Renal Pathophys part 2 - Schoeny (exam 3) Flashcards

1
Q

Painless hematuria in a smoker, what can’t you miss?

A

Bladder cancer

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2
Q

What is the most common cause of asymptomatic hematuria caused by glomerular disease?

A

Basement membrane abnormalities

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3
Q

4 most common cause of asymptomatic hematuria?

Which is the #1 most common?

A

IgA nephropathy*** Most common of the 4
Henoch-Schonlein purpura
Alport syndrome
thin basement membrane disease

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4
Q

Most common cause of primary glomerulonephritis?

A

IgA nephropathy

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5
Q

What 2 other conditions are associated with IgA nephropathy?

A

Celiac disease

Henoch-Schonlein purpura

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6
Q

IgA nephropathy is more common is what race?

A

Caucasians

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7
Q

Light microscopy findings in IgA nephropathy?

A

focal segmentation glomerulosclerosis of crescentic glomerulonephritis.

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8
Q

Immunofluorescence findings in IgA nephropathy?

A

Granular pattern with IgA and complement

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9
Q

Electron microscopy finings in IgA nephropathy?

A

IgA immune complexes present

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10
Q

This IgA mediated vasculitis most commonly affects children 3-8 years, follows a viral or strep infection, and presents with palpable purpura on the legs and buttocks.

A

Henoch Schonlein purpura

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11
Q

Does Henoch Schonlein purpura have renal have renal involvement?

A

50% of the time

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12
Q

Are purpura blanchable or non-blanchable in Henoch Schonlein syndrome?

A

Non-blanchable

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13
Q

What are the 4 categories of tubulointerstitial disease?

A

Acute tubulointerstitial disease
Acute interstitial nephritis
Chronic tubulointerstitial disease
Acute tubular necrosis

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14
Q

Acute tubulointerstitial disease occurs over what time period?

A

Days to weeks

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15
Q

Microscopic findings in acute tubulointerstitial disease?

A

Edema of cells, neutrophils, and focal necrotizing infiltrates

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16
Q

T/F? Acute tubulointerstitial disease can be due to a drug reaction.

A

true.

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17
Q

Other than drug reactions, name some causes for acute tubulointerstitial disease.

A
Systemic infections(legionnaire disease, strep, CMV, mono)
Primary renal infections (pyelonephritis)
Immune disorders (SLE and Sjogren's)
18
Q

AIN is usually caused by?

A

Drugs - specifically penicillin’s and sulfonamides

19
Q

Microscopic findings in AIN

A

Interstitial lymphocytes and macrophages, eosinophils. Sometimes giant cells and granulomas

20
Q

Presentation of AIN patient?

A

Hematuria, acute renal failure, rash, eosinophilia, proteinuria

21
Q

Chronic tubulointerstitial disease presents with?

A

Renal insufficiency, HTN, anemia, non-nephrotic proteinuria

22
Q

Chronic tubulointerstitial disease occurs over what time frame?

A

Years

23
Q

Microscopy findings in chronic tubulointerstitial disease?

A

Cellular infiltrate composed of lymphocytes and macrophages.

Interstitial fibrosis present

24
Q

Causes of chronic tubulointerstitial disease?

A
Urinary tract obstruction
Chronic pyelonephritis
Drugs (NSAIDs, Cisplatin, cyclosporine)
Vascular Disease (HTN, atherosclerosis)
Heavy metals (cadmium and lead)
Malignancies (multiple myeloma)
25
Q

Tamm Horsfall protein in the urine should immediately make you think of?

A

ATN

26
Q

Causes of ATN?

A

Ischemic (sepsis, blood loss)

Toxic (aminoglycosides, IV contrast, mercury, ethylene glycol poisoning, hyperuricemia)

27
Q

A patient with ATN with increased urine output is in what stage of ATN?

A

Recovery stage

28
Q

The maintenance phase of ATN is characterized by?

A

Slowed renal flow

29
Q

UA findings in UTI?

A

Leukocyte esterase and nitrates positive.

30
Q

Symptoms of UTI?

A

dysuria, urinary frequency, urgency, and suprapubic discomfort

31
Q

Risk factors for pyelonephritis?

A

Obstruction, vesicoureteral reflux, diabetes, other (renal lesions, immunosuppression, trauma, pregnancy, sex)

32
Q

Complications of pyelonephritis?

A
Emphysematous pyelonephritis (gas production in renal parenchyma)
Papillary necrosis
33
Q

What is the most common substance to make up kidney stones?

A

Calcium oxalate (50% of cases)

34
Q

What bacteria are struvite kidney stones associated with?

A

Proteus, Pseudomonas, Providencia

35
Q

Uric acid stones are associated with?

A

Leukemia and lymphoma

36
Q

What is the only type of radiolucent stone?

A

Uric acid

37
Q

What kidney disease is associated with Berry aneurysms in the brain?

A

Polycystic kidney disease?

38
Q

Most common renal neoplasm in adults?

Kids?

A

Adults - renal cell carcinoma

Kids - Wilms tumor

39
Q

Classic triad of renal cell carcinoma?

A

Hematuria, flank pain, palpable mass

40
Q

Paraneoplastic syndrome can be seen in renal cell carcinoma. What is paraneoplastic syndrome?

A

Polycythemia, hypercalcemia, HTN

41
Q

What pathogen is linked to squamous cell carcinoma of the bladder?

A

Schistosomiasis hematobium