Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PAEDIATRICS > Renal Diseases & Edema > Flashcards

Renal Diseases & Edema Flashcards

1
Q

State 5 contents of the glomerular cell free ultrafiltrate

A

Glucose, phosphate, creatinine, urea, peptides and LMW proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Factors affecting glomerular filtration x2

A

Size selective barrier of the GBM
Strong negative ionic charges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Factors that modify filtration x3

A

Rate of flow of glomerular plasma volume
Hydrostatic pressure within Bowman’s space
Permeability of the glomerular capillary wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define nephrotic syndrome x3

A

Proteinuria >3,5 g/24hrs
Hypoalbuminemia
Edema and hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primary causes of nephrotic syndrome x5

A

C3 glomerulopathy
Membranous nephropathy
Minimal change disease
Focal segmental glomerulosclerosis
Membranoproliferative glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Secondary causes of nephrotic syndrome x5

A

Vasculitides - SLE
Malignancy
Infections- HIV, hepatitis
Heart failure
NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

State 2 causes of hyperlipidemia in nephrotic syndrome

A

Hypoalbuminemia results in synthesis of proteins and lipoproteins
Decreases lipid catabolism due to reduced lipoprotein lipase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Complications of nephrotic syndrome x6

A

Increase risk of infection
Hypercoagulable state
Vitamin D deficiency
Anemia
Chronic kidney disease
Protein malnutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Differential diagnosis of edema x5

A

Protein loosing enteropathy
Hepatic failure
Heart failure
Protein malnutrition
Acute or chronic glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical features of minimal change nephrotic syndrome MCNS x5

A

Periorbital edema that reduces throughout the day
Generalized edema
Anorexia, irritability, abdominal pain
Absence of hypertension and gross hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Features that make MCNS less likely x5

A

Gross hematuria
Hypertension
Renal sufficiency
Hypocomplementemia
Age <1 or >8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnosis of nephrotic syndrome x4

A

Proteinuria
Microscopic hematuria
Serum albumin < 2.5g/dL
Elevated levels of cholesterol and triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of severe symptomatic edema x4

A

Sodium restriction
Fluid restriction if hyponatremic
Elevate swollen scrotum with pillows
Increase diuresis with loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical manifestations of acute post-streptococcal glomerulonephritis x5

A

Proteinuria dark urine > edema and oliguria
Hypertension >encephalopathy or heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complications of glomerulonephritis x5

A

Acute renal failure
Hypertension
Heart failure
Uremia
Hyperkalemia and hyperphosphatemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

State the filtration apparatus of the kidney x3

A

Endothelium of glomerular capillaries
Glomerular basement membrane
Visceral layer of Bowmans capsule- contains podocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pathophysiology of minimal change disease

A

Infection or vaccination > T cell activation > release of glomerular permeability factor > damage of foot processes of podocytes > selective proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pathophysiology of focal segmental glomerulosclerosis x5

A

Injury to podocytes > effacement or thinning > collapsing of glomerular capillaries > deposition of lipids and proteins ie hyalinosis > scarring ie glomerulosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pathophysiology of membranous nephropathy

A

It is primary or secondary to SLE, drugs and hepatitis
There is activation of the complement system > immune complexes that build up in the subepithelium

20
Q

Describe pathophysiology of edema in nephrotic syndrome in terms of RAAS

A

Decreased intravascular volume > reduced renal perfusion > activation of the RAA > increased secretion of vasopressin > stimulation of tubular reabsorption of sodium > edema

21
Q

How to grade edema x4

A

Grade:
1. Depression of 2mm and rebounding immediately
2. 3-4mm and rebounding within 15 seconds
3. 5-6mm and rebounding within 60 seconds
4. 8mm and rebounding within 2-3 minutes

22
Q

State 6 characteristics of nephritic syndrome

A

Hematuria
Oliguria
RBC casts in urine
Proteinuria < 3,5g/24 hours
Hypertension
Azotemia- urea and creatinine

23
Q

Clinical presentation of hemolytic uremic syndrome HUS x6

A

Abdominal pain
Decreased urine output
Hematuria
Bruising
Lethargy confusion
Hypertension

