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Liz's Clinical Chemistry Module 3 > Renal Disease > Flashcards

Renal Disease Flashcards

(55 cards)

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1
Q

5 major categories of renal diseases

A
  • Glomerular (damage to glomeruli)
  • Tubular (infection/toxin destroys cells)
  • Interstitial (infections)
  • Vascular (disruption to blood supply)
  • Others
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2
Q

6 glomerular diseases

A
  • Acute Post-Streptococcal
  • Glomerulonephritis
  • Acute GN, Chronic GN
  • Membranoproliferative GN
  • Focal segmental GN
  • Rapidly progressive GN
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3
Q

Acute Post-Streptococcal Glomerulonephritis

- Specific causative bacteria

A

Group A Beta hemolytic strep

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4
Q

Acute Post-Streptococcal Glomerulonephritis

- How immune complexes causes the disease

A

Cellular infiltrates deposit on glomerular basement membrane

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5
Q

Acute Post-Streptococcal Glomerulonephritis

- Anatomic structure in the glomerulus is damaged

A

?

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6
Q

Acute Post-Streptococcal Glomerulonephritis

- 6 typical urinalysis findings

A
  • Gross hematuria
  • Proteinuria
  • Red cell casts
  • Hypertension
  • Edema
  • Transient oliguria w/ reduced GFR
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7
Q

Acute Post-Streptococcal Glomerulonephritis

- Pathognomonic finding for the disease

A

Red cell casts

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8
Q

Acute Post-Streptococcal Glomerulonephritis

- Two chemistry lab findings

A

↑ BUN and creatinine

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9
Q

Acute Post-Streptococcal Glomerulonephritis

- One immunological finding

A

Positive test for streptococcal Abs (Abs of M proteins)

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10
Q

List 3 symptoms for chronic glomerulonephritis

A
  • Edema
  • Hypertension
  • Oliguria
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11
Q

Pathognomonic urinalysis findings for chronic glomerulonephritis

A

Broad and waxy casts

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12
Q

2 categories of tubular diseases

A
  • Acute Tubular Necrosis (ischemic and toxic)

- Renal Tubular Acidosis

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13
Q

Describe tubular damage caused by trauma, shock, or sepsis, in ischemic acute tubular necrosis

A

The damage leads to ↓ renal perfusion. Reduced oxygen disrupts tubular basement membrane function

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14
Q

List typical toxic agents that cause toxic acute tubular necrosis and the specific part of the nephron that becomes damaged

A
  • Heavy metals, ethylene glycol, organic solvents, drugs, mushrooms
  • Causes damage and death to PT
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15
Q

6 typical urinalysis findings of acute tubular necrosis

A
  • Mild proteinuria
  • Hematuria
  • Low specific gravity
  • Renal epithelial cells, renal epithelial cell casts, granular casts
  • Oliguria
  • ↑ BUN
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16
Q

Pathognomonic findings for acute tubular necrosis

A

Renal epithelial cell casts

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17
Q

Explain the pathogenesis of renal tubular acidosis

A

Tubules can’t secrete hydrogen ions to acidify urine, ↓ blood pH, causing acidosis

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18
Q

5 tubulointerstitial diseases

A
  • Pyelonephritis (acute and chronic)
  • Cystitis
  • Urethritis
  • Acute tubulointerstitial nephritis
  • Acute tubulointerstitial necrosis
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19
Q

Pyelonephritis

- 3 predisposing factors

A
  • UTI
  • Pregnancy
  • Diabetes mellitus
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20
Q

Pyelonephritis

- 3 common routes of infection

A
  • Ascending from bladder
  • 3% from bloodstream
  • From lymphatic system
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21
Q

Acute pyelonephritis

- 6 typical urinalysis findings

A
  • > 5 WBCs/hpf (clumps)
  • Bacteria
  • Mild proteinuria
  • Positive blood
  • Positive nitrate
  • WBC casts
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22
Q

