Pathology (First day) Flashcards Preview

CRRAB II - Pathology > Pathology (First day) > Flashcards

Flashcards in Pathology (First day) Deck (37)
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0
Q

What causes the highly negative charge of the GBM?

A

Heparin sulfate

1
Q

What makes up the backbone of the glomerular basement membrane?

A

Type IV Collagen monomers

2
Q

What are the three layers to the GBM, starting with the capillaries?

A

Lamina interna
Lamina densa
Lamina externa

3
Q

What synthesizes the GBM components?

A

Podocytes

4
Q

What two proteins, if mutated, can lead to nephrotic syndrome?

A

Nephrin and podocin

5
Q

What cells are indicated in lying down collagen and secrete mediators of inflammation?

A

Mesangial cells

6
Q

What two characteristics exclude filtration of albumin?

A

Size, negative charge

7
Q

What is the most common kidney disease, with 5% of the US population having this?

A

Kidney stones

8
Q

What is oftentimes the root cause of glomerular diseases?

A

Immune mediation

9
Q

What is oftentimes the root cause of tubulointerstitial kidney disease?

A

inflammation, toxic/ischemia

10
Q

What is azotemia?

A

Increase in BUN and creatinine.

11
Q

What is uremia?

A

Azotemia with clinical symptoms

12
Q

What are common symptoms of uremia?

A
Pruritis
Anemia
gastroenteritis
pericarditis
peripheral neuropathy
13
Q

What are the basic distinguishing factors of nephrotic and nephritic syndromes?

A

Nephritic: Blood in urine
Nephrotic: protein in urine

14
Q

What are key findings in nephritic syndrome?

A

Hematuria
Mild proteinuria
HTN

15
Q

What are key findings in nephrotic syndrome?

A
Hyperproteinuria (>3.5 gm/day)
Hypoalbuminemia
Edema
Hyperlipidemia
Lipiduria
16
Q

What is the most common cause of acute renal failure?

A

Acute tubulonecrosis

17
Q

How will someone with a renal tubular defect present to the clinic?

A

Polyuria
Nocturia
Electrolyte imbalances

18
Q

How will someone with acute renal failure present to the clinic?

A

Oliguria/anuria

Rapid onset azotemia

19
Q

How will someone present to your clinic with nephrolithiasis?

A

Renal colic

Hematuria

20
Q

What equation approximates renal clearance?

A

Urine concentration x Urine flow / Plasma concentration

21
Q

What are some causes of a pre-renal increase in BUN?

A

Increased Urea synthesis (catabolism, lots of protein)

Decreased renal perfusion (Hypotension, CHF, Renal vein thrombosis)

22
Q

What are renal causes of increased BUN?

A

Glomerular disease
ATN
Interstitial disease

23
Q

What are some post renal causes of increased BUN?

A

Anything with flow obstruction

24
Q

What are prerenal causes for increased Creatinine?

A
Increased synthesis (Anabolic roids, car accident, muscle hypertrophy)
CHF, Shock
25
Q

What is the normal ratio of BUN to Creat?

A

10-20:1

26
Q

What is the equation for FENa?

A

(Urine Na x Plasma Cr x 100) / (Urine Cr x Plasma Na)

27
Q

What does a FENa < 1.0% favor in diagnosis? >2.0%?

A

1%: Prerenal

2.0: ATN

28
Q

What is the normal protein make-up of urine?

A

1/3 albumin
1/3 small globulins
1/3 Tamm-Horsfall protein (secreted by tubule cells)

29
Q

What can cause a false positive for proteinuria check in a urine dipstick test?

A

Alkaline urine
Blood in urine
Dilute urine

30
Q

What is the most common fusion for horseshoe kidneys?

A

Lower lobe (90%)

31
Q

What are the key microscopic findings to Cystic Renal Dysplasia?

A

Undifferentiated mesenchyme/cartilage
Immature collecting ducts
Variable sized cysts lined by flattened epithelium

32
Q

What is the inheritance pattern of polycystic kidney disease?

A

Autosomal dominant

33
Q

What are the most common genes affected in polycystic kidney disease?

A

PKD 1 and PKD 2

34
Q

How may someone with polycystic kidney disease present to the clinic?

A

Pain and hematuria

35
Q

What other organ is oftentimes affected with cysts in polycystic kidney disease?

A

Liver

36
Q

What are two other key pathologies common to patients with Polycystic kidney disease?

A

Berry aneurisms

Mitral valve prolapse