Renal Disease Flashcards by Kyle Ancheta

Glomerular disease involves immune complex formation and
deposition

Immunologic

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Glomerular disease involves exposure to chemicals, toxins and amyloid materials

Non-immunologic

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Deposition of immune complexes formed in response to Group A
Streptococcal infection

Acute Post-Streptococcal
Glomerulonephritis

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Acute Post-Streptococcal
Glomerulonephritis

Signs and symptoms:
Urinalysis:

 Signs and symptoms: edema, fever, fatigue, hypertension
 Urinalysis: gross hematuria, proteinuria, RBC casts, dysmorphic
RBCs, hyaline and granular casts, WBC

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Acute Post-Streptococcal
Glomerulonephritis lab findings

increase BUN and ASO titer

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More serious form of acute glomerular disease that involves
deposition of immune complexes
from systemic immune disorders

Rapidly Progressive/Crescentic Glomerulonephritis

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Damaged glomeruli allow release of cells and ______ into the Bowman’s capsule leading to crescentic
formation and pressure changes

Rapidly Progressive/Crescentic Glomerulonephritis

fibrin

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Rapidly Progressive/Crescentic Glomerulonephritis

Urinalysis:

Urinalysis: gross hematuria, proteinuria, RBC casts, dysmorphic RBCs, hyaline and granular casts, WBC

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Example of systemic disorder of Rapidly Progressive/Crescentic Glomerulonephritis

SLE

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(+) __________________________________ which is cytotoxic to collagen leading to complement activation and capillary destruction

Goodpasteur Syndrome

Antiglomerular Basement Membrane Ab

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Goodpasteur Syndrome
May lead to ________________________
and ____________________________
May follow ____________________

May lead to chronic glomerulonephritis
and end-stage renal disease
May follow viral respiratory infection

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Goodpasteur Syndrome

Signs and symptoms:
Urinalysis:

 Signs and symptoms: hemoptysis and dyspnea
 Urinalysis: hematuria, proteinuria, RBC casts

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(+) __________________________________ that targets neutrophils in the vascular walls initiating immune response and granuloma formation in the lungs and kidneys

Wegener’s Granulomatosis

Antineutrophilic Cytoplasmic Antibody (ANCA)

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Wegener’s Granulomatosis

Urinalysis:

 Urinalysis: hematuria, proteinuria, RBC cast

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Wegener’s Granulomatosis lab findings:

increase serum BUN and creatinine; Ab testing

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Allergic _______ that causes decrease in the number of platelets
and affects vascular integrity

Henoch-Schonlein Purpura

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Henoch-Schonlein Purpura

Signs and symptoms:
Urinalysis:

 Signs and symptoms: red skin patches, blood in sputum and stool
 Urinalysis: proteinuria, hematuria, RBC casts

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Henoch-Schonlein Purpura Test:

Test for occult blood

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Involves IgG deposition on the glomerular membrane leading to
pronounced thickening

Membranous Glomerulonephritis

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Membranous Glomerulonephritis can be seen in:

Seen in SLE, Sjogren’s syndrome, secondary syphilis and hepatitis
B infection

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Membranous Glomerulonephritis

Urinalysis:

 Urinalysis: hematuria and proteinuria

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Membranous Glomerulonephritis Test:

ANA, HBsAg, FTA-ABS

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Membranous Glomerulonephritis Treatments:

Gold and Mercury Treatments

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Cellular proliferation affecting capillary walls or the glomerular
basement membrane

Membranoproliferative Glomerulonephritis

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Membranoproliferative Glomerulonephritis Urinalysis:

 Urinalysis: hematuria, proteinuria

Membranoproliferative Glomerulonephritis lab findings:

decreased serum complement

Gradual worsening of symptoms leading to loss of kidney function

Chronic Glomerulonephritis

Chronic Glomerulonephritis Signs and symptoms: Urinalysis:

 Signs and symptoms: fatigue, anemia, hypertension, edema and oliguria  Urinalysis: hematuria, proteinuria, glucosuria, isosthenuria and many casts

Chronic Glomerulonephritis lab findings:

increased BUN and creatinine, electrolyte imbalance

IgA deposition on the glomerular membrane leading to thickening. ________ IgA in mucosal infection

IgA nephropathy/Berger’s Disease Increase

Acute onset may occur as a result of circulatory disruption causing systemic shock and decrease in blood pressure

Nephrotic Syndrome

Involves membrane damage and changes in the electrical charges of the basement membrane leading to the passage of high molecular weight proteins and lipids into the urine.

