accompanied by
urinary infections involving urea-splitting bacteria

A

Magnesium
ammonium phosphate calculi

107
Q

which calculi may be associated
with increased intake of foods with high purine content and with
uromodulin-associated kidney disease.

A

Uric acid calculi

108
Q

which calculi are seen in conjunction with hereditary
disorders of cystine metabolism

A

cystine calculi

109
Q
A
110
Q
A

AUBF (28 decks)

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