Acute pyelonephritis

- Pathognomonic finding

A

WBC casts

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23
Q

Chronic pyelonephritis

- Most common cause of chronic pyelonephritis

Study These Flashcards
A

Backward flow of urine up ureters

24
Q

Chronic pyelonephritis

- 7 typical urinalysis findings

Study These Flashcards
A
  • ↑ protein
  • WBCs in clumps
  • Low specific gravity
  • Macrophages
  • Granular casts
  • Waxy casts
  • Broad casts
25
Chronic pyelonephritis | - 2 pathognomonic findings
Waxy and broad casts
26
Cystitis | - 4 typical symptoms
- ↑ frequency and urgency of urination - Pain in pelvic/abdominal region - Fever and chills - Burning sensation on urination
27
Cystitis | - 2 common bacterial causes
- E. coli | - Staphylococcus saprophyticus
28
Cystitis | - 5 common urinalysis findings
- Positive blood - Positive leukocyte esterase - Positive nitrite (if bacteria produce nitrite) - WBCs - Bacteria (1/3 will be neg) NO CASTS
29
Nephrotic syndrome | - 4 disease processes that may lead to the syndrome
- Glomerulonephritis - Systemic Lupus Erythematosus (SLE) - Diabetes mellitus - Sickle cell anemia
30
Nephrotic syndrome | - Renal damage that leads to symptoms and lab findings
Glomerular basement membrane becomes highly permeable to plasma proteins and lipids
31
Nephrotic syndrome | - 2 clinical symptoms
- Edema | - Hypertension
32
Nephrotic syndrome | - 3 typical chemistry findings
- Hypoproteinemia - ↑ cholesterol - ↑ triglycerides
33
Nephrotic syndrome | - 4 urinalysis findings
- Massive proteinuria - Microscopic hematuria - Oval fat bodies - Fatty casts and waxy casts
34
Nephrotic syndrome | - Pathognomonic findings
- Oval fat bodies - Fatty casts - Waxy casts
35
4 vascular renal disease
- Hypertension - Benign nephrosclerosis - Renal artery stenosis - Microangiopathies
36
Why can vascular disease lead to renal disease?
The kidneys receive 20-25% of cardiac output so anything that interferes w/ blood flow impacts kidney function
37
Why can hypertension lead to renal disease?
↑ pressure changes the structure of vascular walls which ↑ the risk for renal failure
38
What is the lab marker for renal disease caused by hypertension?
Microaluminuria
39
Hemolytic Uremic Syndrome (HUS) | - Bacterial causative agent and what food is it found in?
E. coli found in ground meat
40
Hemolytic Uremic Syndrome (HUS) | - Why the toxin causes hemolysis and thrombosis
Toxin binds to RBCs, affects platelet function, and causes ↑ adhesion of WBCs to endothelium
41
Hemolytic Uremic Syndrome (HUS) | - Processes that lead to vasoconstriction
The toxin causes ↑ production of endothelia and loss of endothelial nitric oxide favors vasoconstriction, this in presence of blood clots, occludes vessels, causes necrosis, and thickening of capillary walls
42
Nephrolithiasis | - 4 factors that favor stone formation
- ↑ concentration of stone constituent in urine - changes in urine pH - ↓ urine flow - Presence of bacteria
43
Nephrolithiasis | - 4 categories of kidney stones
- Calcium salts - Triple phosphate (struvite) - Uric acid - Cystine
44
Nephrolithiasis | - 3 symptoms
- Severe flank pain - Nausea - Vomiting
45
Nephrolithiasis | - 3 typical urinalysis findings
- Hematuria - Bacteriuria - Crystals
46
Nephrolithiasis | - 2 typical chemistry findings
↑ BUN and creatinine
47
Abrupt ↓ in renal function sufficient to ↑ plasma creatinine and BUN
"Acute renal failure"
48
Pre-renal causes of acute renal failure
- Extracellular fluid loss - ↓ cardiac output - Sepsis/shock
49
Renal causes of acute renal failure
- Vascular disorders (DIC) - Glomerulonephritis - Tubular necrosis
50
Post-renal causes of acute renal failure
Obstructions
51
Acute renal failure | - 3 chemical findings
- Hyperkalemia - ↑ plasma phosphorus - ↓ blood pH
52
Acute renal failure | - 2 urinalysis findings
- Positive blood and protein in urine | - Oliguria
53
Acute renal failure | - 1 hematological finding
Anemia
54
What is the GFR associated w/ chronic renal failure?
GFR < 15mL/minute
55
What specific part of the nephron becomes damaged in toxic acute tubuler necrosis?
Proximal tubules

Liz's Clinical Chemistry Module 3 (7 decks)

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