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Chemistry Module 3 > T1: Renal Diseases > Flashcards

T1: Renal Diseases Flashcards

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1
Q

5 major categories of renal diseases

A
  1. Glomerular (damage to glomeruli)
  2. Tubular (infection/toxin destroys cells)
  3. Interstitial (infections)
  4. Vascular (disruption to blood supply)
  5. Others
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2
Q

6 glomerular diseases

A
  1. Acute Post-Streptococcal
  2. Glomerulonephritis
  3. Acute GN, Chronic GN
  4. Membranoproliferative GN
  5. Focal Segmental GN
  6. Rapidly Progressive GN
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3
Q

Acute Post-Streptococcal Glomerulonephritis

- specific causative bacteria

A

Group A Beta hemolytic strep

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4
Q

Acute Post-Streptococcal Glomerulonephritis

- How immune complexes causes the disease

A

cellular infiltrates deposit on glomerular basement membrane

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5
Q

Acute Post-Streptococcal Glomerulonephritis

- Six typical urinalysis findings

A
  1. Gross hematuria
  2. Proteinuria
  3. Red cell casts
  4. Hypertension
  5. Edema
  6. transient oliguria with reduced GFR
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6
Q

Acute Post-Streptococcal Glomerulonephritis

- Pathognomonic finding for the disease

A

Red cell casts

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7
Q

Acute Post-Streptococcal Glomerulonephritis

- two chemistry lab findings

A

increased BUN and Creatinine

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8
Q

Acute Post-Streptococcal Glomerulonephritis

- one immunological finding

A

positive test for streptococcal antibodies (antibodies of M proteins)

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9
Q

Three symptoms for chronic glomerulonephritis

A

edema, hypertension, oliguria

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10
Q

Pathognomonic urinalysis finding for chronic glomerulonephritis

A

Broad and waxy casts

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11
Q

two tubular diseases

A
  1. Acute Tubular Necrosis (Ischemic and Toxic)

2. Renal Tubular Acidosis

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12
Q

Describe tubular damage caused by trauma, shock, or sepsis, in ischemic acute tubular necrosis

A

the damage leads to decreased renal perfusion. Reduced oxygen disrupts tubular basement membrane function

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13
Q

6 typical urinalysis findings of acute tubular necrosis

A
  1. mild proteinurea
  2. Hematuria
  3. Low Specific gravity
  4. renal epithelial cells, renal epithelial cell casts, granular casts
  5. Oliguria
  6. Increased BUN
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14
Q

Pathognomonic findings for acute tubular necrosis

A

Renal epithelial cell casts

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15
Q

Explain the pathogenesis of renal tubular acidosis

A

Tubules can’t secrete hydrogen ions to acidify urine, decreases blood pH, causing acidosis

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16
Q

Five tubulointerstitial diseases

A
  1. Pyelonephritis (acute and chronic)
  2. Cystitis
  3. Urethritis
  4. Acute Tubulointerstitial Nephritis
  5. Acute Tubulointerstitial Necrosis
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17
Q

Pyelonephritis

- three predisposing factors

A
  1. Urinary tract infection
  2. Pregnancy
  3. Diabetes mellitus
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18
Q

Pyelonephritis

- three common routes of infection

A
  1. Ascending from bladder
  2. 3% from bloodstream
  3. From lymphatic system
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19
Q

Acute Pyelonephritis

- six typical findings

A
  1. > 5 WBC’s/hpf (clumps)
  2. Bacteria
  3. Mild proteinuria
  4. Positive blood
  5. Positive nitrite
  6. WBC casts
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20
Q

Acute Pyelonephritis

- pathognomonic finding

A

WBC casts

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21
Q

Chronic Pyelonephritis

- most common causes of chronic pyelonephritis

A

Backward flow of urine up ureters

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22
Q

Chronic Pyelonephritis

- seven typical urinalysis findings

A
  1. increased protein
  2. WBC’s in clumps
  3. low specific gravity
  4. macrophages
  5. granular casts
  6. waxy casts
  7. Broad casts
23
Q

Chronic Pyelonephritis

- pathognomonic finding

A

waxy and broad casts

24
Q

Cystitis

- 4 typical symptoms

A
  1. increased frequency and urgency of urination
  2. Pain in pelvic/abdominal region
  3. Fever and chills
  4. Burning sensation on urination
25
Q

