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Stage 4: CSIM 2 > Week 11: Nephrotic and Nephritic syndrome > Flashcards

Week 11: Nephrotic and Nephritic syndrome Flashcards

1
Q

RENAL CELL CARCINOMA is more associated with proteinuria/ haematuria

A

Proteinuria

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2
Q

RENAL TUBULAR ACIDOSIS is more associated with proteinuria/ haematuria

A

Proteinuria

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3
Q

MYELOMA is more associated with proteinuria/ haematuria

A

Proteinuria

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4
Q

What is considered a normal eGFR in healthy males/ females

A

130 ml/min/1.73m2 in MALE

120 ml/min/1.73m2 in FEMALE

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5
Q

Nephrotic/ nephritic syndrome is associated with haematuria/ proteinuria

A

Nephrotic syndrome: Proteinuria

Nephritic syndrome: haematuria

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6
Q

Nephrotic/ nephritic syndrome has acute/ insidious onset

A

Nephrotic syndrome: insidious onset

Nephritic syndrome: acute onset

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7
Q

Nephrotic/ nephritic syndrome is associated with raised JVP

A

Nephritic syndrome is associated with raised JVP

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8
Q

Nephrotic/ nephritic syndrome is associated with oedema

A

Nephrotic syndrome is associated with oedema

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9
Q

General pathology for all nephritic syndromes

A

Immune problem at glomerulus

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10
Q

General pathology for all nephrotic syndromes

A

Problem with GBM (structural/ function abnormalities of podocytes)

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11
Q

Nephrotic syndrome is defined by

  • what amount of proteinuria
  • what other 3 features
A
  1. Proteinuria >3.5g in 24h
  2. Hypo-albuminaemia <25g/L
  3. Oedema
  4. Hyperlipidaemia
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12
Q

Features consistent with nephritic syndrome

  • Urine content
  • Blood content
  • Urine amount
  • other extra renal features
A
  1. Haematuria (microscopic/ visible)
  2. Proteinuria (<2g in 24h)
  3. Uraemia
  4. Oliguria
  5. Hypertension
  6. Oedema (sacral, ankle, periorbital)
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13
Q

General complications of nephrotic syndrome

A
  1. Sepsis (loss of immunoglobulin)

2. Venous thrombosis (loss of clotting factors)

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14
Q

General complications of nephritic syndrome

A

Salt and water retention leading to

  1. Hypertension
  2. Oedema
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15
Q

What type of disease does blood at the start of urinating indicate

A

Urethral disease

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16
Q

What type of disease does blood at the start of urinating indicate

A

Bleeding from prostate/ base of bladder

17
Q

What type of disease does constant blood throughout urinating indicate

A

Bleeding from bladder/ kidneys

18
Q

Most common cause of haematuria

  1. overall
  2. > 40yo
  3. > 55yo
A

Overall: UTI/ transient unexplained

> 40yo: cancer (bladder/ kidney/ prostate)

> 55yo: BPH

19
Q

Pts who are >60yo and have what kidney symptoms should have a 2 week referral

A
  1. Unexplained visible haematuria AND

2. Dysuria OR raised WBC

20
Q

Pts who are >45yo and have what kidney symptoms should have a 2 week referral

A
  1. Unexplained visible haematuria (no UTI) OR

2. Visible haematuria that persists/ recurs after successful UTI tx

21
Q

Who should be referred to urology for asymptomatic microscopic haematuria

A
  1. Age >35yo

2. Smokers/ ex-smokers

22
Q

2 most common causes of nephrotic syndrome

A
  1. Diabetes

2. Pre-eclampsia

23
Q

Causes of physiological proteinuria

A
  1. Orthostatic (common in adolescents)
  2. Exercise
  3. Transient with fever
  4. Transient with UTI
24
Q

Causes of pathological proteinuria

A
  1. Glomerulonephritis
  2. Vasculitis
  3. Decreased reabsorption of proteins in tubules (eg immunoglobulins)
  4. Too many plasma proteins causing overflow (eg light chains in myeloma, Hb in haemolysis)
  5. Post-renal causes: stones, tumours, UTI
25
Q

What type of systemic diseases can cause proteinuria

  • autoimmune diseases
  • pregnancy conditions
A
  1. T1/ T2DM
  2. Amyloidosis
  3. Vasculitis
  4. SLE
  5. Pre-eclampsia
26
Q

Why is nephrotic syndrome associated with more clotting

A

Due to loss of antithrombin 3 in urine

27
Q

Nephrotic syndromes are usually associated with more clotting.

What is an exception to this? ie a nephrotic syndrome leading to more bleeding?

Pathophysiology of this.

A

Amyloidosis

Due to reduced activity of thrombin after binding with amyloid

Stage 4: CSIM 2 (47 decks)

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