Renal Disorders (exam2)

Question 1

What is largely in charge or retaining proteins in the blood

Answer 1

negative charge of the podocytes

Question 2

What is Nephrotic Disease or syndrome

Answer 2

The increased permeability to Plasma Proteins

Question 3

what test is needed to determine proteinuria

Answer 3

a 24 hr urine collection

Question 4

What is the definition of Proteinuria

Answer 4

> 3.5 g of protein in 24 hours

Question 5

what is the most common protein leaked out when gaps in podocytes allow proteins to leak out

Answer 5

Albumin

Question 6

Hypoalbuminemia results in decreased intravascular oncotic pressure leading to what

Answer 6

edema

Question 7

Treatment of Glomerular Dz

Answer 7

Low Salt diet
Diuretics
Treatment of HTN
Statins

Question 8

What is Minimal change Disease

Answer 8

Abnormality in the capillary walls in the glomerulus

common in children 80-90 % of the cases

Question 9

Focal Segmental Glomerulosclerosis (FSGS)

Answer 9

Sclerosing in glomerulus
Causes 35% of nephrotic syndrome in adults

Second most common cause in children

Question 10

Membranous Nephropathy

Answer 10

Immune complexes deposited in glomerulus

Rare in childre

Question 11

Secondary causes of Nephrotic Diseases (30%)

Answer 11

• Systemic Lupus Erythematousus
• Diabetic Nephropathy
• Amyloidosis
• Hepatitis B and C
• HIV

Regardless the cause of the NS primary or secondary . consultation with a nephrologist is needed

Question 12

What keeps the proteins from leaking out

Answer 12

the foot processes of the podocytes

Question 13

Minimal Change Disease is the most common or least common Neprhrotic Disease ?

Answer 13

Most common #1 most common epecially in children 2-6 y.o.

Average age in adults who get MCD is 40

Question 14

what percentage of Minimal Change Disease is idopathic

Answer 14

90%

Question 15

Clinical Presentation of Minimal change disease

Answer 15

Facial edema - number 1
malaise/ fatigue, muscle wasting
wt gain-

Question 16

Most serious complication of Minimal Change Disease

Answer 16

Hypovolemia

Question 17

what will be found in the urine that is specific to Minimal change disease

Answer 17

Oval Fat Bodies

Question 18

Diagnosis MCD

Answer 18

24 hour urine collection needed.

A albumin/creatinine ratio >5

specific gravity
low albumin

Question 19

True or False- Minimal change Disease is treated first in Adults but hold treatment for Pediatrics until a Renal Biopsy

Answer 19

False- Treat children right away without biopsy first.

this is because the children will respond really well to the steroids

Question 20

Tx of Minimal Change Disease

Answer 20

Corticosteroids

90% of children respond within 2 weeks

Adults can take up to 16 weeks

Continue steroids for 6 wks after remission of proteinuria

Question 21

If they are steroid resistant or if the pt can not have steroids we utilize what to treat Minimal Change Disease

Answer 21

Cyclophosphamide-Antineoplastics
Chlorambucil-Immunosuppressants
Mycophenolate- Immunomodulators

Question 22

Exam findings of pts with FSGS

Answer 22

Pleural effusion
Ascites
Abdominal pain
Ulcerations and infections d/t edema
severe hypertension

Question 23

UA of focal segmental glomerulosclerosis will find what

Answer 23

Large amounts of protein

Hyaline and broad waxy casts, red blood cell casts are generally absent

broad casts may be observed

serum creatinine
concentration or creatinine clearance usually within reference ranges in early stages

Question 24

Tx of FSGS

Answer 24

Ace or Arb

Treat secondary processes

if persistant proteinuria/MS -corticosteroids: 60-80 mg/d for 2-6 months

Question 25

Membranous Nephropathy is also known as

Answer 25

membranous glomerulonephritis or MGN

Question 26

MGN deposits immune complexes on the glomerular basement membrane which does what

Answer 26

Thickens the GBM leading to a loss in protein in the urine

Question 27

What are the ways that the antigen-antibodies that are deposited in membranous nephropathy come from

Answer 27

Form from

Autoantibiodies

and from outside the kidney- cows milk