Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RENAL SYNDROMES WALL > Renal Syndromes Wall 4/24 HIGH YIELD > Flashcards

Renal Syndromes Wall 4/24 HIGH YIELD Flashcards

1
Q

Diagnosis of kidney disease is best accomplished by looking at what four pieces of information?

A

1) changes in serum creatinine
2) Abnormalities in urinalysis
3) Altered Renal Homeostasis
4) Abnormal kidney imaging studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

More specific diagnoisis is started by asking what 4 questions?

A

1) acute or chronic
2) pre, intrinsic, or post renal
3) Glomerular, tubular, vascular
4) Inflmammatory, non-inflammatory
5) Assoc w/underlying systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Three categories of intrinsic disease?

A

Glomerular, tubular, vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

5 categories of glomerular disease?

A

Nephrotic, Nephritic, Mixed, Mesangial Nephritic,Chronic glomerular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the features of Nephrotic syndrome according to Nichols?

A

Edema, selective heavy proteinuria, hypoalbuminemia, hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What will GFR look like in Nephrotic?

A

Probably normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

BP in nephrotic?

A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the typical level of proteinuria in nephrotic syndrome?

A

3g/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is the urinary sediment in Nephrotic active or inactive and what does this mean?

A

Urinary sediment is inactive (no red cells or red cell casts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name the nephrotic syndromes we covered

A

FSGS, Minimal Change, Membranous nephropathy, post-infectious glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common symptoms of Nephritic syndrome?

A

hematuria, renal insufficiency, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name the nephritic syndromes we covered?

A

MPGN, Dense Deposit Disease, IgA nephropathy, Anti-GBM, Rapidly progressing GN, Alport Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Signs of mixed glomerular disease?

A

heavy proteinuria, low albumin and edema, inflammation, hematuria (all of these can be presesnt but dont have to be)
Ex: Lupus Nephritis stage 4 diffuse proliferative type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the signs of Mesangial Nephritic Syndrome

A

capillary are fine so you should have steady GFR, steady BP, can have Hematuria because it is inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 types of Tubular syndromes?

A

Inflammatory interstitial (infectious and non-infectious, Non-inflammatory interstitial, chronic interstitial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vascular syndromes?

A

Prerenal azotemic, renal artery stenosis, hypertensive nephrosclerosis, vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Renal artery stenosis related to what>

A

hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is pre-renal azotemia?

A

Nothing wrong with the Kidney, just not enough flow or pressure due to another problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a typical dipstick analysis reading in nephrotic syndrome?

A

3+ or 4+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most common type of nephrotic syndrome in children?

A

Minimal Change Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most common glomerulopathy in caucasians?

A

Membranous Glomerulopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the most common nephrotic syndrome in African Americans

A

Focal Segmental Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most common form of nephrotic disease overall?

A

Diabetic Nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Nephritic syndrome is most characterized by what?

A

Inflammation in the glomerulus. Can be driven by immune complex, anti-GBM antibodies, ANCA. etc…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Inflammation in the glomerulus causes what in the urine?

A

Blood (microscopic or gross) or red cell casts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

A red cell cast is made by a red cell trapped in what protein?

A

Tamm-Horsfall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why are you more likely to see declining GFR with nephritic syndrome than with Nephrotic?

A

Endothelial cells are swollen shut so you lose surface area for filtration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Why do you have hypertension in Nephritic syndrome

A

Low GFR so you are retaining salt and water to keep fluid volume.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why does the retention of salt and water in Nephritic syndrome lead to HTN whereas salt and water retention in Nephrotic syndrome leads to edema?

A

In nephritic syndrome, the plasma oncotic pressure is fairly stable because you’re not losing albumin and other proteins so the salt and water retention distributes evenly to the extracellular space and you get plasma volume expansion as well as some ISF volume expansion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Pulmonary edema is caused by what?

A

increased plasma volume

31
Q

Classic example of nephritic syndrome?

A

Poststreptococal glomeruloephritis

32
Q

Classic example of glomerulonephritis restricted to the mesangial space?

A

IgA nephropathy

33
Q

Most common example of Mixed Nephrotic/Nephritic

A

Diffuse proliferative Glomerulonephritis related to SLE

34
Q

Membranoproliferative Glomerulonephritis is in which category of glomerular disease and frequently follows what disease?

A

Mixed, Hepatitis C

35
Q

What is the appearace of the BM in MPGN?

A

Tram track appearance

36
Q

What is a cryoblobulin disease?

A

Hepatitis C….IgM

37
Q

What is the hallmark of tubule injury?

A

Decreased GFR.

