renal Flashcards
when does APCKD present why we have hematuria
it presents in 4th and 5th decade we have hematuria because of cyst rupture
what causes dead in infants for arpkd
Die during first decade of life due to
renal failure, hepatic fibrosis and
pulmonary hypoplasia
compare the psgn with iga nephropathy timeline
Kidney biopsy will show mesangial IgA deposits on IF. In contrast, PSGN is seen 1-3wks after streptococcal pharyngitis and is usually not recurrent.
what is seen is psgn
IF demonstrates a 'lumpy-bumpy' granular deposits of IgG and C3 on the GBM, and subepithelial, electron-dense deposits are seen c4 complenet levels normal
tell pathophys of RPGN
Crescents consist of glomerular parietal cells, lymphocytes, and macrophages along w/ abundant fibrin deposition. Crescents eventually become fibrotic, disrupting glomerular fxn and causing irreversible renal injury
pathophys of edema in nephrotic syndrome
Loss of protein > low plasma oncotic P >
fluid into interstitium > Increased RAAS
+ ADH > worsening edema
Di inspidus nephrogenic
ADH Nephrogenic DI • Partial: slow but steady rise in urine osmolality with water deprivation but not increase in osmolality with ADH • Urine osmo under 500 Primary Polydipsia • Increase in serum and urine osmolality with water deprivation (similar to partial nephrogenic DI but more rapid) • Hx of psych or medication induced xerostomia
DPGN 2° to
circulating IC deposition may
complicate IE and can result in
acute renal insufficiency.
infective endocarditis
explain patophys of MCD
Systemic T-cell dysfxn leads to the production of glomerular permeability factor, which causes podocyte foot process fusion and ↓ the anionic properties of the GBM. The loss of (-) charge leads to selective albuminuria.
Can be caused by URI, immunization,
insect bite
explain function proteinuria and tubular proteinuria
Tubular proteinuria • B2 microglobulin, Ig light chain, AA and retinaL binding protein in urine Functional proteinuria • Caused by exercise, high fever, emotional stress, cold exposure
hyaline arteriosclerosis vs malignant htn
Homogeneous deposition of eosinophilic hyaline material in the intima and media of small arteries and arterioles characterises hyaline arteriolosclerosis
Malignant HTN: fibrinoid necrosis and
hyperplastic arterioloscleosis, amphorous
material with onion like, concentrick
thickening of the walls
cholestrol embolism syndrome
Blue digits and livedo reticularis with normal peripheral pulses • If after vascular procedure think atheroemboli (contains cholesterol clefts) Postprocedure atheroemboli • Acute kidney injury is most common symptoms • Rarey frank infarction and flank pain (atheroemboli is small) • GI tract, CNS and retinal vessels are common involve
explain pathogensis of BPH
BPH • Bladder outflow obstruction • Epithelial and stromal hyperplasia in the periurethral and transitional zone Results • Bladder wall hypertrophy • Bladder diverticulum • Hydronephrosis > renal parenchymal pressure atrophy
explain pathophys of atn which is affected by toxins and which is affected by ischemia
Ischemic injury predominantly affects the renal medulla, which has a relatively low blood supply. The terminal (straight) portion of the proximal tubules and the thick ascending limb of the LOH are the most commonly involved portions of the nephron due to their high meta rate and loca
ethylene glycol injestion casuese what
Ethylene glycol ingestion causes
ATN w/ vacuolar degen and
ballooning of the PCT cells.
portal htn affects kidney fucntion
Portal HTN causing renal failure • Hallmark: renal vasoconstriction Prolonged hypotension or severe infection • Acute tubular necrosis • Renal failure, olgiuria
when do u see sterile pyuria
Sterile pyuria:
chlamydia, ureaplasma, TB
renal oncytoma
Renal Oncocytomas • Originate from the collecting duct • Well differentiated without perinuclear clearing • Central scar
mechanism of nsaid induced renal papillary necrosis
NSAIDs concentrate in the renal medulla
can cause uncouple oxidative
phosphorylation (depletes glutathione)
causing lipid peroxidation
what do you see in tubular epithelial necrosis
Tubular epithelial necrosis, denudation
of BM, epithelial casts
how does uremia alter thyroid function
Can cause uremia which decreases T4 to
T3
what sort of arthiritis is assoicated with HENoch scholen purpura
Migratory arthralgias
what is adynamic bone disease
pth resistance
how does rcc of the right kideny -present with
RCC tends to invade the renal vein; IVC obstr can occur by intraluminal extension of the tumour. obstr of the IVC produces symmetric bilateral extremity oedema, often a/w prominent devel of venous collaterals in the abdo wall.
