Proteinuria and Hematuria Flashcards Preview

IM_Renal and GU > Proteinuria and Hematuria > Flashcards

Flashcards in Proteinuria and Hematuria Deck (27):
1

Proteinuria is defined as urinary excretion of greater than _______ mg protein/24hrs

150

2

Different classifications of proteinuria

glomerular - due to increased glomerular permiability (seen in nephrotic syndrome)
tubular - abnormal tubular structure so protein isn't reabsorbed as well (seen in sickle cell, urinary tract obstruction, interstitial nephritis)
overflow - increased production of small proteins

3

What other conditions can cause proteinuria

UTI, fever, heavy exertion/stress, CHF, orthostatic proteinuria, pregnancy

4

Nephrotic syndrome features urine protein excretion rate of greater than _____g/24 hr

3.5

5

Key features of nephrotic syndrome

urine protein >3.5, hypoalbuminemia leading to edema, , HYPERLIPIDEMIA since liver cannot keep up with protein loss, hypercoagulable state (due to loss of certain anticoaglulants in urine), increased infection (due to loss of immunoglobulins in urine

6

What primary glomerular diseases can cause nephrotic syndrome

membranous nephropathy (MCC adults)
focal segmental glomerulosclerosis (FSGS)
membranoproliferative GN
minimal change dx (MCC children)

7

What systemic diseases can cause proteinuria

DM, collagen vascular disease, SLE, RA, HSP, polyarteritis nodosa, Wegener granulomatosis, amyloidosis, crycglobulinemia

8

What drugs/toxins can cause nephrotic syndrome

captopril, heroin, heavy metals, NSAIDs, penicillamine

9

T/F: Infection can cause nephrotic syndrome

TRUE

10

What malignancy can cause nephrotic syndrome

multiple myeloma

11

What methods can be used to diagnose proteinuria

Urine dipstick
Urinalysis
Test for microalbuminuria
regular renal function tests

12

What do RBC casts, WBC casts, and fatty casts on urine sediment suggests?

RBC - glomerulonephritis
WBC - pyelonephritis and interstitial nephritis
Fatty - nephrotic syndrome (lipiduria)

13

What to do if urinalysis suggestions presence of protein

24 hour urine collection to establish presence of significant proteinuria

14

Microalbuminuria can be an early sign of what?

diabetic nephropathy

15

Treatment for transient asymptomatic proteinuria

NONE BITCH GET YO HONEY BUTTA CHICKEN BISCUIT

16

Treatment for symptomatic proteinuria or persistent asymptomatic proteinuria

further testing!
treat underlying disease
edema - diueretics
hypo-immunoglobulinemia - vaccinate against pneumo and influenza
hyperlipidemia - cholesterol lowering agent, protein and sodium limited diet

17

Why are ACE inhibitors useful in treating diabetics with HTN?

decreases urinary albumin loss, essential.

18

Hematuria is defined as greater than ____erythrocytes/HPF on urinalysis

3

19

Gross/painless hematuria is a commonly a presenting sign of which 2 malginancies

bladder cancer and renal cell carcinoma

20

Microscopic hematuria is more commonly ____ in origin; gross hematuria is more commonly _____________ or _______ in origin
______ can cause either

glomerular
nonglomerular, urologic
infection

21

What can cause harmless hematuria

strenuous exercise (ex: marathon running), fever

22

Name some causes of hematuria

kidney stones
trauma (blunt, foley placement, invasive procedures)
BPH
malginancy (renal cell or bladder cancer)
infection (UTI, urethritis, pyelo)
glomerular disease, IgA nephropathy
bleeding disorders
medications
systemic disease
polycystic kidney disease, simple cysts

23

What medications can cause hematuria

cyclophosphamide, anticoagulants, salicylates, sulfonamides

24

How to workup hematuria

urine dipstick, urinalysis (CRUCIAL), urine specimen, 24 hr urine, blood tests to check for coagulopathy, ....if no cause is identified by these try IVP, CT, or US to rule out stones, tumors, cysts, strictures, or AVMs, renal biopsy

25

What to do if pyuria present on urinalysis

send urine culture

26

If dipstick is positive for blood, but urinalysis doesn't reveal hematuria (no RBCs) then what is most likely?

hemoglobunuria or myoglobunuria

27

If suspicion for malignancy is high on urine specimen, what to do

perform cystoscopy to evaluate bladder regardless of cytology results