38
Q

WHy does low GFR occur with tubule injury

A

No reabsorption is occuring which kills the pressure differental between the capillaries and the urinary space so filtration can’t occur.

39
Q

Do you lose the ability to dilute or to concentrate first?

A

Concentrate, Bilution is collecting duct/distal tubule process.

40
Q

Isothenuric urine means what and when is it seen>

A

Isothenuric urine means that the urine osmolarity is the same as the plasma osmolarity in the glomerulus . This occurs during episodes of tubule injury when reabsorption can’t occur.

41
Q

What is the specific gravity of isosthenuric urine?

A

1.010

42
Q

Fractional excretion of urine during tubule injury>

A

over 1%

43
Q

What types of casts are seen in a tbular disease urinalysis?

A

Granular casts

44
Q

What is the proteinuria in tubular injury?

A

Very low, glomerulus works fine

45
Q

Hallmark of inflammatory tubular injury>

A

Sterile pyuria…wbcs in urine not in respone to infection. Also look for eosinophils

46
Q

Example of infectious inflammatory kidney injury?

A

Pyelonephritis

47
Q

specific gravity of 1.010 means what?

A

You cant concerntrate urine pretty much

48
Q

Nocturia is a sign of what?

A

Inability to concentrate urine

49
Q

What types of casts are seen in interstitial kidney diseases?

A

Waxy casts

50
Q

Most interstitial kidney diseases lead to what in regards to kidney morphology?

A

small kidneys

51
Q

What does chronic calcineurin inhibitor (cyclosporin, tacrolimus) use lead to?

A

Nephrotoxicity

52
Q

Vascular syndromes include?

A

Renal Artery stenosis, hypertensive nephrosclerosis, renal artery stenosis, prerenal azotemia

53
Q

High BUN: Creatinine ratio is the best marker of what?

A

Pre-renal disturbance. Why does this make sense, because anytime you have a pre-renal disturbance that cuts down on kidney perfusion, you autoregulate to keep GFR normal, When you auto-regulate, you enhance proximal reabsorption b/c this is where bulk reabsorption o things like sodium and water takes place ANNND, urea follows water so BUN goes up. Sucka

54
Q

Will urine be concentrated or dilute in vascular syndrome?

A

Concentrated…high spec gravity

55
Q

What defines pre-renal azotemia

A

problem is above the kidneys, leads to poor perfusion.

56
Q

Lab findinrgs in pre-renal azotemia?

A

high BUN: creatinine ratio, low FENA (frac excretion of sodium), concentrated urine,

57
Q

Causes of pre-renal azotemia

A

anything that decreases blood flow or volume

58
Q

What effect do NSAIDs have on the kidneys that can make pre-renal azotemia worse

A

NSAIDS block prostaglandin production which means the afferent arterioles cannot dilate

59
Q

What effect do ACEi (angiotensin converting enzyme) and ARB (angiotensin receptor blocker) have on the kidneys that makes pre-renal azotemia worse?

A

they inhibit angiotensin II function…this prevents AII from doing its vasoconstriction work on the efferent arteriole

60
Q

Hypertensive nephrosclerosis leads to what?

A

medial hypertrophy of renal arterioles, ischemic glomerular atrophy, decreased number of functioning nephrons

61
Q

Noninflammatory means the urinalysis is bland

A

true

62
Q

Hypertensive nephrosclerosis does what to kidney size?>

A

decreases it

63
Q

Vasculitis involving the kidney is generally nephritic or nephrotic?

A

Nephritic

64
Q

WHat are examples of vasculitis involving the kidney>

A

Anything that presesnts as hemolytic uremic syndrome (red cells being injured), polyarteritis nodosa, ANCA associated vasculitis, Malignant hypertension

65
Q

Rapidly progressing glomerulonephritis includes?

A

Immune complex, anti-GBM, pauci-immune

66
Q

How quickly does rapidly progressing glomerulonephritis move?

A

Gets worse within weeks

67
Q

Name two immune complex RPGNs?

A

Lupus diffuse proliferative, post-strep

68
Q

Anti-GBM?

A

antibody against the noncolagenous portion of type IV collages

69
Q

Ploasmapharesis to remove antibody in what disease?

A

Anti-GBM

70
Q

Pauci Immune?

A

No immune deposits when looked at underimmunoflourescence

71
Q

Rapidly progressing glomerulonephritis also distinguised by what microscopic feature?

A

crescents

72
Q

BU: creatinine ratio high?

A

Prerenal azotemia

73
Q

BUN and Creatinine high

A

kidney failure

RENAL SYNDROMES WALL (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions