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UA Spring > Renal disease pt 1 > Flashcards

Renal disease pt 1 Flashcards

1
Q

Kidney major function

A

Blood filtration to remove waste products

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2
Q

3 types of renal diseases

A
  • glomerular
  • tubular
  • interstitial
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3
Q

Major origin of glomerular disorders

A
  • Immune origin
  • Immune complexes circulate in bloodstream and deposit in glomerular membranes
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4
Q

Damage in glomerular disorders that cause disruption in normal glomerular filtration

A
  • cellular proliferation
  • leukocytic infiltration
  • thickening of glomerular basement membrane
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5
Q

List non-immune causes of glomerular damage

A
  • Exposure to chemicals/toxins
  • Disruption of electrical membrane charges
  • Deposition of amyloid material
  • Basement membrane thickening associated with diabetic nephropathy
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6
Q

A normal capillary in a glomerulus keeps WBCs, RBCS, and proteins where?

A

In the blood (not filtered thru glomerulus). Only lets watery fluid into urine

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7
Q

Glomerulonephritis

A
  • Sterile, inflammatory process that affects the glomerulus
  • Associated with blood, protein, and casts in urine (sometimes WBCs)
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8
Q

List the types of glomerulonephritis

A
  • Acute poststreptococcal (AGN)
  • Rapidly progressive
  • Goodpasture, Wegener’s, Henoch-Schonlein
  • Membraneous GN
  • Membranoproliferative GN
  • Chronic GN
  • IgA Nephropathy
  • Nephrotic Syndrome
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9
Q

Types of nephrotic syndrome

A
  • Minimal Change Disease
  • Focal Segmental Glomerulosclerosis
  • Alport Syndrome
  • Diabetic Nephropathy
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10
Q

Acute Post-Streptococcal GN (AGN) usually occurs in

A

Kids and young adults following respiratory infections from Group A Strep (contain M protein in cell wall) S. pyogenes

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11
Q

AGN mechanism

A
  • Immune complexes formed from Strep antibodies and become deposited in glomerular membranes
  • Management of complications until immune complexes cleared from blood and inflammation stops
  • Usually no permanent kidney damage
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12
Q

AGN urinalysis findings

A
  • RBC (including dysmorphic)
  • WBC
  • Proteinuria
  • Oliguria
  • RBC casts
  • Hyaline casts
  • Granular casts
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13
Q

AGN serum findings

A
  • Elevated BUN
  • ASO (antistreptolysin) positive titer
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14
Q

Rapidly progressive glomerulonephritis (RPGN)

A
  • More serious form of acute glomerular disease with poor prognosis, often terminating in renal failure
  • SLE can cause RPGN
  • Symptoms started by immune complex deposition
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15
Q

Which cell type causes capillary wall damage in RPGN?

A

Macrophages

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16
Q

What happens when macropohages destroy the capillary wall in RPGN?

A
  • Cells and plasma release into Bowman’s space
  • Crescentic formations containing macrophages, fibroblasts, and polymerized fibrin
  • Permanent damage to capillary tufts of kidney
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17
Q

RPGN urinalysis findings

A
  • Similar to acute GN except clinical pic becomes more abnormal as disease progresses
  • Markedly elevated protein
  • Reduced GFR and loss of function due to glomerulosclerosis
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18
Q

Goodpasture’s Syndrome morphologically similar to

A

RPGN

19
Q

Goodpasture’s Syndrome can follow

A

Viral infections

20
Q

Goodpasture’s Syndrome results from

A
  • Cytotoxic auto-antibody against glomerular and alveolar basement. membrane
  • Antiglomerular basement membrane antibody detectable in serum
21
Q

What does antiglomerular basement membrane auto-Ab do?

A
  • Attaches to basement membrane and initiates complement, which produces capillary destruction
  • Attracts neutrophils, which come to attack the vessel wall -> inflammation, GN, alveolar capillaritis
22
Q

Goodpasture’s Syndrome urinalysis findings

A
  • Proteinuria
  • RBC
  • RBC casts
23
Q

Vasculitis (blood vessel inflammation) can lead to what types of glomerular issues?

A
  • Wegener’s granulomatosis
  • Henoch-Schonlein purpura
24
Q

Kidney damage due to vasculitis due to

A
  • Immune complex deposition
  • Auto-Ab binding vasculature
  • Immune-mediated inflammation
25
Q

Wegener’s granulomatosis causes

A

A granuloma producing inflammation of small blood vessels (mainly kidney + lungs)

26
Q

Which antibody is found in Wegener’s granulomatosis?

A

Anti-neutrophilic cytoplasma antibody (ANCA) found in serum, which binds PMNs in the vascular walls

27
Q

Lab findings in Wegener’s granulomatosis

A
  • RBC
  • RBC casts
  • Proteinuria
  • Elevated BUN/creatinine
28
Q

Henoch-Schonlein purpura (red patches on skin) mainly occurs in

A

Children following upper resp infections

29
Q

Lab findings of Henoch-Schonlein purpura

A
  • Elevated protein
  • RBC
  • RBC casts
  • Elevated plts
30
Q

Difference between membranous GN and membranoproliferative GN

A

Membranous GN = basement membrane only

Membranoproliferative GN = both basement membrane + mesangium

31
Q

Membranous GN pathology

A
  • Thickening of glomerular basement membrane
  • IgG immune complex deposition
32
Q

Membranous GN lab findings

A
  • Proteinuria
  • RBC
  • Thrombosis
33
Q

Membranoproliferative GN Type 1

A

Thickening of capillary walls in Bowman’s capsule (increased cellularity)

34
Q

Membranoproliferative GN Type 2

A

Dense deposits in glomerular basement membrane

35
Q

Membranoproliferative GN affects

A

Children

36
Q

Membranoproliferative GN lab findings

A
  • Proteinuria
  • RBC
  • Decreased serum complement
37
Q

IgA Nephropathy most commonly causes

A

Glomerulonephritis

38
Q

Increased IgA in IgA nephropathy due to

A

Mucosal infection (genetic link to mutated IgA)

39
Q

IgA Nephropathy found in

A

Kids and young adults

40
Q

IgA Nephropathy pathology

A

IgA complexes deposited in glomerular membrane

41
Q

IgA Nephropathy UA findings

A

Hematuria macroscopic (follows infection or hardcore exercise)

42
Q

Chronic glomerulonephritis

A

Accumulation of damage due to the previously mentioned disorders can lead to the chronic version

43
Q

Chronic glomerulonephritis lab findings

A
  • Hematuria
  • Proteinuria
  • Glycosuria (tubular dysfunction)
  • Decreased eGFR
  • Increased BUN/creatinine
  • Electrolyte imbalance

UA Spring (8 decks)

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