Renal Flashcards
Nephritic syndromes
Acute streptococcal glomerulonephritis
Rapidly progressive glomerulonephritis (RPGN)
IgA nephropathy (Berger disease)
Alport syndrome
Membranoproliferative glomerulonephritis (MPGN)
Nephritic symptoms → inflammatory process hematuria oliguria azotemia (↑BUN, ↑serum creatinine) HTN proteinuria Hypercellular/inflamed glomeruli
Nephrotic syndromes
Focal segmental glomerulosclerosis (FSGN) Minimal change disease Membranous nephropathy Amyloidosis Diabetic glomerulonephropathy
Nephrotic symptoms massive proteinuria ( >3.5mg/day) hypoalbuminuria → edema frothy urine with fatty casts ↑ risk of thrombus and infection
Nephritic-nephrotic syndromes
Diffuse proliferative glomerulonephritis (DPGN) Membranoproliferative glomerulonephritis (MPGN)
Poststreptococcal glomerulonephritis
Nephritic syndromes cola/tea colored urine Starry sky lumpy bumpy appearance subepithelial humps
Rapidly progressive glomerulonephritis
nephritic syndrome
crescent moon glomerular inflammation
Present in several disease processes
Goodpasture syndrome
Granulomatosis with polyangiitis (Wegener)
Microscopic polyangiitis
Diffuse proliferative glomerulonephritis
Nephritic-nephrotic syndrome
due to SLE
wire-looping capillaries
IgA nephropathy (Berger disease)
nephritic syndrome
hematuria with concurrent GI or respiratory infection
IgA Immune complex deposition
Alport syndrome
nephritic syndrome collagen IV mutation (basement membranes) eye problems sensorineural deafness glomerulonephritis basket weave on EM
Membrano-proliferative glomerulonephritis
nephritic-nephrotic syndrome
tram track appearance
type 1 → secondary to Hep B or C
type 2 → autoimmune persistent complement activation
Minimal change disease
nephrotic common in children triggered by infection or immunization responds well to corticosteroids podocyte effacement
Focal segmental glomerulosclerosis
Nephrotic AA and Hispanics Idiopathic or secondary to HIV, sickle cell, heroin abuse, obesity podocyte effacement does not respond well to corticosteroids
Membranous nephropathy
Nephrotic "spike and dome" Primary → Abs to phospholipase A2 Secondary → drugs, infections, SLE, or tumor NSAIDs, gold Hepatitis B or C, syphillis poor response to steroids
Calcium kidney stones
envelop shape
most common type of kidney stone
Ammonium magnesium phosphate kidney stones
rectangular coffin lid
aka struvite stones
staghorn calculi
can be cause from bacterial infections (Proteus mirabilis, Staph saprophyticus, Klebsiella)
Uric acid kidney stones
RadiolUcent
rhomboid shape
Cysteine kidney stones
hexagonal shape
cyxteine → six sides
Loop diuretics
Furosemide, Torsemide, bumetanide
inhibits Na/K/2Cl cotransporter in thick ascending limb
Loops Lose Calcium (↑ Ca excretion)
Sulfonamide
Adverse effects → OHH DAANG Ototoxicity Hypokalemia Hypomagnesemia Dehydration Allergy (Sulfa) Alkalosis (metabolic) Nephritis Gout
Ethacrynic acid
Loop diuretic
used in patients with sulfa allergy
Thiazide diuretics
hydrochlorothiazide, chlorothalidone, metolazone
Inhibit NaCl reabsorption in DCT
↓ Ca excretion
Adverse effects → hyperGLUC hyperGlycemia hyperLipidemia hyperUricemia hyperCalcemia sulfa allergy
Potassium sparing diuretics
aka aldosterone receptor antagonists
Spironolactone, Eplerenone
Amiloride
Triamterene
inhibits aldosterone from stimualating Na reabsorption in the collecting duct
Adverse effects:
hyperkalemia
Mannitol
Osmotic diuretic
Acetazolamide
CA inhibitor
↑ HCO3 excretion
Used in metabolic alkalosis
ACE inhibitors
-pril
AA: cough angioedema teratogen → contraindicated in pregnancy ↑ creatinine (↓GFR) Hyperkalemia ↑bradykinin
Angiotensin II receptor blockers
-sartan
AA:
teratogen
does not increase bradykinin like ACE inhibs do
Aliskiren
renin inhibitor
AA: teratogen
Granular casts
muddy brown appearance
acute tubular necrosis
