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Urinary Systems #2 > Glomerular Disease > Flashcards

Glomerular Disease Flashcards

1
Q

What can be caused by immune disease processes or non-immune disease?

A

Protein-Losing Nephropathy

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2
Q

What is the space between the podocytes called?

A

Slit pore*

  • they restrict movement based on size and charge
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3
Q

The following substances are listed from smallest to largest. What is the smallest substance that is not filtered substantially?

Sodium
Creatinine
Albumin
Immunoglobulin G (IgG)

A

Albumin

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4
Q

What is a protein induced by inflammation that deposits in the kidney?

A

Amyloid

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5
Q

Can amyloid already in the kidney be removed?

A

No

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6
Q

What is the hallmark of PLN?

A

Proteinuria

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7
Q

What do many patients with PLN have?

A

Low albumin
High cholesterol
Hypertension (due to stimulation of RAAS)

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8
Q

What are other causes you need to rule out for proteinuria?

A

UTI
Stones

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9
Q

PLN can be caused by immune disease processes or non-immune causes.
- What are the immune causes?

A

Glomerulonephritis, and they can be further classified based on morphology

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10
Q

PLN can be caused by immune disease processes or non-immune causes.
- What are the non-immune causes?

A
  1. Glomerulopathies, which are glomerular diseases that don’t have the inflammation of a glomerulonephritis
  2. Amyloidosis
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11
Q

(T/F) Glomerular disease is more common in Cats

A

False

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12
Q

What are the breeds that have a high enough incidence of hereditary nephropathy?

A
  • Bernese mountain dog
  • Bull terrier
  • English cocker spaniel
  • Dalmatian
  • Doberman pinscher
  • Greyhound
  • Newfoundland
  • Rottweiler
  • Soft-coated wheaten terrier
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13
Q

PLN starts as a disease of the glomerulus, which can then cause damage to the ___________ and ____________

A

tubules, interstitium

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14
Q

What type of sheets does amyloid form?

A

beta-pleated sheets

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15
Q

What two breed species get amyloidosis?

A

Shar Pei dogs & Abyssinian cats

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16
Q

A syndrome of recurrent fevers and hock swelling as young dogs. Renal failure and proteinuria don’t appear until middle age

A

Shar Pei Fever

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17
Q

Amyloid can occur secondary to ______________ or from ______________

A

Chronic inflammation, Familial problems

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18
Q

Which patient will benefit the most from drugs to inhibit RAAS?
Dog w/ AKI
Cat w/ CKD
Dog w/ PLN

A

Dog w/ PLN

19
Q

The nephrotic syndrome consists of 4 components:

A

Hypoproteinemia
Proteinuria
Hypercholesterolemia
Ascites or Edema (tends to be the last feature to develop)

20
Q

(T/F) Azotemia is required to be present for a dog to have nephrotic syndrome

A

False

21
Q

If the glomerulus is leaky, why does the creatine go up?

A

The entire nephrons become lost (proteinuria causes fibrosis
of the interstitium) and the global renal function declines, leading to azotemia - an increased creatinine

22
Q

Glomerular disease ultimately leads to:

A

Tubulointerstitial damage
Nephron loss from glomerulosclerosis

23
Q

In a Urinalysis, what is a characteristic of glomerular disease?

A

Proteinuria (UPC >0.5) with an inactive sediment

24
Q

Persistent proteinuria due to systemic problems, like fever or myoglobinemia is classified as:

A

Pre-renal

25
Q

In a Dipstick, a trace of 1+ protein in concentrated urine may be normal but is rarely normal with ___________

A

isothenuria

26
Q

In dogs and cats, what does alkaline urine usually mean?

A

urinary tract infection

27
Q

(T/F) Most cases of PLN have High platelet numbers

A

True

28
Q

(T/F) Platelet numbers can be low if the PLN is caused by vectorborne infectious

A

True

29
Q

What would be considered mandatory testing for all proteinuric dogs?

A
  • 4DX test or similar
  • Other infectious disease testing may be warranted also
30
Q

(T/F) We usually do not biopsy if chronic severe azotemia is present, because of the expectation of finding irreversible fibrosis.

A

True

31
Q

What is the role tubule plays in the pathogenesis of glomerular disease?

A

Tubules can’t stand protein and try their best to reabsorb it, but the resulting interstitial protein incites inflammation

32
Q

(T/F) The presence of proteinuria on the dipstick is diagnostic for glomerulonephritis

A

False

33
Q

(T/F) Almost all patients with PLN are azotemic at diagnosis

A

False

34
Q

(T/F) Omega 3 fatty acids supplementation is renoprotective in dogs

A

True

35
Q

Angiotensin-converting enzyme inhibitors block the conversion of Angiotensin ____ to Angiotensin _____

A

I, II

36
Q

Angiotensin receptor antagonists (blockers) block the action of Angiotensin ____

A

II

37
Q

What are some ACE inhibitors that block the conversion of angiotensin I to angiotensin II?

A

Enalapril
Benazepril

38
Q

Angiotensin receptor antagonists, like ___________, block the action of angiotensin II.

A

Telmisartan
- as effective as benazepril in controlling proteinuria in cats
- it is an effective anti-hypertensive in cats

39
Q

Aldosterone antagonists, like __________, block the action of aldosterone. They are used predominantly as diuretics.

A

Spironolactone

40
Q

_____________ causes sodium reabsorption and potassium excretion

A

Aldosterone

41
Q

When thinking of hypertension, what are the target organs at most risk for damage?

A

eyes, brain, heart and kidneys.

42
Q

Is a calcium channel blocker, and is frequently combined with RAAS inhibitor drugs

A

Amlodipine (for controlling hypertension)

43
Q

Immunosuppressive drug for ICGN, which has the fewest side effects and seems effective

A

Mycophenolate mofetil

44
Q

Antithrombin III (natural anticoagulant) is the same size as __________

A

albumin

Urinary Systems #2 (9 decks)

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