Week 5 - C - Diabetes and myeloma Flashcards
What makes up the renal parenchyma?
The tubules, glomeruli and the interstitium
What is one of the most common causes of ESRD in the UK?
Diabetes mellitus - 18%
o The single most important intervention in the long term care of diabetes mellitus is the control of BP, to protect the heart, the brain and the kidney
Is diabetic nephropathy more common in type 1 or 2 diabetic patients?
It is more common in type 2 diabetic patients
What percentage of patients presenting with T2DM already have nephropathy?
10% of patinets already have nephropathy
Diabetic nephropathy causes nodular glomerulosclerosis, what is seen in this?
Kimmelsteil Wilson nodules are seen here
How else does diabetes contribute to nephropathy?
It causes the astherocslerosis of larger renal arteries which will increase blood pressure and decrease GFR
It also makes the kidneys more susceptible to pyelonephritis
The combination of vascular damage and inflammation results in ischaeia of the renal papillae
What is this called?
Renal papillary necrosis
What is renal papillary necrosis often seen in combination with?
Often seen in combination with pyelonephritis
is diabetes a cause of nephrotic or nephritic syndrome?
Diabetes causes nephrotic syndrome
o Cancer of plasma cells (a type of WBC responsible for producing antibodies)
Abnormal plasma cells accumulate in the bone marrow and interfere with normal blood cells
What is this?
Myeloma
What are signs of myeloma?
Back pain, anaemia, weigh loss, hypercalcaemia, amyloidosis
What are the proteins found in the urine in myeloma?
What investigation is used to see them?
Find bence jones proteins in the urine - seen on plasma electrophoresis
The presence of bence jones proteins can cause the patinet to enter acute renal failur
What are bence jones protein?
It is a result of the abnormal plasma cells causing the formation of abnormal light chains which are the bence jones proteins
How is the amyloid material seen?
classically positive congo red staining showing apple-green befringence under polarised light
