Glomerular Dz

Question 1

Where is proteinuria first detected?

Answer 1

On a urine dipstick- semi-quantitative screening test that is more sensitive to albumin

Question 2

How can you tell the difference of renal proteinuria caused by glomerular pathology and tubular pathology?

Answer 2

Glomerular pathology will cause a higher UPC ratio because it is allowing every protein to pass through

Question 3

If the UPC is >8 what should be considered?

Answer 3

amyloidosis

Question 4

What would the UPC ratio be if tubular disease was present?

Answer 4

UPC <2

Question 5

what is the most significant proteinuria?

Answer 5

Glomerular protein loss- protein losing nephropathy

Question 6

Which breeds are predisposed to glomerulonephritis?

Answer 6

Samoyed, cocker spaniel, sharpei and abyssinian

Question 7

What is the average amount of BP readings you should obtain?

Answer 7

5

Question 8

Why is hypercoagulability seen with glomerular dz?

Answer 8

Excessive loss of antithrombin leading to thromboemboli formation

Question 9

How is hypercoagulability measured?

Answer 9

Thromboelastography

Question 10

What is late glomerular disease characterized by?

Answer 10

Nephrotic syndrome- edema and loss of protein into urine from increased glomerular permeability

Question 11

What is VERY LATE glomerular disease characterized by?

Answer 11

Uremic syndrome

Question 12

Why is kidney biopsy contraindicated in IRIS stage IV?

Answer 12

results will come back and patient wouldn’t have made it that long or the patient could bleed out from coagulopathy

Question 13

Where are the two international renal pathology service centers where biopsies are sent to?

Answer 13

Texas A&M and Ohio

Question 14

What are findings seen with nephrotic syndrome?

Answer 14

Proteinuria, hypoalbuminemia, ascites/edema, hypercholesterolemia, hypertension, hypercoagulability

Question 15

What is the drug of choice for glomerular disease?

Answer 15

Mycophenolate mofetil

Question 16

What are physiologic causes of proteinuria?

Answer 16

Strenuous exercise, seizures, fever & stress

Question 17

What are pre-renal causes of proteinuria?

Answer 17

Abnormal concentrations of proteins (multiple myeloma-bence jones proteins)

Question 18

What breed is predisposed to x-linked glomerulonephritis?

Answer 18

Samoyed

Question 19

What breed is predisposed to alport syndrome glomerulonephrits?

Answer 19

Cocker spaniels

Question 20

What breeds are predisposed to amyloid deposits?

Answer 20

shar-pei, beagle, abyssinian, siamese

Question 21

What is found when you use a thromboelastography on a hypercoagulable patient?

Answer 21

Decreased antithrombin, increased fibrin, increased d-dimers

Question 22

what is the difference of early, late and very late glomerulonephritis?

Answer 22

Early: no CS, loss of BCS, lethargy, anorexia
Late: edema, loss of protein into urine, abdominal effusion, subcutaneous pitting edema, acute onset blindness, thromboembolic disease
Very late: uremic syndrome

Question 23

What needs to be done before you put a patient on immunosuppressive therapy?

Answer 23

Origin of proteinuria from glomerulus

Question 24

What does ACEi work on?

Answer 24

Decrease efferent glomerular arteriolar resistance