Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > PATH: Nephrotic Syndrome I > Flashcards

PATH: Nephrotic Syndrome I Flashcards

1
Q

What is nephrotic syndrome?

A

Insiduous onset of:

1) edema
2) proteinuria
3) hypoalbuminemia
4) hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are casts?

A

cylindrical formations of cells or proteinaceous material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What makes up a hyaline cast?

A

precipitation of Tamm-Horsfall mucoprotein (which are secreted by renal tubular cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What makes up granular casts?

A

aggregates of plasma proteins or the break-down of cellular casts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are granular casts characteristic of?

A

Non-inflammatory tubular interstitial disease (renal disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is contained within a fatty cast?

A

oval fat bodies with Maltese cross (cholesterol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When do you see fatty casts?

A

In nephrotic syndrome (due to associated lipiduria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When do you see RBC casts?

A

with glomerular damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When do you see WBC casts?

A

inflammation during renal diseases (ex. pyelonephritis, acute post-strep GN, nephritic syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What characteristics of the glomerulus lead to immune complex entrapment?

A

1) High plasma flow rate (20% of CO)
2) High intraglomerular pressure
3) High glomerular hydraulic conductivity (permeability)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or false: nephrotic syndrome has a drop in GFR that will lead to high serum creatinine.

A

FALSE: the kidney function is normal so you will have normal or mildly elevated creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which has worse edema: nephrotic or nephritic syndrome?

A

Nephrotic!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which has worse proteinuria: nephrotic or nephritic?

A

Nephrotic (> 3.5g/day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What cells are targeted with nephrotic syndrome? Nephritic syndrome?

A

Nephrotic: podocytes (filter leaking; charge barrier gone)
Nephritic: endothelial cells (filter bleeding; big gaps but charge barrier remains)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why do you see hypocholerterolemia and lipiduria (with potential xanthelasma) in nephrotic syndrome?

A

Increased hepatic synthesis of cholesterol, TG, and lipoproteins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 3 purposes of performing a renal biopsy?

A

1) Make a diagnosis
2) Determine prognosis
3) Guide therapy

17
Q

What are the relative contraindications for renal biopsy?

A

single kidney
high pressure hydronephrosis
adult PKD

18
Q

What are the ABSOLUTE contraindications for renal biopsy?

A

bleeding diathesis

uncontrolled HTN

19
Q

Where is the main site of size hindrance in the glomerulus?

A

Lamina densa of GBM

Slit diaphragm

20
Q

Where are the main sites of charge hindrance in the glomerulus?

A

Lamina rara interna

Fenestrated capillary endothelium

21
Q

Why can albumin not cross the GBM?

A

it is small enough, but its negative charge excludes it and keeps it in the lumen!

22
Q

What diameter molecules are restricted?

A

over 4 nanometer

23
Q

Where do proteins get reabsorbed?

A

Most get reabsorbed in the proximal tubule via endocytosis (vesicles fuse with lysosomes, proteins broken down to AAs, cross basolateral membrane and re-enter blood)

24
Q

What multi-ligand receptors may aid int he receptor-mediated endocytosis of protiens in the PT?

A

Megalin and Cubulin

25
Q

What diseases lead to subepithelial deposits?

A

Membranous Nephropathy

Post-infectious GN (later in disease)

26
Q

What diseases lead to subendothelial/mesangial deposits?

A

Focal or Diffuse Proliferative Lupus Nephritis
Early Post-Infectious GN
IgA Nephropathy

27
Q

Why do you see decreased small proteins and increased larger proteins in the urine of someone with nephrotic syndrome?

A

You have loss of surface area due to effacement but LARGER gaps between them!

28
Q

What are the 3 types of proteinuria?

A

1) Glomerular (albumin dominant)
2) Tubular (low MW proteins)
3) Overflow (production/filtration> reabsorption capacity)

29
Q

What is an example of an overflow proteinuria?

A

multiple myeloma

30
Q

What is the major limitation of the urine dipstick?

A

The body makes around 150 mg/day of protein AT THE MOST and urine dipsticks only detect > 300-500 mg/day

31
Q

What is the earliest clinical manifestation of diabetic nephropathy?

A

microalbuminuria

32
Q

What is the main goal of managing nephrotic syndrome?

A

preserving kidney function

33
Q

What is the main prognostic indicator of nephrotic syndrome?

A

degree of proteinuria

34
Q

How can you tell the difference between chronic and rapidly progressive glomerulonephritis?

A

Chronic will have HTN, renal insufficiency, Proteinuria >3g/day, and shrunken, smooth kidneys
Rapidly progressive will be normotensive, in renal failure, have less proteinuria, and have RBC casts in the urine

Renal (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions