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AUBF LEC > Renal Diseases Prt. 1 > Flashcards

Renal Diseases Prt. 1 Flashcards

1
Q

• Conditions that affect renal function
• Can be classified as:

A
  1. Glomerular
  2. Tubular
  3. Interstitial
  4. Renal Failure
  5. Renal Lithiasis
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2
Q

Glomerular Disorders

A

Glomerular nephritis
Nephrotic syndrome

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3
Q

Glomerular disorders

Main cause:

A

Immune complexes

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4
Q

Glomerular disease

• Deposition of _______ trigger immune reaction producing changes or damages in the glomerular membrane
• Result to thickening of glomerular membrane or complement activation

A

immune complexes

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5
Q

Glomerular disorders

• Non-immunologic causes:

A

• Exposure to chemicals and toxins
• Disruption of the negative charge of the membrane (nephrotic syndrome)
• Deposition of amyloid material
• Thickening of the membrane caused by diabetic nephropathy

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6
Q

Glomerular disorder

• Sterile inflammation

• Presence of blood, protein and casts in urine

A

Glomerulonephritis

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7
Q

Glomerular disorders

• Can progress from acute to chronic to nephrotic syndrome and eventually end stage renal disease (ESRD)

A

Glomerulonephritis

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8
Q

Glomerular disorders -Glomerulonephritis

• Sudden onset of symptoms due to glomerular damage

• Symptoms:
• fever, edema (most noticeably around the eyes), fatigue, nausea, hypertension, oliguria, proteinuria, and hematuria

A

Acute Post-streptococcal Glomerulonephritis

• Acute glomerulonephritis (AGN)

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9
Q

Glomerular disorders - Glomerulonephritis

Acute Post-streptococcal Glomerulonephritis

• Acute glomerulonephritis (AGN)

• Main cause:______
• Virulence factor:

• Antibody + organism complex deposited in the
glomerular membrane = inflammation reaction

A

infection by B-hemolytic streptococcus (S. pyogenes)

M protein

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10
Q

Glomerular disorders - Glomerulonephritis

Hallmark of AGN

A

BC cast

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11
Q

Glomerular disorders - Glomerulonephritis

Diagnostic tests for Streptococcal infection

A

(+) Anti streptolysin O
(+) Anti-DNAse B

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12
Q

Glomerular disorders - Glomerulonephritis

• More serious; Poorer prognosis

• Main cause: Deposition of immune complexes as a result of complication of another glomerulonephritis or immune disorders (i.e SLE)

A

Rapidly Progressive (Crescentic) Glomerulonephritis

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13
Q

Glomerular disorders - Glomerulonephritis

• Immune complexes attract macrophages = damage capillary walls
• Damaged capillary walls release cells and plasma to bowman’s capsule
• Cells & plasma proteins = crescentic formation that destroys capillaries (irreversible)

A

Rapidly Progressive (Crescentic) Glomerulonephritis

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14
Q

Glomerular disorders - Glomerulonephritis

• Findings:
• Similar to AGN but worsens as disease progresses
• Marked proteinuria & decreased GFR
• Increased fibrin degradation products + IgA deposition in glomerular membrane

A

Rapidly Progressive (Crescentic) Glomerulonephritis

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15
Q

Glomerular disorders - Glomerulonephritis

• Autoimmune disorder caused by Anti-glomerular Membrane
Antibody (Anti-GBM antibodies)

A

Good Pasteur Syndrome

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16
Q

Glomerular disorders - Glomerulonephritis

Good Pasteur Syndrome

• Diagnosis:

A

(+) anti-glomerular membrane antibody in patient’s serum

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17
Q

Glomerular disorders - Glomerulonephritis

• Findings:

• Hemoptysis and dyspnea followed by hematuria
• Proteinuria and presence of RBC casts
• If left unmanaged, can progress to chronic glomerulonephritis and end stage renal disease

A

Good Pasteur Syndrome

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18
Q

Glomerular disorders - Glomerulonephritis

Granulomatosis with Polyanglitis
• Former…

A

Wegener’s Granulomatosis

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19
Q

Glomerular disorders - Glomerulonephritis

• Caused by: Anti-Neutrophilic Cytoplasmic Antibody (Autoantibody)

• ANCA binds to neutrophils = neutrophils activated = granuloma formation

A

Granulomatosis with Polyanglitis

Wegener’s Granulomatosis

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20
Q

Glomerular disorders - Glomerulonephritis

• Findings:
* Initial respiratory symptoms that later develop renal involvement

• Urine: hematuria, proteinuria, RBC casts
• Blood: Increased creatinine & BUN levels

A

Granulomatosis with polyangiitis

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21
Q

Glomerular disorders - Glomerulonephritis

Granulomatosis with polyangiitis

• Diagnosis:

A

(+) ANCA in patient’s serum

22
Q

Glomerular disorders - Glomerulonephritis

Granulomatosis with polyangiitis

• Diagnosis:

• Incubate patient’s_____ +_____ or _____

• Indirect immunofixation = detect____

A

serum

ethanol or formalin-fixed neutrophils

ANCA

23
Q

Glomerular disorders - Glomerulonephritis

Granulomatosis with polyangiitis

Ethanol-fixed neutrophils:_____

Formalin-fixed neutrophils:

A

perinuclear pattern (p-ANCA)

granular pattern in the cytoplasm (c-ANCA)

24
Q

Glomerular disorders - Glomerulonephritis

• Occurs in children following upper respiratory infections

• Decrease platelets = vascular problems

A

Henoch-Schonlein Purpura

25
Q

Glomerular disorders - Glomerulonephritis

• Findings:
• Respiratory & Gastrointestinal symptoms

• Renal Involvement (most serious complication):
• Heavy proteinuria
• Hematuria
• RBC Casts

