Renal Pathophys Part 2 Schoeny Exam 3 Flashcards
The most common cause of asymptomatic hematuria is
IgA nephropathy - caused by immune complex formation and also Most common primary cause of glomerulonephritis
What other 2 diseases is IgA nephropathy associated with?
celiac disease and Henoch-Schonlein purpura
What are the pathological findings in IgA nephropathy?
light microscopy?
immunofluorescence?
electron microscopy?
-Light microscopy: Focal segmental glomerulosclerosis of crescentic glomerulonephritis -Immunofluorescence: Granular pattern with IgA and complement -Electron microscopy: IgA immune complexes present
7-year-old boy is brought into your clinic with a rash he has developed over his legs and buttocks. You note palpable, non-blancheable purpura on BIL legs that are bright red. MOC reports the child also has symptoms of GI bleeding, hematuria, abdominal pain and arthralgia. Of note, he had a URI 2 weeks ago. You tell the mom that his condition is?
a. IgE mediated allergic reaction
b. IgA mediated vasculitis
c. Tubulointerstitial Disease
b. IgA mediated vasculitis. Yep, he has Henoch Schonlein purpura
Acute tubulointerstitial disease can be due to a drug reaction from PCNs, rifampin, sulfonamides, or ciprofloxacin. What symptoms would be associated with this condition?
rash, fever, eosinophilia and elevated IgE present
Which 2 immune disorders are associated with acute tubulointerstitial disease?
SLE (of course) and Sjogren’s
Microscopic findings of acute tubulointerstitial disease ?
edema of cells, neutrophils, and focal necrotizing infiltrates
Acute Interstitial Nephritis (AIN) is usually drug induced most commonly caused by which 2 classes of medications?
PCNs and sulfonamides
AIN is a P(penicillins)AIN in the asS(sulfonamides)
I’m reaching here but just go with it people
microscopic findings of AIN?
Interstitial lymphocytes and macrophages, eosinophils. Sometimes giant cells and granulomas
symptoms of AIN?
hematuria, acute renal failure, rash, eosinophilia, proteinuria
renal insufficiency, hypertension, anemia and non-nephrotic proteinuria occurring over years describes?
chronic tubulointerstitial disease
Chronic tubulointerstitial disease caused by long term use of NSAIDS is also referred to as?
analgesic nephropathy
microscopic findings of chronic tubulointerstitial disease?
cellular infiltrate composed of lymphocytes and macrophages. Interstitial fibrosis present
Besides muddy brown casts, which other kind of casts can you see in Acute Tubular Necrosis (ATN) ?
Tamm Horsfall protein
(ATN (attention!) your Horse fell) lol
what is the most common cause of acute renal failure?
ATN
Name some nephro toxic causes of ATN.
aminoglycosides IV contrast mercury ethylene-glycol poisoning hyperuricemia (high cell turnover with malignancies)
What are the other two causes of ATN? You should remember this…hopefully
Yes! Ischemia and sepsis ;)
Which stage of ATN is characterized by oliguria (renal flow slows to <400 mls of urine, starts within 24 hrs of initiating event) ?
a. initiating
b. maintenance
c. recovery
maintenance
which stage of ATN is characterized by increased urine output, up to 3 L?
recovery stage. Beware, electrolyte disturbances can lead to increased risk of death
Diabetic nephropathy can cause what kind of renal disorder?
nephrotic syndrome due to porous capillary walls
what are the 3 most common bacteria to cause acute pyelonephritis?
e.coli, Proteus, Enterobacter
Diabetics gas production within the renal parenchyma due to e.coli can cause what type of pyelonephritis complication?
emphysematous pyelonephritis
Struvite-staghorn calculi are kidney stones associated with what 3 types of infectious organisms?
Proteus, Providencia and Pseudomonas
What is the classic triad of renal cell carcinoma?
hematuria, flank pain and a palpable mass
Production of erythropoietin in renal cell carcinoma results in?
polycythemia
