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Nephrology > parenchymal kidney disease > Flashcards

parenchymal kidney disease Flashcards

1
Q

33 yr old woman presents with double vision, worsening headache, proteinuria for 3 years treated with ACEi
LVH
3+ protein, 3+ RBCs

A

.

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2
Q

how do you eliminate a pre-renal cause to kidney injury

A
  • ECF volume depletion?
  • drugs?
  • cardiac or liver dysfunction?
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3
Q

how do you eliminate a post-renal cause?

A

no obstruction on ultrasound

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4
Q

RBC casts should point you in the direction of

A

Proliferative glomerular disease

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5
Q

nephrotic syndrome can ONLY be caused by

A

a glomerular disease that is nonproliferative

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6
Q

4 features of nephrotic syndrome

A

proteinuria >3.5g/day

  • edema
  • hypoalbuminemia
  • dyslipidemia
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7
Q

which glomerular disease has RBC casts?

A

proliferative

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8
Q 
hypertension
hematuria 
proteinuria 
AKI 
typical constellation for
A

Nephritic syndrome, or glomerulonephritis

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9
Q

mesangial cell proliferation is due to

A

IgA nephropathy

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10
Q

how do you manage IgA nephropathy

A

Block RAAS

  • steroids
  • immunotherapy
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11
Q

DDx for endocapillary proliferation

A

proliferative lupus nephritis

- post-infectious GN

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12
Q

DDx for epithelial cell proliferation

A

crescentic GN, most aggressive

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13
Q

Order of aggressiveness of GN

A 
WORST - crescentic
- then endocapillary
then mesangial (best)
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14
Q

Linear GBM stain –>

A

Anti- GBM

GOOD PASTURES

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15
Q

Course/granular stain of glomerulus

A

SLE nephritis

post-infectious GN

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16
Q

Little or no staining of Glomerulus

A

ANCA vasculitis

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17
Q

which proliferative GN do you consider Plasma exchange for?

A

Crescentic GN

18
Q

what can cause decreased oncotic pressure?

A

Nephrotic syndrome, or redcued albumin synthesis

19
Q

what can increase capillary permeability?

A

diabetes

malnutrition

20
Q

syndrome that causes protein to leak into the urine

A

nephrotic syndrome

21
Q

how do you measure protein excretion?

A

24 hr urine collection

Albumin to CR ratio

22
Q

proteinuria is considered

A

> 3.5g/24 hours

23
Q

normal value for 24 hour urine collection

A
24
Q

why are lipids elevated in nephrotic syndrome?

A

hepatic lipoprotein synthesis is elevated by decreased oncotic pressure

25
Q

Fatty casts and OFB are indicative of

A

nephrotic syndrome

26
Q

important clinical feature of nephrotic syndrome is

A

Hypercoaguable state!! - 30% of patients have renal vein thrombosis

27
Q

3 pathologic causes of nephrotic syndrome

A

minimal change
FSGS
Membranous

28
Q

2 secondary causes of nephrotic syndrome

A

Diabetes

amyloid/MM

29
Q

most common cause of nephrotic syndrome ini children is

A

minimal change disease

30
Q

2 secondary causes of minimal change disease

A

NSAIDs

hodgkin lymphoma

31
Q

nephrotic syndrome cause that accounts for 50% of cases in blacks

A

FSGS

32
Q

presence in some glomeruli of focal/segmental areas of mesangial collapse and sclerosis is

A

FSGS

33
Q

most common cause of nephrotic syndrome in adults is

A

membranous

34
Q

Secondary causes of membranous GN

A

MAID

35
Q

thickening of BM with little or no cell proliferation is characteristic of

A

Membranous nephropathy

36
Q

Kimmelsteil wilson nodules are

A

characteritstic of diabetic glomeruloscelrosis

37
Q

what can be used to treat the proteinuria

A

ACEi/ARBs

38
Q

classic features of tubulointerstitial diseases

A

WBCs or WBC casts in urine

39
Q

2 clues that you have a tubulointersititial kidney disease

A

hyperkalemia

renal tubular acidosis

40
Q

Acute TBI disease can include

A

AIN

ATN

41
Q

chronic TBI can be caused by

A

drugs
chronic obstruction
autoimmune disease
cystic diseases PKD

Nephrology (7 decks)

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