Urinary tBL

Question 1

Glomerular diseases such as nephrotic & nephrtic syndrome presents with..

Answer 1

Proteinuria and/or Hematuria

Question 2

Tubulo-interstitial diseases like nephrosclerosis or obstruction present with..

Answer 2

Decreased GFR (increased serum creatinine)

Urinalysis with minimal proteinuria and/or blood

Question 3

Symptoms of nephrotic syndrome

Answer 3

Proteinuria

Hypoalbuminemia

Hypercholesterolemia

Edema

Question 4

Primary diseases causing nephrotic synrdome

Answer 4

Minimal change disease

Focal segmental glomerulosclerosis

Membranous glomerulopathy

Question 5

Minimal change disease

Answer 5

• Most common cause of nephrotic syndrome in children
• Podocyte problem causes proteins to filter into the urinary space
• Presentation:
  
  • Sudden onset of severe nephrotic syndrome
    
    • Proteinuria is due to loss of anionic charge in GBM - not due to a structural change
  • Normal BP & normal GFR

Question 6

Pathological hallmark of minimal change disease

Answer 6

Foot processes are diminished

–> altered integrity of the GBM

Question 7

Systemic diseases causing nephrotic syndrome

Answer 7

Diabetic nephropathy: most common cause of CKD

• First, microalbuminuria, then full blown nephrotic syndrome

Amyloidosis/Multipl Myeloma & Lupus

Question 8

Nephritic syndrome is caused by what type of diseases?

Answer 8

inflammatory ones that mess up retention, circulatory congestion, hypertension, and reduce GFR–> also presents w proteinuria & hematuria

Ex) Lupus

Question 9

Describe the interaction between diuretics and RAS

Answer 9

Diuretics make you pee –> reduces renal blood flow –> increased serum creatinine & lower plasma volume

RAS will compensate by constricting the efferent arteriole –> increased GFR & higher water/sodium retention

Question 10

ACE inhibitors and angiotensin receptor blockers have what effect on GFR?

Answer 10

They prevent RAS from vasoconstricting the efferent arteriole.

–> Lowers the GFR

Question 11

If you give an NSAID, a diuretic, and an ACE inhibitor or Angiotensin receptor blocker, what happens?

Answer 11

The diuretic lowers plasma volume, causing reduced renal blood flow

The ACE inhibitor & ARB prevents RAS from bringing GFR back up

The NSAID will inhibit prostaglandins & bradykinin to vasoconstrict the afferent arteriole so renal blood flow gets even lower

–> renal failure