Glomerular, Polycystic, Nephrolithiasis Flashcards Preview

CLIN MED II, Nephro > Glomerular, Polycystic, Nephrolithiasis > Flashcards

Flashcards in Glomerular, Polycystic, Nephrolithiasis Deck (39):
1

Damage of the renal glomeruli by deposition of inflammatory proteins in the glomerular membranes as the result of an immunologic response

Glomerulonephritis

2

60% of glomerulonephritis cases are in what age group

children ages 2-12

3

Causes of GN are divided into 2 groups:

Focal (less than 1/2 glomeruli affected)

Diffuse (affects most glomeruli)

4

Clinical features of GN

Hematuria

Oliguria / anuria

Edema of face and eyes in AM,
edema of feet and ankles PM

HTN is common

5

Causes of FOCAL (< 1/2 glomeruli) GN in children

Benign hematuria

Henoch-Schonlein purpura

Mild postinfectious GN

IgA nephropathy

Hereditary nephritis

6

Causes of FOCAL (<1/2) GN in adults

IgA nephropathy

Hereditary nephritis

SLE

7

Causes of DIFFUSE GN in children

Postinfectious GN

Membranoproliferative GN

8

Causes of DIFFUSE GN in adults

SLE

Membranoproliferative GN

Rapidly Progressive GN

Postinfectious GN

Vasculitis

9

Henoch-Schonlein purpura

Focal GN found in children

10

IgA nephropathy

Focal GN found in both children and adults

11

Hereditary nephritis

Focal GN found in both children and adults

12

SLE

causes focal GN in adults

13

Membranoproliferative GN

causes DIFFUSE GN in children and adults

14

RPGN

causes DIFFUSE GN in adults

15

Vasculitis

causes DIFFUSE GN in adults

16

Lab that detects post infectious GN 60-80% of the time

Antistreptolysin - O

17

Urinalysis in GN

Hematuria / Acanthocytes

RBC casts

Proteinuria

18

Other diagnostic lab value found in GN

Serum complement (C3) levels are often decreased

19

Excretion of > 3.5g protein in 24 hrs.

Nephrotic syndrome

20

Characteristics of nephrotic syndrome

Proteinuria (3.5g +)

Hypoalbuminemia

Lipiduria

Hypercholesterolemia

Edema

21

Why are patients with nephrotic syndrome at risk of thrombosis?

Due to loss of proteins S and C and antithrombin III

22

Symptoms of nephrotic syndrome

Malaise
Abdominal distension
Anorexia
Facial edema
Oliguria
Scrotal swelling
SOB
Weight gain

23

Signs of nephrotic syndrome

Ascites
Edema
Hypertension
Orthostatic Hypotension

**Retinal sheen** ?

Skin striae

24

Tx nephrotic syndrome

ACE-I, early in course of disease

Diuretics for edema

Anticoagulants, if needed

Steroids, esp in children, if indicated. Stronger immunosuppressants if relapse (cyclo's, etc)

25

ADPKD

Most common form of PKD

Bilateral

Symptoms develop during 4th decade of life

26

ARPKD

Less common

Begins in utero

can lead to fetal / neonatal death

surviving infants > short life, renal/hepatic failure

27

ACKD

Acquired cystic kidney disease

occurs in ppl w long term renal disease

more common in African American men

28

ADPKD, clinical features

back and flank pain

headaches (risk of aneurysm)

nocturia

Hematuria, HTN, UTI's, weight loss

Renal colic, N/V

29

ADPKD urinalysis

Proteinuria, hematuria, pyruria, bacteruria

30

ADPKD diagnostic method of choice

Ultrasonography (fluid filled cysts)

31

3 anatomical points at which kidney stones can lodge

1. Ureteropelvic junction (UPJ stones)

2. Uretervesicular junction (UVJ BLADDER stones)

3. Ureter at levels of iliac vessels

32

4 major types of stones

Calcium (75-85%)

Uric acid (5-8%)

Cystine (<1%) - genetic

33

Pain from a stone in the upper ureter radiates

to anterior abdomen

34

pain from a stone in the lower ureter radiates

ipsilateral groin, testicle or labia

35

Pain from a stone in the UVJ radiates

lower pelvic pain

urinary frequency / urgency

36

Imaging modality of choice for kidney stones

Helical CT

no contrast needed

**ultrasound for pregs and kids**

37

Gold standard Tx for large kidney stone (>10 mm)

Ureteral stent or percutaneous nephrostomy

38

Medications for calcium stones

Hydrochlorothiazede, to decrease urine calcium excretion

39

Medication for uric acid stones

Allopurinol to decrease uric acid excretion