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2 Renal > The Kidney in Systemic Disease > Flashcards

The Kidney in Systemic Disease Flashcards

1
Q

what is macrovascular disease?

A

disease that affects the large vessels of the body eg aorta, coronary arteries

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2
Q

what is microvascular disease?

A

disease that affects the small vessels of the body eg optic vessels, small coronary arteries etc

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3
Q

how does diabetes cause renal hypertrophy?

A

plasma glucose stimulates growth factors in kidney
mesangial cells get bigger and nodules form
BM thickening

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4
Q

how does diabetes haemodynamically affect the kidneys?

A

vasodilates the kidneys
causes hyperfiltration
increases GFR

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5
Q

diabetes decreases GFR: T or F

A

F, increases it until you get diabetic nephropathy which then decreases it

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6
Q

how does diabetes cause renal hypertension?

A

dilates the afferent arteriole

constricts the efferent arteriole

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7
Q

diabetic nephropathy is a slow progressive disease T or F

A

T

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8
Q

how does diabetic nephropathy cause inflammation in the kidney?

A

proteins are lost from the glomerulus and deposited into the cytoplasm causing cell activation and inflammation

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9
Q

what causes the decreased GFR in diabetic nephropathy?

A

microalbuminuria

hypertension

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10
Q

albumin is higher in end stage renal disease from diabetic nephropathy than at the start T or F

A

T

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11
Q

management of diabetic nephropathy?

A

HbA1c <7%
BP <130/80
ACEi
lipid control

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12
Q

what effect do ACEi’s have on the blood pressure of the kidneys and how do they do this?

A

decrease it by decreasing pressure in the efferent arteriole

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13
Q

renal replacement therapy for diabetics?

A

if young + T1, kidney/pancreas transplant
if young, kidney transplant
if not, dialysis

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14
Q

diabetic patients are more symptomatic at a lower GFR T or F

A

F, more symptomatic when their GFR is high

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15
Q

first sign of renal damage in diabetes

A

microalbuminuria

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16
Q

there is a good prognosis for dialysis in diabetic patients T or F

A

F, very low survival rate over 5yrs

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17
Q

hypertensive patients with shrunken kidneys on imaging and proteinuria?

A

hypertensive nephropathy

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18
Q

what is ischaemic nephropathy

A

reduced GFR associated with reduced renal blood flow beyond the ability to compensate

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19
Q

consequences of ischaemic nephropathy?

A

renal atrophy

progressive CKD

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20
Q

what type of hypertension is most commonly the cause of hypertensive nephropathy?

A

essential

21
Q

what renal conditions can cause hypertension?

A 
renal artery stenosis
fibromuscular disease (growth of BV wall)
22
Q

who gets renal artery stenosis?

A

older men with risk factors

23
Q

renal artery stenosis is usually unilateral T pr F

A

T

24
Q

signs of hypertensive nephropathy?

A

atherosclerotic disease
flash pulmonary oedema
abdo bruit
AKI/CKD

25
Q

how is hypertensive nephropathy diagnosed?

A

renal USS

CT/MR angiography to confirm

26
Q

3 mainstays of treatment for hypertensive nephropathy patients

A

statin
anti-platelet
ACEi

27
Q

surgical intervention for hypertensive nephropathy?

A

angioplasty +/- stenting

28
Q

when should an ACEi not be given for renal artery stenosis?

A

if it is bilateral

29
Q

who gets fibromuscular dysplasia?

A

females aged 15-50

30
Q

what are the main vessels affected in renal artery stenosis?

A

carotid arteries

renal arteries

31
Q

how is cardiorenal functon decreased in kidney disease?

A

kidneys trying to correct injury by reabsorbing more Na and H20 but this overloads the heart and decreases its function

32
Q

what is a myeloma?

A

cancer of the plasma cells

33
Q

how can antibodies be damaging to the kidneys?

A

are proteins so can deposit in the kidney and cause inflammation

34
Q

what is a paraprotein?

A

an abnormal antibody

35
Q

clinica signs of myeloma?

A 
anaemia
hypercalcaemia
renal failure
amyloidosis
recurrent infection
36
Q

symptoms of myeloma?

A

bone pain
weakness
fatigue
w loss

37
Q

classic presentation of myeloma?

A

back pain and renal failure

38
Q

where does AL amyloidosis from a myeloma deposit?

A

glomerulus

39
Q

how is myeloma detected via blood test?

A

serum protein electrophoresis

serum free light chains

40
Q

what biopsies should be done in suspected myeloma?

A

bone marrow

renal

41
Q

Tx of myeloma?

A

chemo

stem cell transplant

42
Q

how is hypercalcaemia managed in myeloma?

A

saline +/- bisphosphonates

43
Q

small vessel vasculitis presents in what decades of life?

A

50s-70s

44
Q

what findings would indicate kidney involvement in vasculitis?

A

proteinuria

creatinine high

45
Q

if there are 2 people with lupus standing next to each other, what would they be called?

A

lupi

46
Q

most common renal abnormality found in lupus?

A

proteinuria

47
Q

lupus nephritis is common in lupus patients T or F

A

T

48
Q

Tx for mild lupus nephritis?

A

treat lupus only

49
Q

Tx for severe lupus nephritis?

A

steroids
cyclophosphamide
azathioprne

2 Renal (34 decks)

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