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**Old DOOS > Kidney 3 > Flashcards

Kidney 3 Flashcards

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1
Q

what is the semi-quantitative number for a trace dipstick protein

A

<30 mg/dL

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2
Q

A 2+ dipstick protein indicates what range of protein in the urine?

A

100>300 mg/dL

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3
Q

how many dL in a L?

A

10

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4
Q

what are the three types of proteinuria?

A

prerenal/overflow
glomerular
tubular

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5
Q

what is prerenal/overflow proteinuria?

A

globulins

light chains

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6
Q

what is glomerular protein that leads to proteinuria?

A

albumin

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7
Q

what can cause functional proteinuria?

A

fever
exercise
CHF stress

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8
Q

what is orthostatic proteinuria?

A

t occur when laying down

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9
Q

what are the three types of glomerular proteinuira?

A

functional
orthostatic
fixed/persistent (most concerning)

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10
Q

what causes tubular proteinuira?

A

microglobulins

albumin

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11
Q

what is the nephrotic range of proteinuria?

A

> 3.5 gm/day

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12
Q

with nephritic syndrome how will the urine sediment look?

A

active or angry

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13
Q

what will urine sediment look like w/ nephrotic syndrome?

A

bland or busy

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14
Q

is nephritis syndrome usually acute or chronic

A

acute

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15
Q

symptoms of nephrotic syndrome

A 
proteinuria >3.5 gms
hypoalbuminemia
edema
hyperlipidemia
hyperlipiduria
urine usually bland
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16
Q

what is seen with nephritis syndrome

A

proteinuria usually <3.5
hematuria- casts, dysmorphic rbcs
altered renal function (increased SrCr, decreased crCl)
HTN often severe

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17
Q

how much albumin can you make in one day?

A

12-15 grams

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18
Q

causes of a bland urine

A

minimal change dz
membranous glomerulonephropathy
focal segmental glomerulosclerosis

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19
Q

causes of a secondary bland urine

A

diabetic neuropathy

amyloidosis

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20
Q

primary cause of an angry urine

A

membranoproliferative glomerulonephritis

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21
Q

what can cause acute post infectious GN?

A

sub bacterial endocarditis
shunt nephritis
abscess

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22
Q

what types of nephritis syndromes will present w/ low complement levels?

A

Acute post infectious GN
membranoprolifeartive GN
SLE
lcryoglobulinemia

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23
Q

nephritis syndrome w/ normal complement levels can be caused by what?

A 
IgA nephropathy
idiopathic RPGN
AG basement membrane
PAN (polyarteritis nodosa) 
wegener's 
HSP
Goodpasture's
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24
Q

what does a proliferative glomerulus dz involve?

