PLN Flashcards

1
Q

Albumin has an overall _____ charge

A

Negative

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2
Q

AGTII, Thromboxane, and ET-1 are all _______ substances

A

Vasoconstrictive

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3
Q

4 key features of nephrotic syndrome:

A

Hypoproteinemia (decreased TP)

Proteinuria

Hypercholesterolemia

Ascites

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4
Q

PLN should be on your radar if proteinuria has been present for how long?

A

At least 2 weeks

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5
Q

If UPC is >2, patient likely has:

A

Glomerular disease

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6
Q

If UPC is <2, patient might have:

A

Glomerular or tubular disease

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7
Q

UPC >0.5 with an inactive sediment is characteristic of:

A

Glomerular disease

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8
Q

Normal UPC in a dog is ______

A

< 0.5

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9
Q

Normal UPC in cats is:

A

< 0.4

(Ideally, less than 0.2)

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10
Q

4 differentials for hypoalbuminemia?

A

PLN

PLE

Liver failure

Blood loss

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11
Q

Defining feature of PLN on a chem profile is ______

A

Hypercholesterolemia

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12
Q

5 differentials for Hypercholesterolemia?

A

PLN

Recent meal

Lipid disorder

Cushing’s

Hypothyroidism

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13
Q

Contraindications for renal biopsy?

A

Severe, chronic azotemia

Moderate- severe Hypertension

Severe uremia

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14
Q

Severe chronic azotemia is a contraindication for renal biopsy for 2 key reasons:

A

Chronic, Severe azotemia = you’re likely just going to find irreversible fibrosis

Azotemia causes platelet dysfunction; patient is at increased risk of bleeding!!

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15
Q

What is severe uremia a contraindication for renal biopsy?

A

Risk of bleeding!

Uremia causes platelet dysfunction, patient can’t clot as well!

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16
Q

Where do you want to biopsy from for kidney biopsy?

A

Renal cortex!

This is where glomeruli live

17
Q

Omega-3 fatty acids are ______ protective in dogs

A

Renal
Can also help with suppressing inflammation

18
Q

3 drug classes that block RAAS:

A

ACE inhibits, angiotensin receptor blockers, aldosterone antagonists

19
Q

Effect of AGII on the kidneys =

A

Works on proximal tubule to increase sodium reabsorption

20
Q

Effect of AGII on blood vessels =

A

Vasoconstriction!
Increases systemic pressure, increases tissue perfusion!

21
Q

Effect of AGII on the adrenals =

A

Release of aldosterone

Aldosterone makes distal tubule reabsorb Na+ and secrete K+

22
Q

RAAS is stimulated when ____ ___ _____

A

Flow is low!

If flow is low, to RAAS we go!
(To maintain our systemic BP yo)

23
Q

AGII constricts the _______ arteriole more than the _______ arteriole

A

EFFERENT

Afferent

24
Q

Block AGII = decrease vasoconstriction = _________

A

Decreases glomerular blood pressure
Decrease the force that is pushing protein through the glomerular barrier!

25
Q

3 side effects of ACE inhibitors:

A

Hyperkalemia

Hypotension

Azotemia

26
Q

How can ACE inhibitors cause Azotemia?

A

If you decrease BP enough, you can decrease GFR to levels that result in azotemia

Ace inhibitors overcome efferent arteriole constriction!

27
Q

You started a patient on enalapril one week ago. You recheck a chem and BP a week later
Creatinine has increased by 35%, what should you do?

A

> 20% increase = decrease dose or discontinue med

28
Q

How low does albumin need to be for plasma to leak out and cause ascites?

A

VERY LOW <2 mg/dL

29
Q

Good drug for mild-moderate hypertension?

A

ACE Inhibitors

30
Q

Good drug for SEVERE hypertension?

A

Amlodipine

31
Q

Severe hypertension = ______

Hypertensive = ________

Normotensive = _________

A

> 180 mm Hg

140-180 mm Hg

<140 mm hG

32
Q

Inherited forms of PLN will not respond to Immunosuppressive drugs. True or false?

A

TRUE

33
Q

Why can’t we use steroids to treat PLN?

A

steroids cause proteinuria in dogs

34
Q

What are common side effects of mycophenolate?

A

Diarrhea, GI upset

35
Q

If you’re losing albumin in your urine, you’re also losing:

A

Antithrombin III
(Same size as albumin)

36
Q

Loss of ATIII is bad because

A

Now patient is at risk of clotting!

37
Q

What drug can be used to combat loss of antithrombin III?

A

Plavix!
(Clopidogrel)

It prevents platelet clumping and clot formation

38
Q

_____ is the term used to describe apoptosis that occurs due to detachment from the basement membrane

A

Anoikis