Renal Disorders I Flashcards Preview

MODHIII - Unit 3 > Renal Disorders I > Flashcards

Flashcards in Renal Disorders I Deck (42)
1

Clinical symptoms of acute kidney injury

- oliguria
- elevated serum creatinine

2

Clinical signs of nephrotic syndrome

- severe proteinuria

3

Clinical signs of nephritic syndrome

- hematuria

4

Location of injury in acute kidney injury

- proximal tubule, sometimes distal tubule

5

Location of injury in nephrotic syndrome

- glomerular capillary filtration defect (podocyte defect)

6

Location of injury in nephritic syndrome

- breaks in the glomerular capillary loops

7

Possible diagnoses for acute kidney injury

- acute tubular necrosis
- acute interstitial nephritis
- acute pyelonephritis

8

Possible diagnoses for nephrotic syndrome

- membranous nephropathy
- FSGS
- minimal change disease

9

Possible diagnoses for nephritic syndrome

- acute nephritic syndrome: crescentic glomerulonephritis, lupus nephritis, post infectious glomerulonephritis
- isolated hematuria: IgA nephropathy, alport's disease

10

Clinical indicators of renal dysfunction

- edema
- decreased renal output
- foamy urine: proteinuria
- dark or red urine: hematuria (tea colored, cola colored)

11

Laboratory indicators of renal dysfunction

- increased creatinine, blood urea nitrogen
- increased protein excretion (urine dipstick, urine protein/creatinine ratio, 24 hour urine protein)
- hematuria (urine dipstick, microscopic exam)

12

Signs of chronic kidney disease

- Glomerular sclerosis
- interstitial fibrosis
- tubular atrophy

13

Ways to assess renal biopsy

- light microscopy
- immunofluorescence microscopy
- electron microscopy

14

Patterns of immunofluorescence staining in glomerulus

- linear capillary loop pattern
- granular capillary loop pattern
- mesangial pattern

15

Disease associated with linear capillary loop pattern immunofluorescence stain

- Anti-GBM disease

16

Diseases associated with granular capillary loop pattern immunofluorescence stain

- membranous nephropathy, lupus nephritis

17

Diseases associated with mesangial pattern immunofluorescence stain

- IgA nephropathy, lupus nephritis

18

Layers of basement membrane

- lamina externa
- lamina densa
- lamina interna

19

Mechanisms of glomerular injury

1. immune mechanisms: immune complex mediated, T-cell mediated
2. non immune mechanisms: structural disorders

20

Disorder associated with immune complex mediated glomerular injury

- membranous glomerulopathy

21

Disorders associated with T-cell mediated glomerular injury

- minimal change disease
- lupus nephritis

22

Disorder associated with non immune glomerular injury

- alport's syndrome

23

Mutation associated with alport's syndrome

- mutation in collagen type IV gene
- leads to structural weakness in basement membrane b/c it's composed of collagen type IV

24

Patient presentation and lab values seen with acute kidney injury

- decreased urinary output (oliguria), and uremia (azotemia)
- labs: increased serum creatinine, and blood urea nitrogen

25

Types of acute kidney injury

- pre renal
- renal
- post renal

26

Pre renal acute kidney injury causes

- cardiac shock, dehydration

27

Renal acute kidney injury

- tubulointerstitial diseases

28

Post renal acute kidney injury causes

- obstructive renal stone

29

Causes of acute kidney injury

- acute tubular necrosis
- acute interstitial nephritis
- acute pyelonephritis

30

Acute tubular necrosis prevelance

- MOST COMMON cause of acute kidney injury

31

Causes of acute tubular necrosis

- injury to tubular epithelial cells
- hypovolemia, ischemia, drug toxicity

32

Presentation of ATN & reversibility

- oliguria
- reversible

33

Key features of ATN

- tubular dilation and flattening of tubular epithelial cells
- necrotic debris in tubular lumen

34

Acute interstitial nephritis key featurs

- interstitial inflammation and tubulitis (lymphocytes in interstitium and in the tubule)
- EOSINOPHILS = drug induced (if eosinophils are present)

35

Acute pyelonephritis causes

- infections of pelvicalyceal system, and renal parenchyma

36

Presentation of acute pyelonephritis

- pain in cost-vertebral angle + other signs of infections

37

Diagnosis of acute pyelonephritis

- pus (WBC) casts
- positive urine culture

38

Key features of acute pyelonephritis

- similar to interstitial nephritis but inflammatory cells are NEUTROPHILS
- neutrophilic infiltrates and neutrophil casts in tubules are characteristic

39

Prognosis of acute pyelonephritis

- benign course if treated, symptoms disappear after treatment with antibiotics

40

Chronic pyelonephritis course

- may have insidious onset or a history of recurrent acute pyelonephritis
- gradual loss of renal function
- results in scarred kidney with chronic inflammation

41

Key features of chronic pyelonephritis

- scarred kidneys, chronic inflammation
- severe tubular atrophy, "thyroidization" of the kidney

42

Three clinical renal syndromes

- acute kidney injury
- nephrotic syndrome
- nephritic syndrome