Diseases of the Renal System 1 Flashcards Preview

Clinical Pathology > Diseases of the Renal System 1 > Flashcards

Flashcards in Diseases of the Renal System 1 Deck (64):
1

What are the 4 main functions of the kidney

Eliminate metabolic waste products
Regulate fluid and electrolyte balance
Acid-base balance
Produce some hormones (renin, erythropoietin)

2

What are the 2 main types of mechanisms of glomerular damage?

Immunological
Non-immunological

3

Give 4 conditions whcih cause damage to the glomerulus by immune complexes being deposited in the glomerulus

Lupus
IgA nephropathy
Henoch Schonlein Purpura
Membranous purpura

4

Give 2 examples of conditions that cause damage to the basement membrane through the deposition of antibodies

Anti glomerular basement membrane disease (goodpasture's syndrome)
Post infective glomerulonephritis

5

5 mechanisms of vascular damage in the kidneys

Thrombotic microangiopathy
Vasculitis
Hypertension
Diabetes
Atheroma e.g. renal artery stenosis

6

Thrombi in capillaries and small arterioles, due to damaged endothelium (bacterial toxins, drugs) or abnormalities in clotting e.g haemolytic uraemic syndrome

Thrombotic microangiopathy

7

Give an example of vasculitis that can affect the kidney

Wegener's granulomatosis

8

Nephrotic syndrome is due to damage of what part of the renal system?

Glomerulus

9

What are the signs of nephrotic syndrome

Hypoalbuminaemia
Proteinuria
Oedema
+/-hypertension
+/-hyperlipidaemia

10

Complciations of nephrotic syndrome

Infections, thrombosis

11

4 causes of nephrotic syndrome

Membranous neuropathy
Focal segmental glomerulosclerosis (FSGS)
Minimal change disease
Diabetes, lupus nephritis, amyloid

12

Most common cause of nephrotic syndrome

Membranous neuropathy

13

Primary glomerular disorder of unknown cause. 30-60yrs, 20-30% progress to end stage renal failure

Membranous neuropathy

14

A pattern of kidney damage affecting the podocytes, with various possible causes (idiopathic, genetic, heroin use, HIV)

Focal segmental glomerulosclerosis

15

Which causes of nephrotic syndrome are more common in males than females?

Membranous neuropathy
Focal segmental glomerulosclerosis

16

In children, what are the most common causes of nephrotic syndrome?

Minimal change disease, or FSGS (less common)

17

What are the 5 signs of acute nephritis

Oedema
Proteinuria
Acute renal failure
Haematuria
Hypertension

Both nephrotic syndrome and nephritis OPAHH

18

4 main causes of acute nephritis

Post infective glomerulonephritis
IgA nephropathy
Vasculitis
Lupus

19

Typically occurs a few weeks after streptococcoal throat infection; common cause of acute nephritis

post infective glomerulonephritis

20

Most common primary glomerular disease- teenagers and young adults iwth haematuria

IgA nephropathy

21

What proportion of people with IgA nephropathy will progress to renal failure over 20 years

20-50%

22

Cause of nephritic syndrome; presents with fever, generally unwell, rash, myalgia, arthralgia

Vasculitis

23

Autoimmune disease commonly affecting women, that can be a cause of acute nephritis

Lupus

24

What are the 3 most common causes of nephritis in children?

Post infective glomerulonephritis
IgA nephropathy
hencoch-schonlein purpura
haemolytic-uraemic syndrome

25

A specific type of IgA nephropathy that is more common in males than females- arthralgia ,abdo pain, rash and haematuria and acute renal failure

