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Nephritic syndrome & UTI & nephrolithiasis Flashcards

1
Q

glomerular disorders characterized by glomerular inflammation and bleeding

A

nephritic syndrome

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2
Q
  1. limited proteinuria (<3.5 g/day)
  2. oliguriza & azotemia
  3. salt retention with periorbital edema & HTN
  4. RBC casts and dysmorphic RBCs in urine
A

nephritic syndrome

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3
Q

immune-complex deposition activates complement; C5 attracts neutrophils –> hypercellualr, inflamed glomeruli on biopsy

A

nephritic syndrome

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4
Q

Nephritic syndrome that arises after group A beta-hemolytic streptococcal infection of the skin (impetigo) or pharynx; may occur after infxn w/ nonstreptococcal organisms, too!

A

PSGN

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5
Q

Kid presents 2-3 weeks after infection w/ hematuria, oliguria, HTN, periorbital edema

A

PSGN

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6
Q

hypercellular, inflamed glomeruli on H&E; mediated by immune complex deposition (granular IF); subepithelial humps on EM

A

PSGN

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7
Q

PSGN treatment

A

supportive

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8
Q

PSGN complications

A

kids rarely progress to renal failure; some adults develop RPGN

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9
Q

nephritic syndrome that progresses to renal failure in weeks to months

A

RPGN

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10
Q

crescents (fibrin + macrophages) in Bowman space of glomeruli

A

RPGN

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11
Q

IgA immune complex deposition in mesangium of glomeruli

A

IgA nephropathy (Berger disease)

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12
Q

kid w/ episodic gross or microscopic hematuria w. RBC casts, usually following mucosal infections (e.g. gastroenteritis); may slowly progress to renal failure

A

IgA nephropathy (Berger disease)

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13
Q

Inherited defect in type IV collage (usu X-linked) –> thinning and splitting of glomerular basement membrane

A

Alport syndrome

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14
Q

Isolated hematuria + sensory hearing loss + ocular disturbances

A

Alport syndrome

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15
Q

linear IF pattern (anti-basement membrane antibody) in RPGN

A

goodpasture syndrome

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16
Q

antibasement membrane antibody

A

goodpasture syndrome

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17
Q

granular IF (immune complex deposition) in RPGN

A

PSGN (most common) or diffuse proliferative glomerulonephritis

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18
Q

what defines a nephrogenic strain?

A

carry M protein virulence factor

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19
Q

6 etiologies of RPGN

A 
Goodpasture syndrome
PSGN
diffuse proliferative glomerulonephritis
Wegener gramulomatosis
microscopic polyangitis
Churg-Strauss syndrome
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20
Q

Negative IF (pauci-immune) in RPGN

A

Wegener’s
microscopic polyangitis
Churg-Strauss

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21
Q

c-ANCA

A

Wegener

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22
Q

p-ANCA

A

microscopic polyangiitis or Churg Strauss

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23
Q

p-ANCA plus granulomatous inflammation, eosinophilia, and asthma

A

Churg-Strauss

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24
Q

infection of urethra, bladder, or kidney; most commonly arises due to ascending infxn (F»M)

A

UTI

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25
Risk factors for UTI
sex, urinary stasis, catheters
26
infection of the bladder
cystitis
27
dysuria, urinary frequency + urgency, suprapubic pain without systemic signs (fever)
cystitis
28
urianalysis findings of cystitis
cloudy urine with > 10 WBCs/hpf
29
Positive leukocyte esterase (due to pyuria) and nitrites (bacteria convert nitrates to nitrites)
dipstick findings of cystitis
30
culture findings of cystitis
>100,000 colony forming units (gold standard)
31
causal agents of UTI
``` e coli (80%0 staph saprophyticus klepsiella pneumonia proteus mirabilis enterococcus faecalis ```
32
pyuria
pus in the urine
33
distinguishing feature of proteus mirabilis cystitis
alkaline urine w/ ammonia scent
34
sterile pyuria (pyruria w/ negative urine culture)
urethritis due to chlamydia or N gonorrhoeae
35
dominant presenting sign of urethritis
dysuria
36
pyelonephritis
infection of the kidney
37
vesicoureteral reflux
reflux from bladder up to ureter
38
fever, flank pain, WBC casts and leukocytosis
pyelonephritis
39
most common pathogens causing pyelonephritis
E coli (90%) Enterococcus faecalis Klebsiella species
40
scarring at upper and lower poles of kidney
characteristic of vesicoureteral reflux
41
leads to renal cortical scarring with blunted calyces
chronic pyelonephritis
42
"thyroidization" of the kidney (atrophic tubules containing eosinophilic proteinaceous material resemble thyroid follicles)
chronic pyelonephritis
43
interstitial fibrosis and atrophy of tubules due to multiple bouts of acute pyelonephritis
chronic pyelonephritis
44
causes of chronic pyelonephritis
vesicoureteral reflux in kids or obstruction (BPH or cervical carcinoma)
45
precipitation of a urinary solute as a stone
nepholithiasis
46
risk factors for nephrolithiasis
high concentration of solute in the urinary filtrate and low urine volume
47
nephrolithiasis presentation
colicky pain with hematuria and unilateral flank tenderness
48
what happens if someone does not pass a kidney stone within hours?
may require surgical intervention
49
most common type of kidney stone
calcium oxalate and/or calcium phosphate
50
cause of calcium oxalate and/or calcium phosphate stone
idiopathic hypercalcemia + Crohn
51
Treatment of calcium oxalate and/or calcium phosphate stones
Hydrochlorothiazide (calcium sparing diuretic)
52
Most common cause is infection with urease positive organisms (Proteus vulgarism or Klebsiella); alkaline urine leads to formation of stone
ammonium magnesium phosphate stone
53
staghorn calculi in renal calyces, wh/ act as nidus for urinary tract infections
ammonium magnesium phosphate
54
treatment of ammonium, magnesium, phosphate stones
surgery to remove stone (due to size) and eradication of pathogen (to prevent recurrence)
55
Radiolucent kidney stone
uric acid kidney stone
56
risk factors for uric acid stone
hot, arid climates, low urine volume, acidic pH
57
most common stone seen in patients with gout; hyperuricemia (in leukemia or MPD) increases risk
uric acid stone
58
treatment of uric acid stone
hydration and alkalization of urine (potassium bicarbonate); allopurinol is also administered in patients with gout
59
associated with cystinuria (a genetic defect of tubules that results in decreased reabsorption of cysteine)
cysteine kidney stones
60
treatment of cysteine kidney stone
hydration and alkalinization of urine; note cysteine may also form staghorn caliculi
61
staghorn caliculi in adult
ammonium magnesium phosphate stone
62
staghorn caliculi in kid
cysteine kidney stone

Renal (22 decks)

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