A

> 3/lobule, increase in number of cells

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25
what goes wrong in minimal change nephrotic syndrome
integrity of endothelial compromised | the podocytes are efaced
26
what goes wrong w/ the glomerulus in SLE
large subendothelial deposits are on top of the basement membrane efaced podocytes smaller deposits in subepithelial
27
what happens in post strep GN?
large subepithelial humps (antigen-antibody complexes)
28
what happens with membranous GN?
smaller depositions in the subepithelial humps
29
what are the three categories of renal biopsies?
``` light microscopy (LM) immunofluoresence (IF) electron microscopy (EM) ```
30
what will complement level be in minimal change dz?
normal
31
what is a hallmark of minimal change dz on EM?
foot process effacement
32
what causes MCD?
largely idiopathic
33
will minimal change dz respond to steroids?
yes, but if it doesn't more likely to progress to renal failure
34
what are some associated w/ minimal change dz?
``` NSAIDs atopic allergic states hodgkins dz T-cell leukemias (these would make it more a secondary MCD) ```
35
what causes 85% of nephrotic syndrome in shildren and 20% of nephrotic syndrome in adults?
minimal change dz
36
are there any abnormalities on light microscopy w/ MCD?
no
37
what can't see you on light microscopy?
foot process effacement
38
what is the most common primary glomerular disorder leading to ESRD and accounts for about 50% of ESRD from glomerular dz.
Focal and Segmental Glomerulosclerosis (FSGS)
39
are complement levels abnormal w/ FSGS?
no, complement levels are normal
40
what conditions are associated w/ FSGS
ADIS | heroin users
41
what symptoms are common at presentation for FSGS?
HTN azotemia hematuria
42
what peaks in the 4th and 5th decades, has normal complements and poor tx options. Often present w/ hematuria w/out casts
membranous nephropmathy (MN)
43
what is azotemia
elevated BUN
44
what is the rule of 1/3s with membranous nephropathy?
1/3 w/ spontaneous remissions 1/3 w/ persistent proteinuria but stable function 1/3 progress to ESRD within 10 years
45
what is frequently associated w/ Hep C, has low complement, commonly progressive.
Membranoproliferative glomerulonephritis (MPGN)
46
what makes the prognosis of MPGN worse?
early age on onset cresentic changes persistent NS decreased GFR
47
Worldwide the most common primary glomerular disease. accounts for 40-50% of asymptomatic hematuria and associated w/ viral illness. normal complement levels
IgA neprhopathy mesangioproliferative GN (IgAN)
48
tx for IgA nephropathy mesangioproliferative GN
tx associated HTN (ARB, ACEI)
49
variation of IgA nephropathy, present like a GI virus
Honch-Schonlein purpua
50
worse prognosis for IgAN with what other factors?
NR proteinuria Uprot -HTN | -High grade biopsy changes -Age
51
what is the Leading cause of ESRD in US ~40%
diabetic nephropathy (DN)
52
what cancers can cause 2ndary glomerular dz?
lyphoma myeloma adenoCA
53
what connective tissue disorders can cause 2ndary glomerular dz?
SLE RA sjogrens ACL syndrome
54
what needs to be controlled in diabetics to prevent nephropathy
BP control weight control reduction of proteinuria
55
what is the most common cause of post-infectious glomerulonephritis?
Group A beta hemolytic strep
56
do you treat PIGN associated w/ GAS?
no, self-limited
57
what will complement levels be like with PIGN?
low
58
who will have persistent GN from PIGN?
those w/ chronic infections
59
for a skin cause of PIGN what lab do you need?
anti-DNAase strep test
60
what will most patients with PIGN present with?
``` hematuria proteinuria rbc casts ARF HTN ```
61
are complement levels high or low with lupus nephritis
low
62
with lupus nephritis what will there be deposits of?
IgA IgG IgM subendothelial deposits associated w/ poor tx outcomes
63
more common in males and hearing loss is seen in 50%, will have hematuria w/ variable proteinuria
alport syndrome | thin basement membrane diseaes
64
is there a specific treatment w/ alport syndrome?
no
65
is thin basement membrane disease usually progressive?
no
66
is pregnancy discouraged in basement membrane disease?
no, but in lots of other renal conditions
67
what does rapidly progressive glomerulonephritis mean?
creatinine is going up on a daily basis
68
what are ANCA associated rapidly progressive glomerulonephritis?
Wegner’s granulomatosis Microscopic polyarteritis nodosa (PAN) Idiopathic cresentic glomerulonephritis
69
what are anti-GBM mediated conditions that can cause RPGN?
Goodpasture’s syndrome | Idiopathic anti-GBM disease
70
rapid renal failure + upper resipratory syndromes
wegner's granulmatosis
71
ANCA positive that may have a respiratory component
Microscopic polyarteritis nodosa (PAN)
72
what are immune-complex mediated conditions that can lead to RPGN?
Lupus nephritis Infection associated Cryoglobulinemia Henoch-Schonlein purpura
73
associated w/ a dramatic respiratory componenet, but has anti-GBN antibody
goodpasture's syndrome
74
protein deposition dz, associated w/ hep c when showing RPGN
Cryoglobulinemia
75
present w/ a vasculitis and RPGN
henoch-schonlein purpua
76
what does the C-ANCA correspond to?
Wegner's
77
what does the p-ANCA correspond to?
polyangitis
78
what are the four types of kidney disorders
simple cyst (aging) ADPKD ACKD (acquired) MSK
79
CKD commonly found in aging people. Will have a normal kidney size and no stones.
simple cyst
80
CKD associated w/ hematuria, pain, UTI is larger than normal and stones are common
ADPKD
81
CKD associated w/ people on dialysis. Hematuria is common, will ahve a small kidney, stones aren't common
ACKD
82
CKD that is common and associated with UTIs. stones are common
medullary (MSK)
83
what are 3 main causes of acute interstitial nephritis
diuretics (most common) abx NSAIDs
84
features of acute interstitial nephritis
``` Fever Skin rash Arthralgias Peripheral eosinophilia Eosinophiliuria Sterile pyuria (leukocyte cast) Hematuria/proteinuria (<1 gm/day) Hyperkalemia RTA ```
85
what is seen in fanconi's syndrome
Uglucose, Uaa, Uposphate, RTA.
86
what will chronic tubulointerstitial disease look like on urinalysis?
sterile pyruia proteinuria (<1gm/day) low specific gravity

**Old DOOS (11 decks)

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