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CAM > Renal Exam > Flashcards

Renal Exam Flashcards

1
Q

rate at which blood gets filtered through all the glomeruli?

A

glomerular filtration rate

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2
Q

blood enters the glomerulus via what vessel?

A

afferent arteriole (an artery)

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3
Q

blood exits the glomerulus via what vessel?

A

efferent arteriole (an artery)

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4
Q

most common cause of primary glomerulonephritis in the world?

A

IgA nephropathy (Berger’s disease)

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5
Q

What nephritic disease can present with hemoptysis?

IgA Nephropathy
PI-G
Goodpasture Syndrome
Lupus nephritis

A

Goodpasture Syndrome

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6
Q

A 12-year-old girl presents to the Emergency Room with gross hematuria that started this morning. UA was negative for nitrates and leukocytes but positive for red blood casts. Serum creatinine was 1.6. What is the most likely diagnosis?
Vitals: Temp: 98.9, Pulse: 98, Resp: 18, BP: 132/88.

A

Post-Infectious Glomerulonephritis (pt may have had hx of strep throat or impetigo)

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7
Q

A 12-year-old girl presents to the Emergency Room complaining of abdominal pain and bruising of the arms and legs that started 12-hours ago. A UA shows no evidence of an infection but 12 RBCs/HPF and ++protein. Her history is notable for strep throat about 2 weeks ago. What is the most likely diagnosis?

A

IgA Vasculitis
(Henoch-Schonlean Purpura- “classic triad”- pupura, arthritis and abdominal pain)

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8
Q

What finding on urine microscopy is indicative of glomerulonephritis?

A

RBC casts

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9
Q

kidney disease w edema and the loss of a LOT of protein from the plasma into the urine due to increased glomerular permeability?

A

nephrotic syndrome,

O is a hole where plasma proteins escape –> edema as water follows into BODY

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10
Q

kidney disease w swelling and inflammation of the glomeruli. Structural damage to the glomerular basement membrane –> allows RBCs, albumin and large molecules (like RBC casts) to get filtered into the urine?

A

nephritic syndrome

I = inflammation of the glomeruliiiii –> albumin & RBCs into URINE

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11
Q

what syndrome is this?
-inflammation of glomeruli
-HTN
-cola-colored urine (hematuria)
-oliguria
-most common cause of primary glomerulonephritis is Berger’s Disease (IgA Nephropathy)

A

nephritic syndrome

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12
Q

most common cause of acute glomerulonephritis worldwide?

A

Berger’s Disease (IgA nephropathy)

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13
Q

what syndrome is this?
-hypoalbuminemia
-hyperlipidemia
-peripheral edema
-massive proteinuria

A

nephrotic syndrome

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14
Q

where is more edema? nephritic or nephrotic syndrome?

A

nephrotic syndrome

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15
Q

which one has high BP? nephritic or nephrotic syndrome?

A

nephritic syndrome

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16
Q

which one has hematuria? nephritic or nephrotic syndrome?

A

nephritic syndrome

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17
Q

which one has low serum albumin?

A

nephrotic syndrome

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18
Q

which one has more proteinuria? nephritic or nephrotic syndrome?

A

nephrotic syndrome

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19
Q

RBC casts are seen in what? nephritic or nephrotic syndrome?

A

nephritic syndrome

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20
Q

onset of which is gradual? nephritic or nephrotic syndrome?

A

nephrotic syndrome

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21
Q

onset of which is sudden? nephritic or nephrotic syndrome?

A

nephritic syndrome

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22
Q

which one is caused by an immune response triggered by an infection? nephritic or nephrotic syndrome?

A

nephritic syndrome

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23
Q

chronic kidney failure persists for at least how many months?

A

> 3+ months

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24
Q

nephritic syndromes have what type of hematuria?

A

Coca Cola colored

25
Q

RBC casts are specific for what condition?

A

glomerulonephritis

26
Q

what are the levels of blood and protein of glomerulonephritis?

A

-hematuria
-moderate levels of proteinuria

27
Q

to confirm the dx of glomerulonephritis, what is the gold standard?

A

kidney biopsy

gold standard = always most invasive

28
Q

tx of glomerulonephritis?

