Renal System Flashcards
What type of vasculitis is anti-GBM disease
Small vessel vasculitis. antibodies are produced against Type 4 collagen
2x MC in men
Bimodal age 20-30 yrs & 60-70 yrs
Renal biopsy of Anti-GBM disease
Linear IgG deposits along Basement memb.
Anti-GBM disease Rx.
Plasmapheresis
Steroids
Cyclophosphamide
MCC of Renal vascular disease
Atherosclerosis
Fibromuscular disease (FMD)
Ix & Rx. of Renal vascular disease
IOC - MR Angio
Balloon Angioplasty
Fibromuscular disease (FMD) features
Young Female + HTN + CKD/ ARF (secondary to ACEi initiation) + Flash Pulm. edema
Retroperitoneal Fibrosis C/F
Low back/ Flank pain + Fever & LL edema
Association of Retro P Fibrosis
Riedal’s Thyroiditis
Previous RT
Sarcoidosis
Drug METHYSERGIDE
Rhabdomyolysis biochemical results??
Elevated Cr., CK
Myoglobinuria
Hypocalcaemia (Myoglobin binds to Ca2+)
Elevated K+, PO4-
METABOLIC ACIDOSIS
Rhabdomyolysis Rx.
IV fluids
Urinary Alkalinization
Rhabdomyolysis Causes
Fall at home for long hrs
McArdles syndrome
ECSTACY
Time taken for AV fistula to develop
6 to 8 weeks
Complications of AV fistula
Infection
Thrombosis (ABSENCE of Bruit)
Stenosis
STEAL Syndrome
Plasmapheresis Indications
GBS, Goodpasture’s,
Myasthenia gravis
ANCA +ve Vasculitis
TTP, HUS
Cryoglobulinaemia
Hyperviscosity synd.
Plasmapheresis Complications?
Hypocalcaemia (due to Citrate)
Coagulation factor depletion
IGs depletion
Met. Alkalosis
HLA/ MHC is located on which Chromosome ??
Chr. 6
Class 1 antigen - A, B, C
Class 2 antigen - DP, DQ, DR
Renal transplant imp. HLA
DR»>B»>A
Graft survival of type of donor??
Living donor»>Cadaveric donor
Hyperacute Graft Rejection type of HS reaction???
1) Hyperacute - Minutes to Hrs.,
Type 2 HS reaction
Caused by Pre-existing antibodies against ABO or HLA antigens.
Rx. Remove the graft
Type of Graft Rejection
1) Hyperacute (min to hrs)
2) Acute (< 6 months)
3) Chronic (> 6 months)
Acute Graft rejection is due to??
Mismatched HLA. CMI (cytotoxic T cells)
MONOCLONAL cell infiltrate predominates
CMV infection
Rx. Steroids & Immunosuppresants
Chronic Graft Rejection is due to ??
Both Antibody + CMI mechanisms
results in Fibrosis of transplanted kidney (CHRONIC ALLOGRAFT Nephropathy)
Rx. for Renal transplant??
Immunosuppression
1) Initial = Ciclosporin/ Tacrolimus + a Monoclonal antibody
2) Maintenance = Ciclosporin/ Tacrolimus + MpMF or Sirolimus
add Steroid if >= 1 steroid responsive acute rejection
Recurrence of original renal disease in Transplanted Kidney ???
MCGN»IgA»FSGS