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Liz's Clinical Chemistry Module 3 > Renal Disease > Flashcards

Renal Disease Flashcards

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1
Q

5 major categories of renal diseases

A
  • Glomerular (damage to glomeruli)
  • Tubular (infection/toxin destroys cells)
  • Interstitial (infections)
  • Vascular (disruption to blood supply)
  • Others
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2
Q

6 glomerular diseases

A
  • Acute Post-Streptococcal
  • Glomerulonephritis
  • Acute GN, Chronic GN
  • Membranoproliferative GN
  • Focal segmental GN
  • Rapidly progressive GN
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3
Q

Acute Post-Streptococcal Glomerulonephritis

- Specific causative bacteria

A

Group A Beta hemolytic strep

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4
Q

Acute Post-Streptococcal Glomerulonephritis

- How immune complexes causes the disease

A

Cellular infiltrates deposit on glomerular basement membrane

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5
Q

Acute Post-Streptococcal Glomerulonephritis

- Anatomic structure in the glomerulus is damaged

A

?

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6
Q

Acute Post-Streptococcal Glomerulonephritis

- 6 typical urinalysis findings

A
  • Gross hematuria
  • Proteinuria
  • Red cell casts
  • Hypertension
  • Edema
  • Transient oliguria w/ reduced GFR
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7
Q

Acute Post-Streptococcal Glomerulonephritis

- Pathognomonic finding for the disease

A

Red cell casts

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8
Q

Acute Post-Streptococcal Glomerulonephritis

- Two chemistry lab findings

A

↑ BUN and creatinine

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9
Q

Acute Post-Streptococcal Glomerulonephritis

- One immunological finding

A

Positive test for streptococcal Abs (Abs of M proteins)

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10
Q

List 3 symptoms for chronic glomerulonephritis

A
  • Edema
  • Hypertension
  • Oliguria
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11
Q

Pathognomonic urinalysis findings for chronic glomerulonephritis

A

Broad and waxy casts

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12
Q

2 categories of tubular diseases

A
  • Acute Tubular Necrosis (ischemic and toxic)

- Renal Tubular Acidosis

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13
Q

Describe tubular damage caused by trauma, shock, or sepsis, in ischemic acute tubular necrosis

A

The damage leads to ↓ renal perfusion. Reduced oxygen disrupts tubular basement membrane function

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14
Q

List typical toxic agents that cause toxic acute tubular necrosis and the specific part of the nephron that becomes damaged

A
  • Heavy metals, ethylene glycol, organic solvents, drugs, mushrooms
  • Causes damage and death to PT
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15
Q

6 typical urinalysis findings of acute tubular necrosis

A
  • Mild proteinuria
  • Hematuria
  • Low specific gravity
  • Renal epithelial cells, renal epithelial cell casts, granular casts
  • Oliguria
  • ↑ BUN
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16
Q

Pathognomonic findings for acute tubular necrosis

A

Renal epithelial cell casts

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17
Q

Explain the pathogenesis of renal tubular acidosis

A

Tubules can’t secrete hydrogen ions to acidify urine, ↓ blood pH, causing acidosis

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18
Q

5 tubulointerstitial diseases

A
  • Pyelonephritis (acute and chronic)
  • Cystitis
  • Urethritis
  • Acute tubulointerstitial nephritis
  • Acute tubulointerstitial necrosis
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19
Q

Pyelonephritis

- 3 predisposing factors

A
  • UTI
  • Pregnancy
  • Diabetes mellitus
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20
Q

Pyelonephritis

- 3 common routes of infection

A
  • Ascending from bladder
  • 3% from bloodstream
  • From lymphatic system
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21
Q

Acute pyelonephritis

- 6 typical urinalysis findings

A
  • > 5 WBCs/hpf (clumps)
  • Bacteria
  • Mild proteinuria
  • Positive blood
  • Positive nitrate
  • WBC casts
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22
Q

Acute pyelonephritis

- Pathognomonic finding

A

WBC casts

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23
Q

Chronic pyelonephritis

- Most common cause of chronic pyelonephritis

A

Backward flow of urine up ureters

24
Q

Chronic pyelonephritis

- 7 typical urinalysis findings

A
  • ↑ protein
  • WBCs in clumps
  • Low specific gravity
  • Macrophages
  • Granular casts
  • Waxy casts
  • Broad casts
25
Q

Chronic pyelonephritis

- 2 pathognomonic findings

A

Waxy and broad casts

26
Q

Cystitis

- 4 typical symptoms

A
  • ↑ frequency and urgency of urination
  • Pain in pelvic/abdominal region
  • Fever and chills
  • Burning sensation on urination
27
Q