A

Henoch-Schonlein Purpura

26
Q

Glomerular disorders - Glomerulonephritis

Complete recovery in >50% of patients, but some progress to a more serious form of glomerulonephritis and renal failure

A

Henoch-Schonlein Purpura

27
Q

Glomerular disorders - Glomerulonephritis

• Deposition of IgG complexes = thickening of glomerular membrane

A

Membranous Glomerulonephritis

28
Q

Glomerular disorders - Glomerulonephritis

Membranous Glomerulonephritis

Disease associated with deposition of IgG Complex:

A

• SLE
• Sjogren syndrome
• Hepatitis B
• Secondary syphilis
• Mercury treatments r Malignancy

29
Q

Glomerular disorders - Glomerulonephritis

• 70% of cases: idiopathic

• Disease slowly progresses and can develop to nephrotic syndrome

A

Membranous Glomerulonephritis

30
Q

Glomerular disorders - Glomerulonephritis

• Findings:
• Hematuria
• RBC Casts (rare)

A

Membranous Glomerulonephritis

31
Q

Glomerular disorders - Glomerulonephritis

• Changes in cellularity of glomerulus and capillaries

• Very poor prognosis

A

Membranoproliferative Glomerulonephritis

32
Q

Glomerular disorders - Glomerulonephritis

Membranoproliferative Glomerulonephritis

• Increased cellularity in bowman’s capsule = thickening of the membrane
• Progress to nephrotic syndrome

33
Q

Glomerular disorders - Glomerulonephritis

Membranoproliferative Glomerulonephritis

• ”dense deposit disease”

• Dense deposits in the basement membrane, tubules and bowman’s capsule

• Exhibit symptoms of chronic glomerulonephritis

34
Q

Glomerular disorders - Glomerulonephritis

Membranoproliferative
Glomerulonephritis

• Endothelial and sub-endothelial deposits

A

Туре 3

35
Q

Glomerular disorders - Glomerulonephritis

• Significant damage to the glomerulus caused by acute glomerulonephritis

A

Chronic Glomerulonephritis

36
Q

Glomerular disorders - Glomerulonephritis

• Findings:
• Fatigue, anemia, hypertension, edema, and oliguria
• Increased serum creatinine and BUN levels

A

Chronic Glomerulonephritis

37
Q

Glomerular disorders - Glomerulonephritis

Chronic Glomerulonephritis

• Urine: proteinuria and hematuria with varieties of casts

•________ = chronic glomerulonephritis is already progressing to end-stage renal disease (ESRD)

A

Broad cast

38
Q

Glomerular disorders - Glomerulonephritis

IgA Nephropathy

Aka

A

Berger’s Disease

39
Q

Glomerular disorders - Glomerulonephritis

• Mucosal infection: increased IgA complexes = deposited in the glomerular membrane

A

IgA Nephropathy
• Berger’s Disease

40
Q

Glomerular disorders - Glomerulonephritis

• Findings:
• Spontaneous/ periodic macroscopic hematuria

• Disease may remain asymptomatic for 20 years or more

• If left unmanaged, may progress to chronic glomerulonephritis and end-stage renal disease

A

IgA Nephropathy
• Berger’s Disease

41
Q

Glomerular disorders

• Damage to shield of negativity and podocytes

• Albuminuria & Lipiduria

A

Nephrotic Syndrome

42
Q

Glomerular disorders

• Decreased blood albumin results to:

• Edema
• Decreased coagulation factors & immunoglobulins
• Prone to infection & coagulation disorders

A

Nephrotic Syndrome

43
Q

Glomerular disorders

Nephrotic Syndrome

• Urinary findings: (2)

A

• Marked proteinuria (>3.5g/day)
• Lipiduria

44
Q

Glomerular disorders

Nephrotic Syndrome

•_________
• Hallmark of nephrotic syndrome
• Lipids droplets inside RTE cells
• Polarizing microscope:_____ formation

A

Oval fat bodies

Maltese cross formation

45
Q

Glomerular disorders - Nephrotic Syndrome

Minimal Change Disease

Aka

A

Lipid nephrosis or Nil Disease

46
Q

Glomerular disorders - Nephrotic Syndrome

• Damage to shield of negativity and podocytes but with minimal cellular changes in the glomerulus

• Most common cause of nephrotic syndrome in children.

A

Minimal Change Disease
(Lipid nephrosis or Nil Disease)

47
Q

Glomerular disorders - Nephrotic Syndrome

Minimal Change Disease
(Lipid nephrosis or Nil Disease)

• Idiopathic but associated with_____

A

HLA-B12 (postulated as t-cell disorder)

48
Q

Glomerular disorders - Nephrotic Syndrome

Minimal Change Disease
(Lipid nephrosis or Nil Disease)

• Good prognosis: responds well to_____ treatment

A

corticosteroid

49
Q

Glomerular disorders - Nephrotic Syndrome

• Only affect certain areas of podocytes

• Most common cause of primary glomerulonephritis in adults

A

Focal Segmental Glomerulosclerosis

50
Q

Glomerular disorders - Nephrotic Syndrome

Focal Segmental Glomerulosclerosis

a._____ - idiopathic
b._____
• Diseases (HIV & Hepatitis) or drugs (analgesic & heroin abuse)

• Findings
• Similar to nephrotic syndrome with moderate to heavy proteinuria and hematuria

A

Primary

Secondary

AUBF LEC (20 decks)

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