also renal conditions Flashcards
(50 cards)
which of the following drugs do NOT cause hyperkalaemia: spirolonolactone, ramipril, amiloride, furosemide, atenolol
furosemide - causes HYPOkalaemiea
A newborn baby is noted to have large palpable masses in the loins and dysmorphic features consistent with Potter’s syndrome. Further investigations show renal impairment and liver fibrosis
autosomal recessive polycystic kidney disease
A 35-year-old man who has a history of hypertension and subarachnoid haemorrhage presents with recurrent UTIs and episodic haematuria
autosomal dominant polycystic kidney disease
AD polycystic kidney disease is cause by a gene mutation on which chromosome?
chromosome 4
defect in gene located on chromosome 6 which encodes fibrocystin
autosomal recessive polycystic kidney disease
mutation on chromosome 16 or 4 affecting renal tubule development
autosomal dominant polycystic kidney disease
inheritance pattern in Alport’s syndrome
X linked
disorder of type IV collagen matrix
mutation in COL4A5 - deficient collagen matrix deposition
presentation of Alport’s syndrome
haematuria (microscopic)
CKD
sensorineural hearing loss
ocular abnormalities - anterior lenticonus, change prescription lots
investigation findings of Alport’s syndrome
microscopic haematuria
RBC casts
renal biopsy = variable thickening of GBM
EM = splitting of lamina densa
anderson fabrys disease presentation
x linked
renal failure angiokeratomas cardiomyopathy, valvular disease neuro stroke psychiatric
investigations + management of anderson fabrys disease
absent/low levels of alpha-glactosidase A in leukocytes or plasma
renal biopsy
management = fabryzyme (enzyme replacement therapy)
what does nephritic syndrome indicate? which cells does it affect?
indicative of proliferative process
affecting endothelial cells
what does nephrotic syndrome indicate? which cells does it affect?
indicative of NON-proliferative process
affects podocytes
criteria for nephritic syndrome
haematuria
oliguria = reduced urine output
proteinuria <3g/24hr
fluid retention causing oedema
hypertension
active urinary sediments - RBCs, RBC casts
commonest cause of nephrotic syndrome in kids + adults respectively?
kids = minimal change diease
adults = focal segmental glomerulosclerosis
nephrotic syndrome criteria
peripheral oedema - ankle pitting
protein uria >3g = “frothy urine”
serum albumin <25
hypercholesterolaemia
how would damage to endothelial or mesangial cells present
red cells in urine + proliferative
how would damage to podocytes present
protein in urine (frothy) + non-proliferative
podocytes atrophy ->creates big gaps -> loss of specific/selective barrier
what does curved RBCs on urine microscopy indicate?
extra capillary proliferation or inflammation within bowmans space
–> curved RBCs squezzing through damaged enothelium
damage to mesangial cells
mesangial cells proliferate
- release angiotensin II -> increase bp
- release chemokines -> attracts inflammatory cells
damage to endothelium
rapid injury -> vasculitis
rapid influx of inflam cells
leakage of these through damaged endothelium wall
minimal change GN
affects podocytes
commonest cause of nephrotic syndrome in KIDS
LM + IF normal
EM = podocye foot process dusion
mx = steroids
commonest cause of idiopathic nephrotic syndrome in adults?
Focal segmental glomerulosclerosis (FSGS)
what can Focal segmental glomerulosclerosis (FSGS) be secondary to?
HIV
heroin use (IVDU)
obesity
