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AUBF > Renal diseases > Flashcards

Renal diseases Flashcards

1
Q

Majority of glomerular disorders are of what origin?

A

Immune origin (IgG, IgA)

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2
Q

What are the classifications of renal disease?

A

Glomerular disorder, tubular disorder, interstitial disorder

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3
Q

What causes Acute post Streptococcal glomerulonephritis?

A

Deposition of immune complexes formed in conjunction with Group A streptococcus on glomerular membranes

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4
Q

What is rapidly progressive (crescentic) glomerulonephritis characterized by?

A

Deposition of immune complexes from systemic immune disorders (SLE); cellular proliferation of epithelial cells inside the Bowman’s capsule forming crescents

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5
Q

What is Goodpasture syndrome?

A

Deposition of anti-glomerular basement membrane antibody to glomerular and alveolar basement membranes

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6
Q

What causes Wegener’s granulomatosis (Granulomatosis with polyangiitis)?

A

Anti-neutrophilic cytoplasmic auto-antibody (ANCA) binds to neutrophils in vascular walls, damaging small vessels in the lungs and glomerulus

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7
Q

What is p-ANCA?

A

Perinuclear ANCA that forms when neutrophils are fixed in ethanol

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8
Q

What is c-ANCA?

A

Cytoplasmic ANCA that forms when neutrophils are fixed in formalin

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9
Q

What is Henoch-Schonlein Purpura?

A

A condition in children following viral respiratory infections with decreased platelets disrupting vascular integrity

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10
Q

What is Membranous Glomerulonephritis (MGN)?

A

Thickening of the glomerular membrane due to IgG immune complex deposition associated with systemic disorders

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11
Q

What is Membranoproliferative Glomerulonephritis (MPGN)?

A

Cellular proliferation affecting the capillary walls or glomerular membrane; possibly immune-mediated

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12
Q

What is Type 1 MPGN?

A

Increased vascular cellularity in the subendothelium

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13
Q

What is Type 2 MPGN?

A

Extremely dense deposits in the glomerular basement membrane (GBM), tubules, etc.

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14
Q

What is Type 3 MPGN?

A

Both subepithelial and subendothelial deposits in the glomeruli

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15
Q

What is Chronic Glomerulonephritis?

A

Marked decrease in renal function due to glomerular damage, potentially progressing to renal failure

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16
Q

What is IgA Nephropathy (Berger’s Disease)?

A

Deposition of IgA on the glomerular membrane resulting from increased IgA levels

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17
Q

What is Minimal Change Disease (MCD)?

A

Little cellular change in the glomerulus, loss of podocyte foot processes; associated with HLA-B12 antigen

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18
Q

What is Focal Segmental Glomerulosclerosis (FSGS)?

A

Disruption of podocytes in certain glomeruli, others remain normal; IgM and C3 deposition in sclerotic areas

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19
Q

What is Diabetic Nephropathy (Kimmelstiel-Wilson Disease)?

A

Most common cause of ESRD, caused by deposition of glycosylated proteins on the glomerular basement membranes due to poorly controlled blood glucose

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20
Q

What is Nephrotic Syndrome?

A

Disruption of podocyte electrical charges, leading to massive protein and lipid loss

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21
Q

What is the rate of proteinuria in Nephrotic Syndrome?

A

> 3.5g/day

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22
Q

Which conditions are associated with Nephrotic Syndrome?

A

MCD (children), MGN (adults), FSGS, and MPGN

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23
Q

What are the serum findings in Nephrotic Syndrome?

A

Decreased albumin, a1-gammaglobulin; increased a2-macroglobulin, b-globulin (LDL)

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24
Q

What are the urinalysis findings in Nephrotic Syndrome?

A

Increased albumin; a-1,b-,y-globulins; negative for a2-macroglobulin; oval fat bodies, fatty casts, waxy casts

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25
Q

What are the findings in Acute Post-Streptococcal Glomerulonephritis?

A

Macroscopic hematuria, proteinuria, dysmorphic RBCs, RBC casts, granular casts, (+) ASO titer and anti-DNASE B

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26
Q

What are the findings in rapidly progressive (crescentic) glomerulonephritis and Goodpasture syndrome?

A

Macroscopic hematuria, proteinuria, RBC casts

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27
Q

What condition is associated with decreased platelet count?

A

Henoch-Schonlein Purpura

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28
Q

What are the findings in Membranous Glomerulonephritis (MGN) and Membranoproliferative Glomerulonephritis (MPGN)?

A

Hematuria (microscopic MGN) and proteinuria

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29
Q

What are the findings in Chronic Glomerulonephritis?

A

Hematuria, proteinuria, glycosuria, cellular and granular casts, waxy broad casts

30
Q

What are the findings in Berger’s Disease (IgA Nephropathy)?

A

Early stages: hematuria; Late stages: similar to chronic glomerulonephritis

31
Q

What are the findings in Minimal Change Disease (MCD)?

