Renal Flashcards
Findings of Post Strep Glomerulonephritis
-renal failure
-HTN
-red cell casts
-edema
-cola colored urine
-following recent skin infection
-immunofluorescence microscopy show granular starry sky deposits (lumpy bumpy) of IgG, IgM, and C3 in mesangium and basement membrane
-C3 bc PSGN complement activation occurs mainly via the alternative complement pathway (no C1, C4)
I
Wegeners
- necrotizing granulomatous vasculitis
- triad: pulmonary sx, involvement of URT, renal disease
- elevated c-ANCA is diagnostic
- crescentic
Causes of anion gap metabolic acidosis?
C: Carbon monoxide, cyanide A: amino glycosides T: Teophylline M: methanol U: uremia D: diabetic ketoacidosis (all types of ketoacidosis) P: Phenformin, Paracetamol/acetominophen I: iron, isoniazid L: lactic acidosis E: ethylene glycol S: salicylates (ASA)
What areas of kidney are vulnerable to ischemia?
- straight proximal tubules
- thick ascending limb of Henle
Tumor Lysis Syndrome
- occurs when tumor cells are lysed during chemo
- lysis releases intracellular ions, such as uric acid
- uric acid is soluble at physiologic pH but can precipitate in the acidic environment of distal tubules and collecting ducts
- prevent with urine alkalization
Filtration Fraction equals:
GFR/RPF
Primary Polydipsia
- low serum Na
- urine osmolality after water deprivation is inc with no additional inc. after vasopressin injection
- inc. urination
- psychological disorder with pathological water drinking
Acute Interstitial
- mediated by IgE or type 4 hypersensitivity
- in response to drug such as beta lactam or NSAIDS
- inflammatory cells commonly infiltrate tubular epithelium and interstitium
- seen with fever, maculopapular rash 1-3 weeks after beginning drug
- eosinophils in urine
- tx: stop using offending drug
Renal Papillary Necrosis
Presents with gross hematuria, flank pain, sterile pyuria, and passage of tissue fragments in urine
Seen in pts with sickle cell dz or trait, diabetic nephropathy, analgesic nephropathy, or severe obstructive pyelonephritis
-most important cause is analgesic abuse
Bell’s Palsy
Damage to CN 7
Causes unilateral facial paresis, dec. lacrimationa and saliva output, dec. taste to ant. 2/3 of tongue, hyperacusis
Xanthogranulomatous Pyelonephritis
- rare variant of chronic pyelonephritis
- granulomatous tissue containing lipid laden macrophages
- associated with proteus inection
Most common cause of secondary hyperparathyroidism?
- chronic kidney failure
Clear Cell Carcinoma
- rounded cells with abundant clear cytoplasm
- most common form of renal cell carcinoma
- originates in proximal tubular epithelial cells
- staining techniques dissolve glycogen and lipids leaving clear spaces