Cystitis

- Two common bacterial causes

A
  1. E. coli

2. Staph saprophyticus

26
Q

Cystitis

- Five common urinalysis findings

A
  1. Positive blood
  2. Positive leukocyte esterase
  3. Positive nitrite (if bacteria produce nitrite)
  4. WBC’s
  5. Bacteria (1/3 will be neg)
    NO CASTS
27
Q

Nephrotic Syndrome

- 4 disease processes that may lead to the syndrome

A
  1. Glomerulonephritis
  2. Systemic lupus erythematosus
  3. Diabetes mellitus
  4. sickle cell anemia
28
Q

Nephrotic Syndrome

- The renal damage that leads to symptoms and lab findings

A

Glomerular basement membrane becomes highly permeable to plasma proteins and lipids

29
Q

Nephrotic Syndrome

- Two clinical symptoms

A
  1. Edema

2. Hypertension

30
Q

Nephrotic Syndrome

- Three typical chemistry findings

A
  1. Hypoproteinemia
  2. Increased cholesterol
  3. Increased triglycerides
31
Q

Nephrotic Syndrome

- Four urinalysis findings

A
  1. Massive proteinuria
  2. Microscopic hematuria
  3. oval fat bodies
  4. Fatty casts and waxy casts
32
Q

Nephrotic Syndrome

- Pathognomonic findings

A

oval fat bodies, fatty casts and waxy casts

33
Q

Four vascular real diseases

A
  1. Hypertension
  2. Benign Nephrosclerosis
  3. Renal Artery Stenosis
  4. Microangiopathies
34
Q

Why can vascular disease lead to renal disease?

A

The kidneys receive 20-25% of cardiac output so anything that interferes with blood flow impacts kidney function

35
Q

Why can hypertension lead to renal disease?

A

incresed pressure changes the structure of vascular walls which increased the risk for renal failure

36
Q

What is the lab marker for real disease caused by hypertension?

A

microalbuminuria

37
Q

Hemolytic Uremic Syndrome (HUS)

- bacterial causative agent and what food is it found in?

A
  • E. coli

- ground meat

38
Q

Hemolytic Uremic Syndrome (HUS)

- Why the toxin causes hemolysis and thrombosis

A

Toxin binds to RBC’s, affects platelet function, and causes increased adhesion of WBC’s to endothelium

39
Q

Hemolytic Uremic Syndrome (HUS)

- Processes that lead to vasoconstriction

A

The toxin causes increased production of endothelia and loss of endothelial nitric oxide favors vasoconstriction, this in presence of blood clots, occludes vessels, causes necrosis, and thickening of capillary walls

40
Q

Nephrolithiasis

- four factors that favor stone formation

A
  1. increased concentration of stone constituent in urine
  2. changes in urine pH
  3. decreased urine flow
  4. presence of bacteria
41
Q

Nephrolithiasis

- Four categories of kidney stones

A
  1. calcium salts
  2. triple phosphate (struvite)
  3. Uric acid
  4. Cystine
42
Q

Nephrolithiasis

- Three symptoms

A
  1. severe flan pain
  2. nausea
  3. vomiting
43
Q

Nephrolithiasis

- Three typical urinalysis findings

A
  1. Hematuria
  2. Bacteriuria
  3. crystals
44
Q

Nephrolithiasis

- Two typical chemistry findings

A
  1. Increased BUN

2. Increased creatinine

45
Q

Abrupt decreased in renal function sufficient to increase plasma creatinine and BUN

A

Definition of “acute renal failure”

46
Q

Pre-renal causes of acute renal failure

A
  • Extracellular fluid loss
  • decreased cardiac output
  • sepsis/shock
47
Q

Renal causes of acute renal failure

A
  • vascular disorders (DIC)
  • glomerulonephritis
  • tubular necrosis
48
Q

Post-renal causes of acute renal failure

A
  • obstructions
49
Q

Acute Renal Failure

- three chemical findings

A
  • Hyperkalemia
  • Increased plasma phosphorus
  • Decresed blood pH
50
Q

Acute Renal Failure

- two urinalysis findings

A
  • Positive blood and protein in urine

- Oliguria

51
Q

Acute Renal Failure

- one hematological finding

A

anemia

52
Q

What glomerular filtration rate is associated with chronic renal failure

A

GFR < 15 mL/min

53
Q

Typical toxic agents that cause toxic acute tubular necrosis (5)

A

Heavy metals, ethylene glyco, organic solvents, drugs, and mushrooms

54
Q

Specific part of the nephron that is damaged in toxic acute tubular necrosis

A

proximal tubules

Chemistry Module 3 (12 decks)

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