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RENAL DSE Flashcards

(57 cards)

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1
Q

CLASSIFICATIONS OF RENAL DISEASE

o Majority are of immune origin (immune complexes, IgG, IgA)
o Common: proteinuria, hematuria, casts

A

Glomerular disorders

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2
Q

GLOMERULAR DISORDERS

A

“WHARG - CIMMM - FADN”

Wegener’s Granulomatosis
Henoch Schönlein Purpura
Acute Post-Streptococcal Glomerulonephritis
Rapidly Progressive (Crescentic) Glomerulo
Goodpasture Syndrome

Chronic Glomerulonephritis
IgA Nephropathy (Berger’s Disease)
Membranous Glomerulonephritis (MGN)
Membranoproliferative Glomerulo (MPGN)
Minimal Change Disease, MCD

Focal Segmental Glomerulosclerosis
(FSGS)
Alport Syndrome
Diabetic Nephropathy
Nephrotic Syndrome

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3
Q

GLOMERULAR DISORDERS

  • Group A Streptococcus (S. pyogenes) infection
    on the glomerular membranes
A

Acute Post-Streptococcal Glomerulonephritis

–along with RHD

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4
Q

GLOMERULAR DISORDERS

Findings:
- Macroscopic hematuria, proteinuria, dysmorphic RBCs/glomerular membrane damage, RBC casts, granular casts
- (+) ASO titer and anti-DNAse B

A

Acute Post-Streptococcal Glomerulonephritis

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5
Q

GLOMERULAR DISORDERS

  • Deposition of immune complexes from
    systemic immune disorders (ex: SLE) on the glomerular membrane
  • Cellular proliferation of epithelial cells
    inside the Bowman’s capsule form “crescents” - MURAG MOON SA HISTO SLIDE
A

Rapidly Progressive (Crescentic) Glomerulonephritis

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6
Q

GLOMERULAR DISORDERS?

Findings:
- Macroscopic hematuria
- Proteinuria
- RBC casts

A

“RGWH”

  • Rapidly Progressive (Crescentic)
    Glomerulonephritis
  • Goodpasture Syndrome
  • Wegener’s Granulomatosis
  • Henoch Schönlein Purpura
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7
Q

GLOMERULAR DISORDERS

Deposition of antiglomerular basement
membrane antibody- IgG to glomerular and
alveolar basement membranes

A

Goodpasture Syndrome

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8
Q

GLOMERULAR DISORDERS

  • Anti-neutrophilic cytoplasmic auto-antibody (ANCA)

-(perinuclear-ANCA) forms when neutrophils are fixed in ethanol

  • (cytoplasmic-ANCA) forms when neutrophils are fixed with formalin
A

Wegener’s Granulomatosis

NOW CALLED: Granulomatosis with Polyangitis-GPA

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9
Q

GLOMERULAR DISORDERS

  • Occurs in children following viral
    respiratory infections
  • Decrease in platelets disrupts vascular
    integrity
A

Henoch Schönlein Purpura

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10
Q

GLOMERULAR DISORDERS

  • Thickening of glomerular membrane
    following IgG immune complex
    deposition associated with systemic
    disorders
A

Membranous Glomerulonephritis (MGN)

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11
Q

GLOMERULAR DISORDERS

  • Cellular proliferation affecting the
    capillary walls or the glomerular
    basement membrane, possibly
    immune-mediated
A

Membranoproliferative Glomerulonephritis (MPGN)

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12
Q

GLOMERULAR DISORDERS

  • Disruption of podocytes in certain
    numbers and areas of glomeruli,
    others remain normal
  • IgM and C3 are evident on the sclerotic areas (using IF)
A

Focal Segmental Glomerulosclerosis
(FSGS)

—FOCAL means certain areas only ang affected

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13
Q

GLOMERULAR DISORDERS?

findings:
- Proteinuria
- Hematuria

A

“MMF”

-Membranous Glomerulonephritis (MGN)
-Membranoproliferative Glomerulonephritis (MPGN)
-Focal Segmental Glomerulosclerosis
(FSGS)

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14
Q

GLOMERULAR DISORDERS

  • Marked decrease in renal function
    resulting from glomerular damage
    precipitated by other renal disorders
  • Progression to renal failure
  • long term, less painful and irreversible
A

Chronic Glomerulonephritis

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15
Q

GLOMERULAR DISORDERS

FINDINGS:
- Hematuria
- Proteinuria, Glucosuria
- Cellular & granular casts
- WAXY AND BROAD CASTS

A

Chronic Glomerulonephritis

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16
Q

GLOMERULAR DISORDERS

Deposition of lgA on the glomerular
membrane resulting from increased
levels of IgA

A

IgA Nephropathy (Berger’s Disease)

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17
Q

GLOMERULAR DISORDERS

FINDINGS:
- Early stages: Hematuria
- Late stages: waxy and broad casts

A

IgA Nephropathy (Berger’s Disease)

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18
Q

GLOMERULAR DISORDERS

  • Little cellular changes in the
    glomerulus
    -Disruption of podocytes primarily in
    children following allergic reactions &
    immunizations
  • Associated with HLA-B12 antigen
A

Minimal Change Disease, MCD or
(Nil Disease/Lipoid Nephrosis)

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19
Q

GLOMERULAR DISORDERS

findings:

  • Heavy proteinuria
  • Transient hematuria
  • Fat droplets
A

Minimal Change Disease, MCD
(Nil Disease/Lipoid Nephrosis)

