Renal Pathophys part 2 - Schoeny (exam 3) Flashcards
Painless hematuria in a smoker, what can’t you miss?
Bladder cancer
What is the most common cause of asymptomatic hematuria caused by glomerular disease?
Basement membrane abnormalities
4 most common cause of asymptomatic hematuria?
Which is the #1 most common?
IgA nephropathy*** Most common of the 4
Henoch-Schonlein purpura
Alport syndrome
thin basement membrane disease
Most common cause of primary glomerulonephritis?
IgA nephropathy
What 2 other conditions are associated with IgA nephropathy?
Celiac disease
Henoch-Schonlein purpura
IgA nephropathy is more common is what race?
Caucasians
Light microscopy findings in IgA nephropathy?
focal segmentation glomerulosclerosis of crescentic glomerulonephritis.
Immunofluorescence findings in IgA nephropathy?
Granular pattern with IgA and complement
Electron microscopy finings in IgA nephropathy?
IgA immune complexes present
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.
Henoch Schonlein purpura
Does Henoch Schonlein purpura have renal have renal involvement?
50% of the time
Are purpura blanchable or non-blanchable in Henoch Schonlein syndrome?
Non-blanchable
What are the 4 categories of tubulointerstitial disease?
Acute tubulointerstitial disease
Acute interstitial nephritis
Chronic tubulointerstitial disease
Acute tubular necrosis
Acute tubulointerstitial disease occurs over what time period?
Days to weeks
Microscopic findings in acute tubulointerstitial disease?
Edema of cells, neutrophils, and focal necrotizing infiltrates
T/F? Acute tubulointerstitial disease can be due to a drug reaction.
true.
Other than drug reactions, name some causes for acute tubulointerstitial disease.
Systemic infections(legionnaire disease, strep, CMV, mono) Primary renal infections (pyelonephritis) Immune disorders (SLE and Sjogren's)
AIN is usually caused by?
Drugs - specifically penicillin’s and sulfonamides
Microscopic findings in AIN
Interstitial lymphocytes and macrophages, eosinophils. Sometimes giant cells and granulomas
Presentation of AIN patient?
Hematuria, acute renal failure, rash, eosinophilia, proteinuria
Chronic tubulointerstitial disease presents with?
Renal insufficiency, HTN, anemia, non-nephrotic proteinuria
Chronic tubulointerstitial disease occurs over what time frame?
Years
Microscopy findings in chronic tubulointerstitial disease?
Cellular infiltrate composed of lymphocytes and macrophages.
Interstitial fibrosis present
Causes of chronic tubulointerstitial disease?
Urinary tract obstruction Chronic pyelonephritis Drugs (NSAIDs, Cisplatin, cyclosporine) Vascular Disease (HTN, atherosclerosis) Heavy metals (cadmium and lead) Malignancies (multiple myeloma)
