Nephritic and Nephrotic Syndrome Flashcards
(50 cards)
How does Nephrotic syndrome present clinically?
Periorboital and Peripheral Edema Frothy Urine Massive Proteinuria (>3.5g/day Hypoalbuminemia Hyperlipidemia
Why are patients with nephrotic sydrome susceptible to infection and a hypercoaguable state?
Defective glomerulus causes the leakage of anti-clotting proteins (C and S) as well as immunoglobulins.
What is the difference between IgA Nephropathy and IgA Vasculitis?
IgA Nephropathy only affects the kidneys. IgA Vasculitis is a more systemic disease.
The glomerulus is supplied blood by the..
afferent and efferent arterioles
Which layer in the glomerulus is fenestrated and highly permeable to water and small solutes?
The endothelium
Which layer in the glomerulus is the charge barrier?
The glomerular basement membrane Negatively charged (due to proteoglycans)
Which layer in the glomerulus has a slit diaphragm, acting as a size barrier?
The visceral epithelial cells (Podocytes)
Define Azotemia
An increase in the level of nitrogenous waste in the blood (urea and creatinine) due to renal insufficiency
Signs of Nephritic Syndrome Include: (6)
Hematuria Hypertension Oliguria Azotemia Variable proteinuria (potential hypoalbuminemia) Edema
What diseases can cause mixed nephrotic and nephritic syndrome?
Lupus Nephritis
Membrano-proliferative glomerulonephritis (MPGN)
______ is the best diagnostic tool for a glomerular disease.
A Renal Biopsy
Triple approach: Light Microscopy, Immunoflorescence, Electron Microscopy
Define Olguria and Anuria
Oliguria - Low urine output (500mL/24hrs)
Anuria - Basically no urine output (<100mL/24 hrs)
500 mL is the minimum amount of fluid needed to be excreted to clear waste from blood.
Define Uremia
A variety of symptoms due to organ dysfunction caused by renal failure.
(Symptomatic renal failure)
In acute Kidney Injury, a fall in GFR can lead to (2)
Rise in serum creatinine (waste products)
Decreased urine output (sometimes)
Which type of AKI is the most common?
Pre-renal AKI (Decreased Renal Perfusion)
What is the classic triad of findings for acute interstital nephritis?
Fever
Rash
Eosinophilia
What is the equation used to calculate the Fractional Excretion of sodium in Acute Kidney Injury (AKI)?
FE(NA) = [(Urine Na / Plasma Na) / (Urine Creatinine / Plasma Creatinine)] x 100%
What is the equation used to calculate the Fractional Excretion of urea in Acute Kidney Injury (AKI)?
FE(urea) = [(Urine urea / BUN) / (Urine Creatinine / Plasma Creatinine)] x 100%
Acute Kidney Injury is defined as a…
…rapid (< 2 week) decline in the Kidney GFR.
Body retains waste products and urine output is decreased (not always.
Why does serum creatining have to be measured at multiple different times in order to diagnose an acute kidney injury (AKI)?
In order to set a baseline creatinine level so that we can determine if there is a rise in creatinine levels over time, which would indicate AKI.
____ allows for constriction of efferent arterioles and is blocked by____.
____ allows for dilation of afferent arterioles and is blocked by ___.
angiotensin II, ACE/ARBs
prostaglandins, NSAIDs
A low cardiac output could lead to what type of acute kidney injury? (pre, intra, or post)
Pre-renal AKI
What are the two types of Uretal Obstructions?
What are the two types of Bladder Obstructions?
What is the a type of Urethral Obstruction?
Extra (cervical cancer) and Intra (stones) Ureteral
Structural (bladder cancer) and Functional (anticholinergics, diabetes)
Prostate cancer, BPH
Which part of the nephron tubule system is most susceptible to toxins? Which is most susceptible to ischemia?
Toxins = The proximal convoluted tubule Ischemia = the loop of henle (medulla is an already hypoxic environment)