Cystitis

- 2 common bacterial causes

A
  • E. coli

- Staphylococcus saprophyticus

28
Q

Cystitis

- 5 common urinalysis findings

A
  • Positive blood
  • Positive leukocyte esterase
  • Positive nitrite (if bacteria produce nitrite)
  • WBCs
  • Bacteria (1/3 will be neg)
    NO CASTS
29
Q

Nephrotic syndrome

- 4 disease processes that may lead to the syndrome

A
  • Glomerulonephritis
  • Systemic Lupus Erythematosus (SLE)
  • Diabetes mellitus
  • Sickle cell anemia
30
Q

Nephrotic syndrome

- Renal damage that leads to symptoms and lab findings

A

Glomerular basement membrane becomes highly permeable to plasma proteins and lipids

31
Q

Nephrotic syndrome

- 2 clinical symptoms

A
  • Edema

- Hypertension

32
Q

Nephrotic syndrome

- 3 typical chemistry findings

A
  • Hypoproteinemia
  • ↑ cholesterol
  • ↑ triglycerides
33
Q

Nephrotic syndrome

- 4 urinalysis findings

A
  • Massive proteinuria
  • Microscopic hematuria
  • Oval fat bodies
  • Fatty casts and waxy casts
34
Q

Nephrotic syndrome

- Pathognomonic findings

A
  • Oval fat bodies
  • Fatty casts
  • Waxy casts
35
Q

4 vascular renal disease

A
  • Hypertension
  • Benign nephrosclerosis
  • Renal artery stenosis
  • Microangiopathies
36
Q

Why can vascular disease lead to renal disease?

A

The kidneys receive 20-25% of cardiac output so anything that interferes w/ blood flow impacts kidney function

37
Q

Why can hypertension lead to renal disease?

A

↑ pressure changes the structure of vascular walls which ↑ the risk for renal failure

38
Q

What is the lab marker for renal disease caused by hypertension?

A

Microaluminuria

39
Q

Hemolytic Uremic Syndrome (HUS)

- Bacterial causative agent and what food is it found in?

A

E. coli found in ground meat

40
Q

Hemolytic Uremic Syndrome (HUS)

- Why the toxin causes hemolysis and thrombosis

A

Toxin binds to RBCs, affects platelet function, and causes ↑ adhesion of WBCs to endothelium

41
Q

Hemolytic Uremic Syndrome (HUS)

- Processes that lead to vasoconstriction

A

The toxin causes ↑ production of endothelia and loss of endothelial nitric oxide favors vasoconstriction, this in presence of blood clots, occludes vessels, causes necrosis, and thickening of capillary walls

42
Q

Nephrolithiasis

- 4 factors that favor stone formation

A
  • ↑ concentration of stone constituent in urine
  • changes in urine pH
  • ↓ urine flow
  • Presence of bacteria
43
Q

Nephrolithiasis

- 4 categories of kidney stones

A
  • Calcium salts
  • Triple phosphate (struvite)
  • Uric acid
  • Cystine
44
Q

Nephrolithiasis

- 3 symptoms

A
  • Severe flank pain
  • Nausea
  • Vomiting
45
Q

Nephrolithiasis

- 3 typical urinalysis findings

A
  • Hematuria
  • Bacteriuria
  • Crystals
46
Q

Nephrolithiasis

- 2 typical chemistry findings

A

↑ BUN and creatinine

47
Q

Abrupt ↓ in renal function sufficient to ↑ plasma creatinine and BUN

A

“Acute renal failure”

48
Q

Pre-renal causes of acute renal failure

A
  • Extracellular fluid loss
  • ↓ cardiac output
  • Sepsis/shock
49
Q

Renal causes of acute renal failure

A
  • Vascular disorders (DIC)
  • Glomerulonephritis
  • Tubular necrosis
50
Q

Post-renal causes of acute renal failure

A

Obstructions

51
Q

Acute renal failure

- 3 chemical findings

A
  • Hyperkalemia
  • ↑ plasma phosphorus
  • ↓ blood pH
52
Q

Acute renal failure

- 2 urinalysis findings

A
  • Positive blood and protein in urine

- Oliguria

53
Q

Acute renal failure

- 1 hematological finding

A

Anemia

54
Q

What is the GFR associated w/ chronic renal failure?

A

GFR < 15mL/minute

55
Q

What specific part of the nephron becomes damaged in toxic acute tubuler necrosis?

A

Proximal tubules

Liz's Clinical Chemistry Module 3 (7 decks)

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