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Flashcards in Nephrology Deck (97)
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1

Causes of glomerulonephritis associated with low C3 (immune complex deposition)

- Lupus nephritis
- post-strep nephritis
- cryoglobulinemic GN
- other immune complex GN (MPGN)

2

Causes of glomerulonephritis associated with anti-GBM autoantibodies

goodpastures, anti-GBM nephritis

3

most common cause of microscopic hematuria

benign familial hematuria (autosomal dominant) 63%

4

Alport's disease

usually x-linked (85%) defect in COL4A5 gene, presents with microscopic hematuria, sensorineural hearing loss, ESRD by 4th decade (males)

5

gross hematuria presenting 1-3 days after a URTI

IgA nephropathy

6

gross hematuria presenting 7-21 days after a pharyngitis

post-strep GN

7

methods to measure proteinuria

protein:creatinine ratio (normal < 20 mg/mmol)
OR
24 hour protein collection (normal < 4 mg/m2/hr, nephrotic > 40 mg/m2/hr)
DO NOT DO URINANALYSIS

8

Hematuria: 4 tests on urinanalysis that would indicate a glomerular origin

- colour = tea or cola-coloured
- dysmorphic RBCs (acanthocytes)
- RBC casts
- proteinuria

9

Triad seen with post-strep GN

gross hematuria
generalized edema
hypertension

10

Long term complications of Fanconi syndrome

FTT, growth failure, intellectual impairment, ocular abnormalities (cataracts, glaucoma), enamel defects

11

Medical treatment of overactive bladder

treat constipation (PEG), anticholinergic (oxybutynin) or alpha-blockers (doxazosin)

12

Definition of nephrotic range proteinuria

> 40 mg/m2/hr
(> 50 mg/kg/day)

13

Most common cause of nephrotic syndrome

Minimal change disease

14

Nephrotic syndrome, finding on biopsy of glomerulus

effacement of podocyte foot processes

15

What organisms are patients with nephrotic syndrome at increased risk of?

Streptococcus pneumoniae and haemophilus influenza - due to loss of complement factor C3b, opsonins and immunoglobulins

16

What should you do before starting a patient with nephrotic syndrome on immunosuppressant medication?

PPD, give polyvalent pneumococcal vaccine (23-serotype and 7-valent conjugate vaccines)

17

Treatment of nephrotic syndrome

prednisone x 4-6 weeks

18

Most common cause of peritonitis in nephrotic syndrome

strep pneumoniae

19

Secondary infectious causes of nephrotic syndrome

malaria, schistosomiasis, hep B/C, HIV

20

Options for surgical repair of urinary reflux - 2 methods

Deflux (injection of stuff into ureter), reimplanation of ureter

21

Gross hematuria, nephrotic syndrome. what to worry about?

renal vein thrombosis

22

Five criteria of nephritis

- hematuria (gross, red cell casts)
- hypertension
- azotemia (elevated urea, cr)
- edema (fluid overload, high JVP)
- proteinuria

23

Alports - extra-renal manifestations

eye - anterior lenticonus, recurrent corneal erosions, macular flecks

ear - deafness (bilateral)

24

BP tables depend on...

height
age
gender

25

What is cysteinuria?

Urinary loss of COLA amino acids (cysteine, ornithine, lyseine and arginine)

26

Diagnosis of cystinosis

leukocyte cysteine levels

27

Usual cause of renal vein thrombosis in infant

IDM

28

In gestation, when is formation of nephrons complete?

36-40 weeks GA

29

Approx how many nephrons are in the kidney?

1 million

30

What factors modify glomerular filtration?

- glomerular hydrostatic pressure
- glomerular oncotic pressure
- rate of flow
- permeability of glomerular capillary wall