Henoch schonlein purpura

26

Typically affects children with E.coli 0157 enteritis

Haemolytic uraemic syndrome

27

What are the 3 signs of haemolytic uraemic syndrome

Acute nephritis, haemolysis and thrombocytopenia

28

What 3 things must be present for a diagnosis of acute renal failure

Anuria/oliguria
High plasma creatinine levels
High plasma Urea

29

What are the 3 classes of causes for acute renal failure

pre-renal
renal
post-renal

30

Give 2 examples of pre renal causes of acute kidney failure

Severe dehydration
Hypotension e.g. bleeding, septic shock, LV failure

31

Give 3 examples of post renal causes of acute kidney failure

Tumours
bladder stones
prostatic enlargement

32

Give 4 examples of renal causes of acute renal failure

Vasculitis
Acute interstitial nephritis

33

Give 3 examples of renal causes of acute renal failure in children

Henoch schonlein purpura
Hameolytic uraemic syndrome
acute interstitial nephritis

34

5 complications of acute kidney disease

Cardiac failure
Arrythmias
GI bleeding
Jaundice
Infection

35

Which might cardiac failure results from acute kidney failure?

Fluid overload

36

Treatment for acute kidney disease

Short term dialysis
Treat underlying cause

37

Permanently decreased GFR and less nephrons

Chronic renal failure

38

Briefly outline the stages of chronic renal failure

1-2 no treatment
3-moderate reduction in GFR
4- severe reduction in GFR
5-end stage kidney failure

39

3 causes of chronic renal failure

Diabetes
Glomerulonephritis
Reflux nephropathy

40

Chronic reflux of urine up the ureter leading to repeated infections and scarring

Reflux nephropathy

41

What does a renal biopsy tell you in chronic renal failure?

Scarring, no evidence of initial cause

42

4 effects of chronic renal failure

Decreased excretion of water and electrolytes-oedema and hypertension
decreased excretion of toxic metabolites
decreased production of erythropoietin- anaemia
renal bone disease

43

elderly patient with acute renal failure

acute interstitial nephritis (drug reactions)
myeloma-tumour of the plasma cells, secrete immunoglobulins

44

Young male with haematuria and rash

Henoch Schonlein Purpura

45

Teenager/young adult with haematuria

Post infective glomerulonephritis
IgA nephropathy

46

Adult with acute renal failure, fever and myalgia

Vasculitis

47

Young woman with haematuria and facial butterfly rash

Lupus

48

Adult with nephrotic syndrome

Membranous neuropathy

49

Child with nephrotic syndrome

Minimal change

50

Imaging of the urinary tract

Cytoscopy

51

Causes of isolated haematuria

IgA nephropathy
Thin basemement membrane disease
Alport type hereidtary nephropathy

52

Inherited abnormalities of collagen type 4 causing abnormal basement membrane in the glomerulus- renal failure +/- deafness +/-occular problems May be autosomal or X linked

Alport type hereditary nephropathy

53

Commonest 3 causes of isolated proteinuria in adults

FSGS
Diabetes
Lupus

54

Commonest 2 causes of isolated proteinuria in children

Henoch Schonlein purpura
FSGS

55

Causes of acute pyelonephritis

Diabetes
Structural abnormalities of urinary tract

56

Complications of pyelonephritis

Abscess formation

57

What is the cause of chronic pyelonephritis

Associated iwth obstruction of urinary tract and reflux of urine up reter, leading to scarring of the kidney and can lead to renal failure

58

Complications of chronic pyelonephritis

Scarring of kidney
Chronic renal failure

59

What is the result of renal artery stenosis

Ischemia of affected kidney
Activation of renin-angiotensin-aldosterone system leads to hypertension

60

Thrombus blocks the capillary within the glomerulus. Inflammatory cells surround an artery which has fibrin in the wall indicating damage

Vasculitis

61

How does hypertension cause damage to the kidney

Thickening of vessel walls-decrease in size of the lumen-chronic hypoxia-loss of renal tubules-decrease in renal function, decreased blood flow activates RAA system

62

Commonest cause of end stage renal failure?

Diabetes

63

How does diabetes affect the kidney?

hyperglycaemia damages the basement membrane- becomes thicker, glomerulus produces excess extracellular matrix which forms nodules. Also affects small vessels leading to ischaemia and damage to renal tubules

64

What tumour is made of plasma cells which produce excess immunoglobulins-deposit in the tubules- inflammation and fibrosis, decreased kidney function, usually irreversible

Myeloma