Renal Path Flashcards
What is the usual cause of Glomerulus disease?
Immune mediated
Describe Atozemia
Biochemical abnormality with increased BUN and creatinine
Name some symptoms seen in uremia
gastroenteritis, neuropathy, pruritis, pericarditis
What qualifies nephrotic syndrome from nephritic syndrome?
amount of proteinuria, 3.5 g/day to nephrotic
What are some causes of renal tube defects?
inherited (RTA, cystinuria), acquired(lead)
What is the GFR for Stage 2 renal disease?
GFR 20-50%
Why are clearance tests used?
To determine transplant candidates, drug dosing and effectiveness of therapy
What are some causes for a pre-renal increase in BUN?
high protein diet, catabolism, GI bleed, hemolysis, malignancy
What are some causes for a pre-renal increase in Creatanine?
muscle hypertrophy, meat diet, steroid, exercise, necrosis
When can a false (+) proteinuria test occur?
With hematuria, dilute urine or meds
What gross symptoms are seen in recessive polycystic kidney disease?
enlarged kidneys and bile duct proliferation
Name some additional abnormalities seen in ADPK?
liver cysts and berry aneurysms
What protein is altered in ADPK? genes?
polycystin 1/216p13/2-4q21
Occurence of horseshoe kidney?
1/500-1000 autopsies
What is the function of mesangial cells?
Secrete inflammation mediators and make collagen
What is the most common type of glomerulonephrotic syndrome in children?
Minimal Change Disease
Describe the risks and symptoms of nephrotic syndromes
hyopalbuminemia - pitting edema
hypogammaglobulinemia - risk of infections
hypercoagulable - loss of at III
hyperlipidemia - fatty casts in urine
When is effacement of foot processes seen?
MCD, FSGS
FSGS may be assoicated with these conditions.
HIV
heroin use
sickle cell disease
obesity
This nephrotic disease exhibits spike and dome appearence on EM
Membranous Neuropathy
Briefly describe the 2 types of membranoproliferative glomerulonephritis
Type I - subendothelial - associated with HBV/HCV- tram tracks
Type II - intramembranous - assoc with C3- overactivation and low levels of C3
hallmark of nephrotic syndromes?
greater than 3.5 g/day
What kidney disorder is associated with Hodgkin Lymphoma?
MCD
Why does MCD respond so well to steroids?
Because the damages in MCD is mediated by cytokines and steroids block cytokine release
When might one see FSGS?
HIV, heroin addiction, sickle cell ds, obesity
What is the treatment for FSGS?
Ace or ARBS
hallmark of Anti-GBN glomerulonephritis?
diffuse, linear pattern on IF
When are crescents seen?
Rapidly Progressive/cresentic GN
Which kidney disorder is associated with celiac sprue or liver disease?
IgA nephropathy, Berger’s ds
Describe the sx of Alport’s disease
hematuria, proteinuria, nerve deafness, eye disorders
What genes are mutated in ADPKD?
polycystin 1 - 16p13.3
polycystin 2 - 2-4q21
What is the typical outcome of ATN?
95% recover if they survive the initial event
What are some causes of tubulointerstitial nephritis?
infection, toxins, metabolic ds, m.myeloma, chronic urinary tract obstruction, radiation, transplant rejection
when are hyalinized arterioles/arteries seen on microscopy?
Nephrosclerosis, maliginant nephrosclerosis
Diagnostic signs of renal artery stenosis?
abdominal bruits, high renin, string of pearls on arteriography
What is angiomyolipoma?
tumors made out of vessels, smooth muscle and fat.
What is the number one cause of nephrptic syndrome in adults?
FSGS
When are subendothelial deposits seen on EM?
MPGN Type I
When are subepithelial deposits seen on EM?
Membranous