Nephrotic Syndrome

Nephrotic Syndrome cause ____ of _________ causes ________ in capillary _______ pressure and edema

Nephrotic Syndrome cause loss of albumin causes decrease in capillary oncotic pressure and edema

Nephrotic Syndrome Urinalysis:

 Urinalysis: massive proteinuria (>3.5 g/day), lipiduria (fat droplets, oval fat bodies, fatty and waxy casts), hematuria

Nephrotic Syndrome lab findings:

decreased serum albumin, increased serum lipids

Inherited disease that affects the glomerular basement membrane (lamellated appearance with areas of thinning)

Alport Syndrome

Alport Syndrome Urinalysis:

 Urinalysis: hematuria

Disruption of podocytes occurring primarily in children following allergic reactions and immunizations

Minimal Change Disease

Disruption of the podocytes in certain areas of the glomerulus

Focal Segmental Glomerulosclerosis

Focal Segmental Glomerulosclerosis are associated with:

Associated with heroin and analgesic abuse, and AIDS

Most common cause of end-stage renal disease

Diabetic Nephropathy/Kimmelstiel-Wilson

Glomerular damage may be due capillary thickening, increase proliferation of the mesangial cells, increase deposition of cellular and non-cellular materials. Presence of microalbuminuria.

Diabetic Nephropathy/Kimmelstiel-Wilson

Damage to the renal tubular epithelial cells due to ischemia and nephrotoxic agents

Acute Tubular Necrosis

Acute Tubular Necrosis examples that cause Ischemia:

Shock and trauma

Examples of nephrotoxic agents that causes Acute Tubular Necrosis:

Antibiotics and antifungal, amphoterecin, cyclosporin, heavy metals

Acute Tubular Necrosis Urinalysis:

Urinalysis: hematuria, RTE cells, RTE casts, other casts

Failure of tubular reabsorption in the PCT (glucose, amino acids, phosphorus, sodium, potassium, bicarbonate and water)

Fanconi’s Syndrome

Fanconi’s Syndrome Urinalysis:

Urinalysis: glycosuria, possible mild proteinuria

Inherited defect of tubular response to ADH or acquired from medications

Nephrogenic Diabetes Insipidus

Fanconi’s Syndrome is associated to __________ and ___________________. Acquired through exposure to _____________.

Nephrogenic Diabetes Insipidus is associated to cystinosis and hartnup disease. Acquired through exposure to toxic agents.

Disorders affecting the interstitium also affects the tubules due to their close proximity

TUBULOINTERSTITIAL DISEASES

Most common renal disease that involves the lower urinary tract (urethra and bladder) or the upper urinary tract (renal pelvis, tubules and interstitium)

Urinary Tract Infection

Urinary Tract Infection signs include:

Signs include frequent and burning urination

Renal Calculi/Lithiasis removal:

 Removal: surgery or high-energy shock waves

Performed to determine the causative agent in urinary tract infection

Bacterial Culture

Most frequently encountered infection that may ascend to the upper urinary tract

Cystitis

Cystitis Urinalysis:

Urinalysis: WBC, bacteria, mild proteinuria, microscopic hematuria and increased pH

Affects the renal tubules and interstitium. Congenital urinary defect resulting to reflux nephropathy

Pyelonephritis

Allergic inflammation of the renal interstitium in response to certain medications

Acute Interstitial Nephritis

Formation of stones in the renal calyces, renal pelvis, ureters and bladder. May be passed in the urine and obstruct the urinary tract

Renal Calculi/Lithiasis

Primary Calculi Constituents:

Calcium oxalate/ phosphate Magnesium ammonium phosphate Uric acid Cystine

Primary Calculi Constituents  ___________________: may be due to metabolic disorders or diet

Primary Calculi Constituents  Calcium oxalate/phosphate (~75%): may be due to metabolic disorders or diet

Primary Calculi Constituents  ______________________________: frequently accompanied by UTI involving urea-splitting bacteria

Primary Calculi Constituents  Magnesium ammonium phosphate: frequently accompanied by UTI involving urea-splitting bacteria

Primary Calculi Constituents  _________: associated with increased intake of foods with high purine content

Primary Calculi Constituents  Uric acid: associated with increased intake of foods with high purine content

Primary Calculi Constituents  ______: seen in conjunction with hereditary disorders of cysteine metabolism

Primary Calculi Constituents  Cystine: seen in conjunction with hereditary disorders of cysteine metabolism

Renal Disease Flashcards

(65 cards)