systemic disease Flashcards

1
Q

what is diabetic nephropathy

A

microvascular complication that develops over time due to metabolic and vascular effects

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2
Q

what are the symptoms of  diabetic nephropathy

A
renal hypertrophy 
inflammation 
proteinuria 
microalbuminuria
haematuria 
tubule-interstital fibrosis
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3
Q

what is the investigations of diabetic nephropathy

A

urinalysis
U&Es
biopsy if haematuria is present

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4
Q

what is ischaemic neuropathy

A

reduced GFR associated with reduced renal blood flow beyond the level of auto regulatory compensation

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5
Q

what is hypertensive neuropathy

A

reduction in renal perfusion pressure activates a series of hormonal and neuronal responses that raise systemic BP

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6
Q

who is affected by renal artery stenosis

A

males >50

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7
Q

what are the symptoms of renal stenosis

A
hypertension
AKI after hypertension treatment 
flash pulmonary oedema
abdominal bruit 
discrepancy in kidney size
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8
Q

what are the investigations of renal stenosis

A

US

CT or MRI angiography

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9
Q

what is the treatment of renal stenosis

A

statin
ACEI (unless bilateral)
anti-platelet angioplasty ± stenting

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10
Q

who is affected by fibromuscular dysplasia

A

females 15-50

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11
Q

what is fibromuscular dysplasia

A

non-inflammatory disease of the blood vessels that causes abnormal growth within the wall of an artery

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12
Q

what vessels are affected by fibromuscular dysplasia

A

both renal arteries (common)

cerebral arteries

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13
Q

what is dysproteinaemia

A

overproduction of immunoglobulins by clonal expansion of cells from B-cell linage

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14
Q

what is myeloma

A

cancer of plasma cells responsible for producing antibodies

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15
Q

what causes renal dysfunctional myeloma

A

monoclonal production of abnormal antibodies (paraproteins)

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16
Q

what is the classical presentation of myeloma

A

back pain + renal failure

17
Q

what are the other symptoms of myeloma

A
anaemia 
hypercalcaemia
bone pain
weakness/fatigue 
weight loss
18
Q

what are the renal symptoms of myeloma

A

monoclonal Ig deposits in glomeruli
dehydration
hypercalcaemia

19
Q

what are the investigations of myeloma

A
bloods = light chains
urine = bence jones proteins
bone marrow biopsy 
renal biopsy 
skeletal survey
20
Q

what is the treatment of myeloma

A

chemo
stem cell transplant
plasma exchange

21
Q

what is small vessel vasculitis, who is usually affected

A

inflammation of the blood vessels

50-70

22
Q

what are the types of small vessel vasculitis

A

GPA
microscopic polyangiitis
churg-strauss

23
Q

what are the symptoms of small vessel vasculitis

A
systemic symptoms
renal involvement 
skin involvement = Churg-strauss
resp involvment = GPA
saddle nose = GPA
24
Q

what are the investigations of small vessel vasculitis

A

ANCA
anti-MPO = microscopic polyangiitis
anti-PR3 = GPA

25
Q

what is the treatment of small vessel vasculitis

A

immunosuppression = steroids, cyclophosphamide

plasma exchange

26
Q

what is SLE/lupus

A

chronic inflammatory disease of unknown origin that affects skin, joints, kidneys, nerves and serous membranes

27
Q

who is affected by SLE

A

women 20-30

28
Q

what are the symptoms of SLE

A

malar rash
photosensitivity
renal disease = lupus nephritis
systemic

29
Q

what are the symptoms of lupus nephritis

A

proteinuria

granular casts

30
Q

what are the investigations of SLE

A

anti-DNA

Anti-SM

31
Q

what is the treatment of lupus nephritis

A

hydroxycloroquine + steroids
± cyclophoshamide or MFF
± azathroprine or MFF (maintainance)