24
Q

Supportive management of HUS x3

A

Antihypertensive meds
Blood transfusion
Hemodialysis

25
Q

Indications of dialysis x5

A

Acidosis, electrolyte imbalance, intoxication, oedema, uremia

26
Q

State 2 types of peritoneal dialysis

A

Automated peritoneal dialysis
Continuous ambulatory peritoneal dialysis

27
Q

Complications of peritoneal dialysis x5

A

Abdominal pain
Nausea and vomiting
Peritonitis
Fever
Hernia

28
Q

State 3 complications of hemodialysis

A

Infection
Poor blood flow
Blood clot formation

29
Q

State 4 factors affecting development of edema

A

Hydrostatic pressure
Oncotic pressure
Lymphatic system
Vascular permeability

30
Q

State 3 ways of classifying edema

A

Pathophysiological mechanism- transudate and exudate
Clinical findings- pitting and non pitting
Location- generalized or localized

31
Q

State 4 types of edema

A

Lymphadema - build up of lymphatic fluid
Lipedema - accumulation of fat under the skin
Angioedema - swelling under the skin caused by an allergic reaction
Myxedema - sever hypothyroidism presenting with pretibial and periorbital swelling

32
Q

4 disorders with increased lymphatic pressure/obstruction

A

Inflammation
Neoplasms
Congenital absence of lymphatic system
Post surgical removal of LN

33
Q

State 3 causes of increased hydrostatic pressure

A

Sodium retention due to venous insufficiency
Increased venous pressure due to DVT or obstruction
Arteriolar dilation > increased blood flow

34
Q

Pathophysiology of hemolytic uremic syndrome x5

A

Infection > toxins damaging endothelial cells > secretion of cytokines > vasoconstriction and intravascular coagulopathy > thrombocytopenia

35
Q

Describe how hemolysis occurs in HUS x3

A

Platelet microthrombi occludes small blood vessels > RBC hemolysis as they pass through > end organ ischemia

36
Q

Describe pathophysiology of acute renal failure x8

A

Decreased blood supply to kidneys
Decreased GFR
Activation of RAAS
Increased aldosterone release
Increased reabsorption of Na and H2O
Increased urine osmolarity
Secretion of antidiuretic hormone
Increased reabsorption of water and urea

37
Q

State 5 effects of RAAS activation

A

Vasoconstriction
Na reabsorption
Aldosterone release
Sympathetic outflow of CNS
Vasopressin release by hypothalamus

38
Q

Pathophysiology of immune hydrops x4

A

Fetal erythrocytes express protein not present on maternal erythrocytes
Maternal immune system is sensitized and produce IgG antibodies
Destruction of fetal erythrocytes > anemia >cardiac failure > edema

39
Q

Pathophysiology of diabetic nephropathy

A

Hyperglycemia induces mesangial expansion - hypertrophy and proliferation
Thickening of the GBM

Intraglomerular HTN causes glomerular sclerosis

40
Q

Define edema

A

Abnormal fluid accumulation in the interstitium due to an imbalance in fluid homeostasis

41
Q

Disorders with normal serum albumin that cause edema x4

A

Increased capillary permeability
Increased hydrostatic pressure
Increased lymphatic pressure
Increased venous pressure

42
Q

Disorders with decreased serum albumin that cause edema x4

A

Nephrotic syndrome
Glomerulonephritis
Renal failure
HUS

43
Q

Pathophysiology of glomerulonephritis x4

A

Immunologic mechanism triggers inflammation and proliferation of glomerular tissue
Damage to basement membrane, mesangium, capillary endothelium
Loss of renally excreted RBCs and Glomerular filtrate
Hematuria, oliguria, increased renin
Edema and hypertension

44
Q

Disorders that cause edema with decreased serum albumin but no proteinuria x3

A

Food protein allergies - celiac disease
Protein losing enteropathy
Liver disease

45
Q

Non immune causes of hydrops fetalis x3 and pathophysiology

A

Maternal infection
Fetal abnormalities
Massive fetal maternal hemorrhage
Severe fetal anemia > hypoxia > fetal edema

46
Q

Describe how B12 deficiency causes megaloblastic anemia

A

There is no DNA synthesis hence cells divide but their nuclei remain immature

PAEDIATRICS (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions