10.27: Renal I Flashcards Preview

MHD V: Renal > 10.27: Renal I > Flashcards

Flashcards in 10.27: Renal I Deck (29):
1

2 main categories of kidney disease?

1. NephrOTIC: proteinuria > 3-3.5g/day
2. NephrITIC: hematuria

2

Which form of kidney disease is hematuria a hallmark of?

Nephritic

3

What is frothy urine characteristic of?

Proteinuria (nephrotic syndrome)

4

Some causes of hematuria?

1. Glomerulonephritis
2. Carcinoma
3. Trauma
4. Infarct

5

Characteristics of nephritic syndrome?

1. Hematuria w/ dysmorphic cells and RBC casts
2. Some degree of oliguria and azotemia
3. Htn.
4. Active urinary sediment

6

What does active urinary sediment mean?

Dysmorphic RBCs or RBC casts in urine

7

What is acute postinfectious glomerulonephritis? presentation?

- Usually presents in children
"Acute nephritic syndrome"
1. Hematuria
2. Edema
3. Htn.
4. Renal failure

8

Normal cause for acute postinfectious glomerulonephritis? and pathology?

- 1 - 4 weeks post pharyngitis from group A Beta hemolytic strep
- These bacteria have M protein virulence factor
- Antigen + IgG immune complexes deposit in renal capillaries activating complement C5a
- Neutrophils are attracted causing damage
- Damage to tissue allows RBCs to pass through leading to hematuria

9

What characteristic of immune complex is unique to postinfectious glomerulonephritis?

- In situ formation of immune complex leading to subepithelial "humps"

10

What is subepithelial humps of immune complex characteristic of?

Post infectious glomerulonephritis

11

What are trilobed cells?

Usually neutrophils

12

Laboratory tests indicative of post infectious glom.?

1. Tea color, smoke, coca cola urine
2. Hematuria w/ mild proteinuria
3. Increased ASO titer (antistrep)
4. Decreased complement levels

13

Prognosis in acute postinfectious glomerulonephritis?

1. 95% recover in children
2. Adults can become chronic glomerulonephritis
3. Small subset of children with gross hematuria can develop severe acute syndrome with renal failure

14

When is renal biopsy needed in acute post infectious glom.?

- Only if the course is a typical
- Not if the course is typical

15

What is the main Ig in the body?

- IgG
- IgA is main Ig in secretions and mucosal immunity

16

What is Berger Disease?

IgA nephropathy

17

Clinical presentation of IgA nephropathy?

- RECURRENT hematuria
- PAINLESS
- Sometimes after upper respiratory tract infection
- Last for days recurring every few months

18

What is recurrent, painless hematuria characteristic of?

IgA nephropathy

19

Pathogenisis of IgA nephropathy?

- Mucosal infection leading to IgA production
- IgA immune complex deposits in mesangium

20

How do complement levels present in IgA nephropathy?

- IgA actives complex system at slow rate so we do not see drop
- Drop in immune complex levels are seen in post infectious

21

What is hematuria with normal complement levels characteristic of?

IgA nephropathy

22

What is necessary for definitive diagnosis in IgA Nephropathy?

Kidney needle biopsy

23

What is hereditary nephritis?

- Mutations in glomerular basement membrane proteins
- Often in collagen type IV
- Alport syndrome is best known type

24

Where is type IV collagen found?

1. Glomerular basement membrane
2. Eyes
3. Ears

25

Triad of symptoms in alport syndrome?

1. Nephritis
2. Nerve deafness: hearing abnormalities
3. Eye disorders such as early cataracts

26

What is Alport syndrome?

- Most common form of hereditary nephritis
- X linked
- Triad of symptoms

27

What is lamina densa splitting and basket weave lamination characteristic of?

- Hereditary nephritis
- Alport syndrome

28

Prognosis of hereditary nephritis?

- Kidney failure at 2 - 50 years of age
- Genetic testing needed for diagnosis

29

What is atypical postinfectious glomerulonephritis?

- Normally we would see pharyngitis 2 weeks before
- In "A typical" this is not the case