A

-if kidney not damaged much: ACEi or ARB
-if kidney is very damaged: dialysis

29
Q

inflammation of glomeruli –> protein and RBC leakage into the urine, typically caused by an immune response

What syndrome is this?

A

Glomerulonephritis

30
Q

most common cause of post-infectious glomerulonephritis?

A

Group A strep (skin or throat)

31
Q

what is the most common type of glomerulonephritis?

A

post-infectious glomerulonephritis

32
Q

post-infectious glomerulonephritis that occurs 2-6 wks of an infection. What type of infection did the pt have?

A

impetigo

33
Q

post-infectious glomerulonephritis that occurs 1-3 wks of an infection. What type of infection did the pt have?

A

Strep pharyngitis

34
Q

which type of glomerulonephritis is caused by a recent strep infection?

A

post-infectious glomerulonephritis

35
Q

what is tx of post-infectious glomerulonephritis?

A

supportive, give loop diuretics for HTN and edema and antibiotics

36
Q

IgA Nephropathy/Berger’s disease is more common in males vs females?

A

Males

37
Q

Results from glomerular mesangial deposition of IgA immune complex is what condition?

A

IgA Nephropathy/Berger’s disease

38
Q

what type of hematuria is found in IgA Nephropathy/Berger’s disease?

A

gross hematuria (red or smoky colored 1-2 days after respiratory tract infection)

39
Q

what types of infections tend to cause IgA Nephropathy/Berger’s disease?

A

upper respiratory infection (streptococcus) or GI infection

40
Q

what is the gold standard for confirming the dx of IgA Nephropathy/Berger’s disease?

A

kidney biopsy

41
Q

IgA Vasculitis/Henoch-Schonlein Purpura tends to occur in which age group?

A

childhood

42
Q

what is the classic triad of Henoch-Schonlein Purpura/IgA Vasculitis?

A

purpura, arthritis, and abdominal pain

43
Q

what is the most common form of systemic vasculitis in children?

A

Henoch-Schonlein Purpura

44
Q

necrotizing glomerulonephritis in which there are few or no immune deposits by immunofluorescence or electron microscopy?

A

Pauci-Immune Glomerulonephritis (PIG)

45
Q

what distinguishes Pauci-Immune Glomerulonephritis (PIG) from IgA nephritis?

A

NO direct immune complex deposition or antibody binding in Pauci-Immune Glomerulonephritis (PIG)

46
Q

What disorder is a form of small-vessel vasculitis associated with ANCAs, causes kidney diseases without direct immune complex deposition or antibody binding?

A

Pauci-Immune Glomerulonephritis (PIG)

47
Q

cause of Pauci-Immune Glomerulonephritis (PIG)?

A

idiopathic

48
Q

what is the gold standard for dx of Pauci-Immune Glomerulonephritis (PIG)?

A

renal biopsy

49
Q

why is Pauci-Immune Glomerulonephritis (PIG) called pauci-immune?

A

Lack of IG deposition

50
Q

tx for Pauci-Immune Glomerulonephritis (PIG)?

A

immunosuppressive or glucocorticoid therapy

51
Q

what main test supports the dx for Pauci-Immune Glomerulonephritis (PIG)?

A

+ANCA

52
Q

what is seen in renal biopsy of Pauci-Immune Glomerulonephritis (PIG)?

A

necrotizing lesions and crescents & NO IG’s

53
Q

disorder where circulating antibodies are directed against an antigen intrinsic to the glomerular basement membrane (GBM) –> resulting in acute or rapidly progressive glomerulonephritis that is typically associated with crescent formation?

A

Anti-GBM

54
Q

involvement of what system is present in most pts with anti-GBM antibody disease?

A

pulmonary involvement

55
Q

When pt w anti-GBM present with lung hemorrhage and glomerulonephritis, they have what pulmonary-renal syndrome?

A

Goodpasture’s syndrome

56
Q

tx for Goodpasture’s syndrome?

A

Plasmapheresis, Prednisone, and Cyclophosphamide

57
Q

Red blood cells are separated from plasma, which is then removed and treated or exchanged with saline or albumin is what tx of Goodpasture’s syndrome?

A

Plasmapheresis

58
Q

what will be found in on kidney biopsy in Goodpasture’s syndrome?

A

Anti-GBM antibodies

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