lecture 7 disease and renal failure unfinished

Question 1

what are the three types of kidney disease

Answer 1

prerenal
in renal
post renal

Question 2

functional unit of the kidney

Answer 2

nephron

Question 3

can the kidney regenerate new nephrones

Answer 3

oh no! its cant

Question 4

3 major layers of the glomerular capillary

Answer 4

endothelium
basement membrane
podocytes

Question 5

how does the capillary membrane stop proteins getting through

Answer 5

negative charge

Question 6

what are the podocytes separated by

Answer 6

slit pores

Question 7

how do patients present with protein loss

Answer 7

they dont

Question 8

what are the bits of the nephrotic syndrome

Answer 8

Peripheral Oedema
PrOteinuria
HypOalbuminaemia
HyperchOlesterolaemia

Question 9

if you have nephrotic syndrome what are you at risk to

Answer 9

infection

thrombotic event

Question 10

what is the primary cause of nephrotic syndrome

Answer 10

problem within the kidney itself

Question 11

example of secondary cause of nephrotic syndrome

Answer 11

lupus

Question 12

what is nephrotic syndrome usually due to a problem with

Answer 12

glomerular capillary wall

Question 13

OEDEMA

Answer 13

OEdema

Question 14

what are the two mechanisms of oedema

Answer 14

underfill

overfill

Question 15

who is the underfill method more common in

Answer 15

children

Question 16

what is oncotic pressure

Answer 16

osmosis due to proteins

Question 17

what is the underfill method

Answer 17

low proteins = fluid moves out of vasculature
RAAS and vasopresin released due to low blood volume
high capillary hydrostatic then pushes fluid out of vasculature also

Question 18

what is the overfill model due to

Answer 18

sodium excretion defect

Question 19

what is overfillmodel

Answer 19

high sodium in blood = high volume
vasopressin and RAAS are supressed
high capillary and low osmotic = fluid moves into tissue

Question 20

key causes of nephrotic syndrome in children

Answer 20

minimal change disease (MCD)
focal segmental glomerulosclerosis (FSGS) 
membranous nephropathy (MN)

Question 21

key causes of nephrotic syndrome in adults

Answer 21

diabetic nephropathy, SLE, amyloidosis, chronic viral infection and cancer

Question 22

how is minimal change disease treated

Answer 22

steroids

Question 23

explain the prognosis of focal segmental glomerulosclerosis

Answer 23

bad - nephrons cant regenerate

Question 24

how does Membranous GN (glomerulonephritis) develop

Answer 24

electron dense or immune deposits get deposited on the basement membrane

Question 25

features of nephritic syndrome

Answer 25

Haematuria, hypertension, acute kidney injury, often oliguria, often proteinuria, oedema may be present

Question 26

2 membrane attack pathways

Answer 26

classic

alternative

Question 27

what is the classic pathway of membrane attack activated by

Answer 27

Fc portion of an immunoglobulin in antibody-antigen complex

Question 28

what else might activate the classic pathway

Answer 28

endotoxins

Question 29

activators of the alternative pathway

Answer 29

bacterial endotoxins, yeast cell walls, aggregated immunoglobulins

Question 30

example of a disease where immune complexes are already in the blood

Answer 30

lupus

Question 31

example of when the antigen is already in the basement membrane

Answer 31

good pastures disease

Question 32

what happens in good pastures disease

Answer 32

damage to alpha 3 chain of type 4 collagen in the basement membrane, this leads to a circulating anti-glomerular basement membrane antibody.