Renal Diseases Flashcards
Classifications of renal diseases:
Glomerular disorders
Tubular
Interstitial
Renal failure
Renal lithiasis
What type of damage is the most common damage of the glomerulus?
Immunologic
Chemical mediators and toxic substances can cause ________
Glomerular injury
Causes of non-immunologic glomerular disorders:
- Exposure to chemicals and toxins
- Disruption of the electrical membrane charges
- Deposition of amyloid material
- Basement membrane thickening
Glomerular injury leads to what?
Hematuria and proteinuria
What is the major cause of immunologic glomerular disorder?
Accumulation of immune complexes
What are the 3 ways that glomerular disorders can occur?
Asymptomatic hematuria/proteinuria
Acute nephritic syndrome
Nephrotic syndrome
Symptoms of ANS
Hematuria
Proteinuria
Oliguria
Azotemia
Edema
Hypertension
Differenciate nephritic and nephrotic syndrome
Nephritic - (+) hematuria, (+) proteinuria
Nephrotic- (+) lipiduria, (+) proteinuria
Explain the cause of lipiduria in nephrotic syndrome
The kidney eliminates large amounts of proteins through the urine. This will cause the liver to try and produce some lipoproteins, but they need to be catabolized first by lipases. The liver also produces Angiopoietin-like 4 (angptl4) which inhibits the lipases, causing lipiduria.
A renal disease caused by infection of group A streptococcus
Acute poststreptococcal glomerulonephritis
What renal disease presents a crescentic formation in the Bowman’s space?
Rapidly progressive glomerulonephritis
A renal disease that has a pronounced thickening of the GBM and is associated with Hepatitis B
Membranous glomerulonephritis
What renal disease is the major cause of nephrotic syndrome in adults?
Membranous glomerulonephritis
Differenciate Membranous Glomerulonephritis with Membranoproliferative Glomerulonephritis
Membranous - no involvement of mesangial cells
Membranoproliferative - involvement of mesangium
Also known as lipid nephrosis
Minimal change disease
Major cause of nephrotic syndrome in children
Lipid nephrosis / minimal change disease
What causes lipid nephrosis?
T cell immunity dysfunction —> disrupt podocyte foot processes —> loss of shield of negativity
IgA nephropathy may be mistaken as _______. This can be differenciated by testing for ______.
Membranoproliferative glomerulonephritis
Serum IgA
Acute gromerulonephritis may progress into ______.
Chronic gromerulonephritis
Antiglomerular basement membrane disease is caused by what?
Cytotoxic autoantibodies
When cytotoxic autoantibodies attack the alveolar basement membrane, it is now called _____
Goodpasture’s syndrome
What is the old name of Granulomatosis with polyangiitis?
Wegener granulomatosis
What happens in Granulomatosis w/ polyangiitis?
The presence of Antineutrophil Cytoplasmic Antibody (ANCA) binds to the neutrophils in the vascular walls —>immune response —> granuloma formation
ANCA with antibodies that form perinuclear pattern
ANCA with granular pattern throughout the cytoplasm
p-ANCA (perinuclear ANCA)
c-ANCA (cytoplasmic ANCA)
A renal disease that primarily occurs in children after a respiratory infection
Henoch-Schönlein Purpura
Clinical tetrad of Henoch-Schönlein Purpura
No thrombocytopenia, palpable purpura
Abdominal pain
Hematuria
Arthritis
What is the most common hereditary nephritis?
Alport syndrome
A renal disease that also manifests eye and/or ear problem
Alport syndrome
How does Diabetes Mellitus cause glomerular damage?
Thickening of the GBM due to the loss of heparan sulfate
A renal disease that may be due to decreased blood flow that causes damage to the tubules
Acute Tubular Necrosis
Tubular disprders are classified into:
Acute Tubular Necrosis (ATN)
Tubular Dysfunction
Difference of iATN and tATN
iATN - lack of oxygen, caused by shock, trauma, surgical procedures
tATN - due to nephrotoxic substances
What is wrong with the kidney in Fanconi syndrome?
The PCT cannot reabsorb substances
Urinalysis findings in Fanconi syndrome:
Glycosuria (high urine glucose)
Normal blood glucose
In Renal Tubular Acidosis, what is wrong with the tubules? What happens to the blood and urine?
The tubules cannot secrete adequate hydrogen ions
Acidic blood, alkaline urine
Sodium reabsorption defect wherein the PCT cannot reabsorb sodium due to the activation of RAAS
Bartter’s syndrome
Sodium reabsorption defect wherein the PCT excessively reabsorbs sodium
Gordon’s syndrome
Sodium reabsorption defect wherein the DCT excessively reabsorbs sodium
Liddle’s syndrome
What happens in Uromodulin-associated Kidney Disease?
A mutation that leads to an abnormal amount of uromodulin will destroy RTEs. This will increase the serum uric acid, leading to complications such as gout
Classification: Lower or Upper UTI
Urethritis
Lower UTI
Classification: Lower or Upper UTI
Pyelonephritis
Upper UTI
Classification: Lower or Upper UTI
Cystitis
Lower UTI
Classification: Lower or Upper UTI
Pyelitis
Upper UTI
85% of UTIs are caused by what?
Gram-negative rods (E. coli, P. mirabilis, Klebsiella, Enterobacter, Pseudomonas)
Acute pyelonephritis is caused by ______. In where?
Bacterial infection in the tubules
Urinalysis findings in acute pyelonephritis
WBCs, bacteria, WBC casts
A renal disease that results from allograft rejection
Acute interstitial nephritis
In acute interstitial nephritis, what WBC is increased in the blood? What is its level in the urine?
Eosinophil
No eosinophiluria
Urinalysis findings in acute interstitial nephritis:
WBCs, WBC casts w/o bacteria, hematuria, proteinuria
Yeast infections are common among _____
Women
Give an example that causes yeast infections
Candida albicans
How does yeast infections occur?
When the bacterial flora is disrupted due to antibiotics or change in the pH, fungi can thrive, causing an imfection.
Sudden loss of renal function is called ______.
Acute renal failure
Acute renal failure is caused by:
Sudden decrease in renal flow
Acute glomerular or tubular diseases
Renal calculi or obstructions
