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Renal > Nephritic syndrome & UTI & nephrolithiasis > Flashcards

Nephritic syndrome & UTI & nephrolithiasis Flashcards

1
Q

glomerular disorders characterized by glomerular inflammation and bleeding

A

nephritic syndrome

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2
Q
  1. limited proteinuria (<3.5 g/day)
  2. oliguriza & azotemia
  3. salt retention with periorbital edema & HTN
  4. RBC casts and dysmorphic RBCs in urine
A

nephritic syndrome

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3
Q

immune-complex deposition activates complement; C5 attracts neutrophils –> hypercellualr, inflamed glomeruli on biopsy

A

nephritic syndrome

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4
Q

Nephritic syndrome that arises after group A beta-hemolytic streptococcal infection of the skin (impetigo) or pharynx; may occur after infxn w/ nonstreptococcal organisms, too!

A

PSGN

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5
Q

Kid presents 2-3 weeks after infection w/ hematuria, oliguria, HTN, periorbital edema

A

PSGN

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6
Q

hypercellular, inflamed glomeruli on H&E; mediated by immune complex deposition (granular IF); subepithelial humps on EM

A

PSGN

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7
Q

PSGN treatment

A

supportive

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8
Q

PSGN complications

A

kids rarely progress to renal failure; some adults develop RPGN

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9
Q

nephritic syndrome that progresses to renal failure in weeks to months

A

RPGN

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10
Q

crescents (fibrin + macrophages) in Bowman space of glomeruli

A

RPGN

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11
Q

IgA immune complex deposition in mesangium of glomeruli

A

IgA nephropathy (Berger disease)

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12
Q

kid w/ episodic gross or microscopic hematuria w. RBC casts, usually following mucosal infections (e.g. gastroenteritis); may slowly progress to renal failure

A

IgA nephropathy (Berger disease)

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13
Q

Inherited defect in type IV collage (usu X-linked) –> thinning and splitting of glomerular basement membrane

A

Alport syndrome

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14
Q

Isolated hematuria + sensory hearing loss + ocular disturbances

A

Alport syndrome

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15
Q

linear IF pattern (anti-basement membrane antibody) in RPGN

A

goodpasture syndrome

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16
Q

antibasement membrane antibody

A

goodpasture syndrome

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17
Q

granular IF (immune complex deposition) in RPGN

A

PSGN (most common) or diffuse proliferative glomerulonephritis

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18
Q

what defines a nephrogenic strain?

A

carry M protein virulence factor

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19
Q

6 etiologies of RPGN

A 
Goodpasture syndrome
PSGN
diffuse proliferative glomerulonephritis
Wegener gramulomatosis
microscopic polyangitis
Churg-Strauss syndrome
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20
Q

Negative IF (pauci-immune) in RPGN

A

Wegener’s
microscopic polyangitis
Churg-Strauss

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21
Q

c-ANCA

A

Wegener

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22
Q

p-ANCA

A

microscopic polyangiitis or Churg Strauss

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23
Q

p-ANCA plus granulomatous inflammation, eosinophilia, and asthma

A

Churg-Strauss

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24
Q

infection of urethra, bladder, or kidney; most commonly arises due to ascending infxn (F»M)

A

UTI

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25
Q

Risk factors for UTI

A

sex, urinary stasis, catheters

26
Q

infection of the bladder

A

cystitis

27
Q

dysuria, urinary frequency + urgency, suprapubic pain without systemic signs (fever)

A

cystitis

28
Q

urianalysis findings of cystitis

A

cloudy urine with > 10 WBCs/hpf

29
Q

Positive leukocyte esterase (due to pyuria) and nitrites (bacteria convert nitrates to nitrites)

A

dipstick findings of cystitis

30
Q

culture findings of cystitis

A

> 100,000 colony forming units (gold standard)

31
Q

causal agents of UTI

A 
e coli (80%0
staph saprophyticus
klepsiella pneumonia
proteus mirabilis
enterococcus faecalis
32
Q

pyuria

A

pus in the urine

33
Q

distinguishing feature of proteus mirabilis cystitis

A

alkaline urine w/ ammonia scent

34
Q

sterile pyuria (pyruria w/ negative urine culture)

A

urethritis due to chlamydia or N gonorrhoeae

35
Q

dominant presenting sign of urethritis

A

dysuria

36
Q

pyelonephritis

A

infection of the kidney

37
Q

vesicoureteral reflux

A

reflux from bladder up to ureter

38
Q

fever, flank pain, WBC casts and leukocytosis

A

pyelonephritis

39
Q

most common pathogens causing pyelonephritis

A

E coli (90%)
Enterococcus faecalis
Klebsiella species

40
Q

scarring at upper and lower poles of kidney

A

characteristic of vesicoureteral reflux

41
Q

leads to renal cortical scarring with blunted calyces

A

chronic pyelonephritis

42
Q

“thyroidization” of the kidney (atrophic tubules containing eosinophilic proteinaceous material resemble thyroid follicles)

A

chronic pyelonephritis

43
Q

interstitial fibrosis and atrophy of tubules due to multiple bouts of acute pyelonephritis

A

chronic pyelonephritis

44
Q

causes of chronic pyelonephritis

A

vesicoureteral reflux in kids or obstruction (BPH or cervical carcinoma)

45
Q

precipitation of a urinary solute as a stone

A

nepholithiasis

46
Q

risk factors for nephrolithiasis

A

high concentration of solute in the urinary filtrate and low urine volume

47
Q

nephrolithiasis presentation

A

colicky pain with hematuria and unilateral flank tenderness

48
Q

what happens if someone does not pass a kidney stone within hours?

A

may require surgical intervention

49
Q

most common type of kidney stone

A

calcium oxalate and/or calcium phosphate

50
Q

cause of calcium oxalate and/or calcium phosphate stone

A

idiopathic hypercalcemia + Crohn

51
Q

Treatment of calcium oxalate and/or calcium phosphate stones

A

Hydrochlorothiazide (calcium sparing diuretic)

52
Q

Most common cause is infection with urease positive organisms (Proteus vulgarism or Klebsiella); alkaline urine leads to formation of stone

A

ammonium magnesium phosphate stone

53
Q

staghorn calculi in renal calyces, wh/ act as nidus for urinary tract infections

A

ammonium magnesium phosphate

54
Q

treatment of ammonium, magnesium, phosphate stones

A

surgery to remove stone (due to size) and eradication of pathogen (to prevent recurrence)

55
Q

Radiolucent kidney stone

A

uric acid kidney stone

56
Q

risk factors for uric acid stone

A

hot, arid climates, low urine volume, acidic pH

57
Q

most common stone seen in patients with gout; hyperuricemia (in leukemia or MPD) increases risk

A

uric acid stone

58
Q

treatment of uric acid stone

A

hydration and alkalization of urine (potassium bicarbonate); allopurinol is also administered in patients with gout

59
Q

associated with cystinuria (a genetic defect of tubules that results in decreased reabsorption of cysteine)

A

cysteine kidney stones

60
Q

treatment of cysteine kidney stone

A

hydration and alkalinization of urine; note cysteine may also form staghorn caliculi

61
Q

staghorn caliculi in adult

A

ammonium magnesium phosphate stone

62
Q

staghorn caliculi in kid

A

cysteine kidney stone

Renal (22 decks)

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