A

Heavy proteinuria, transient hematuria, fat droplets

32
Q

What are the findings in Focal Segmental Glomerulosclerosis (FSGS)?

A

Proteinuria and hematuria

33
Q

What are the findings in Diabetic Nephropathy?

A

Microalbuminuria (positive Micral test)

34
Q

What is the hallmark of Alport syndrome?

A

Similar with nephrotic syndrome findings

35
Q

Damage to renal tubular cells caused by ischemia or toxic agents; odorless urine

A

Acute tubular necrosis

36
Q

Findings in acute tubular necrosis

A

Microscopic hematuria, proteinuria, RTE cells, RTE casts, hyaline, granular, waxy and broad casts

37
Q

Inherited defect in the production of normal uromodulin by the renal tubules and increased uric acid causing gout; normal uromodulin is replaced by abnormal forms that destroy RTE cells

A

Uromodulin-associated Kidney Disease (UKD)

38
Q

Findings in UKD

A

Early stages: RTE cells; Late stages: See chronic GN; Hyperuricemia

39
Q

Generalized failure of tubular reabsorption in proximal convoluted tubule

A

Fanconi syndrome

40
Q

Fanconi syndrome findings

A

Possible cystine crystals, glucosuria

41
Q

Diabetes insipidus: hypothalamus fails to produce ADH

A

Neurogenic DI

42
Q

Diabetes insipidus: renal tubules fail to respond to ADH

A

Nephrogenic DI

43
Q

Findings in DI

A

Low specific gravity, Polyuria (>15 L/day)

44
Q

Renal glycosuria glucose levels

A

Urine: increased, Blood: normal

45
Q

Defective tubular reabsorption of glucose

A

Renal glycosuria

46
Q

Findings in Renal glycosuria

A

Glucosuria

47
Q

Ascending bacterial infection of urinary bladder; acute onset of urinary frequency and burning

A

Cystitis (lower UTI)

48
Q

Infection of renal tubules and interstitium; interference of urine flow to bladder, reflux of urine from bladder, untreated cystitis

A

Acute pyelonephritis (upper UTI)

49
Q

Recurrent infection of renal tubules and interstitium

A

Chronic pyelonephritis

50
Q

Allergic inflammation of renal interstitium; possibly caused by medication binding to interstitial protein

A

Allergic interstitial nephritis

51
Q

Findings: WBCs, bacteria, no casts, microscopic hematuria, mild proteinuria, increased pH

A

Cystitis (lower UTI)

52
Q

Findings: WBCs, bacteria, WBC casts, bacterial casts, microscopic hematuria

A

Acute pyelonephritis (upper UTI)

53
Q

Findings: WBCs, bacteria, WBC casts, bacterial casts, granular casts, waxy and broad casts, hematuria, proteinuria

A

Chronic pyelonephritis

54
Q

Findings: Hematuria, proteinuria, increased WBCs (eosinophils), WBC (eosinophil casts), no bacteria

A

Acute interstitial nephritis

55
Q

Decreased glomerular filtration rate (<25 mL/min), azotemia (increased BUN, creatinine), electrolyte imbalance, decreased renal concentration ability, proteinuria, renal glycosuria, telescoped sediment

A

Renal failure/ESRD findings

56
Q

Telescoped sediment

A

Variety of casts seen in same specimen

57
Q

Formation in calyces, pelvis, ureters, bladder; lithotripsy breaks stones with high-energy shock waves

A

Renal calculi/renal lithiasis

58
Q

Conditions favoring renal calculi formation

A

pH, chemical concentration, urinary stasis

59
Q

Primary finding in renal calculi

A

Microscopic hematuria

60
Q

Major constituent of renal calculi; very hard, dark, rough surface

A

Calcium oxalate

61
Q

Associated with high purine intake, UKD; yellowish-brown/red, moderately hard

A

Uric acid/urate

62
Q

Seen in hereditary metabolism disorders; yellow-brown, greasy, resembles old soap, least common

A

Cystine

63
Q

Pale, friable renal lithiasis

A

Phosphate

64
Q

Accompanied by urinary infections with urea-splitting bacteria; branching/staghorn calculi

A

Triple phosphate

65
Q

Triamterene calculi

A

Mustard-colored stones from insoluble diuretic

66
Q

Adenine calculi

A

Inherited enzyme deficiency, hyperuricemia

67
Q

Xanthine calculi

A

Genetic disorder, absence of xanthine oxidase

68
Q

Renal calculi with highest composition

A

Calcium

69
Q

Magnesium ammonium phosphate in renal calculi

A

0.15

70
Q

Cystine frequency in renal calculi

A

0.02

71
Q

Uric acid frequency in renal calculi

A

0.06

72
Q

Calcium with phosphate frequency in renal calculi

A

0.15

AUBF (26 decks)

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