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20
Q

GLOMERULAR DISORDERS

  • Most common cause of ESRD
  • Deposition of glycosylated proteins on
    the glomerular basement membranes
    caused by poorly controlled blood
    glucose levels
A

Diabetic Nephropathy (KimmelstielWilson Disease)

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21
Q

GLOMERULAR DISORDERS

findings:
- Microalbuminuria
- + Micral test

A

Diabetic Nephropathy (KimmelstielWilson Disease)

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22
Q

GLOMERULAR DISORDERS

  • Genetic disorder showing lamellated
    and thinning of glomerular basement
    membrane
  • with GIANT PLATELETS
A

Alport Syndrome

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23
Q

GLOMERULAR DISORDERS

  • Disruption of the electrical charges/shield of negativity that produce the tightly fitting podocyte barrier resulting in massive loss of proteins & lipids deposited in urine

Occurs in patients with MCD (in children), MGN (in adults), FSGS and
MPGN

Study These Flashcards
A

Nephrotic Syndrome

24
Q

GLOMERULAR DISORDERS

Urinalysis Findings:
- Albumin, a1, B, gamma-globulins
- (-) a2-macroglobulin
- Oval fat bodies
- Fatty casts
- Waxy casts

  • ↑ Albumin
  • ↑ Lipase
  • ↑ Lipids

Serum Findings:
- Albumin, α1, gamma - globulins
- α2-macroglobulin
- β-globulin (LDL)

  • ↓ Albumin
  • ↓ Lipase
  • ↑ Lipids
  • ↑ Apo B100
  • ↑ LDL and
    VLDL
  • ↑ Chole &
    TAG
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A

Nephrotic Syndrome

25
TUBULAR DISORDERS?
"FADUR" Fanconi Syndrome Acute Tubular Necrosis Diabetes Insipidus Uromodulin-associated Kidney Disease (UKD) Renal Glucosuria
26
TUBULAR DISORDERS - Damage to renal tubular cells caused by ischemia/blockage in BL so Oxygen can't pass, results to hypoxia and results to cyanosis - Urine odor = “odorless”
Acute Tubular Necrosis
27
TUBULAR DISORDERS findings: - Microscopic hematuria, proteinuria - RTE cells, RTE casts - Hyaline, granular, waxy and broad casts
Acute Tubular Necrosis
28
TUBULAR DISORDERS - Inherited defect in the production of normal uromodulin by the renal tubules and increased uric acid causing gout - Normal uromodulin is replaced by abnormal forms that destroy the RTE cells
Uromodulin-associated Kidney Disease (UKD)
29
TUBULAR DISORDERS findings: - RTE cells - Hyperuricemia -waxy and broad casts
Uromodulin-associated Kidney Disease (UKD)
30
TUBULAR DISORDERS -Generalized failure of tubular reabsorption in the proximal convoluted tubule
Fanconi Syndrome
31
TUBULAR DISORDERS findings: - Glucosuria - Possible cystine crystals (amino acid)
Fanconi Syndrome
32
TUBULAR DISORDERS - Neurogenic DI = hypothalamus fails to produce ADH - Nephrogenic DI = renal tubules fail to respond to ADH
Diabetes Insipidus
33
TUBULAR DISORDERS findings: - Low specific gravity - Polyuria (>15 L/day
Diabetes Insipidus
34
TUBULAR DISORDERS - (N) Blood glucose = ↑ Urine glucose - Defective tubular reabsorption of glucose
Renal Glucosuria
35
INTERSTITIAL DISORDERS?
"CACA" Cystitis (Lower UTI) Acute Pyelonephritis (Upper UTI) Chronic Pyelonephritis Acute Interstitial Nephritis
36
INTERSTITIAL DISORDERS - Ascending bacterial infection of the urinary bladder - Acute onset of urinary frequency and burning
Cystitis (Lower UTI)
37
INTERSTITIAL DISORDERS FINDINGS: - WBCs, Bacteria, NO CAST - Microscopic hematuria - Mild proteinuria, increased pH
Cystitis (Lower UTI)
38
INTERSTITIAL DISORDERS - Infection of the renal tubules & interstitium -reflux of urine from the bladder (vesicoureteral reflux) & untreated cystitis
Acute Pyelonephritis (Upper UTI)
39
INTERSTITIAL DISORDERS FINDINGS: - WBCs, Bacteria - WBC casts, bacterial casts, - Microscopic hematuria
Acute Pyelonephritis (Upper UTI)
40
INTERSTITIAL DISORDERS - Recurrent infection of the renal tubules & interstitium caused by structural abnormalities affecting the flow of urine
Chronic Pyelonephritis
41
INTERSTITIAL DISORDERS FINDINGS: - WBCs, Bacteria, WBC casts, Bacterial casts, granular casts - Waxy and broad casts - Hematuria, proteinuria
Chronic Pyelonephritis
42
INTERSTITIAL DISORDERS - Allergic inflammation of the renal interstitium in response to certain medications
Acute Interstitial Nephritis
43
INTERSTITIAL DISORDERS FINDINGS: - Hematuria, proteinuria - WBCs (↑ eosinophils, >1%) - WBC casts, NO BACTERIA
Acute Interstitial Nephritis
44
"CAGIS" - Casts = (cellular, coarsely granular, finely granular, waxy) variety of casts seen in the same specimen - Azotemia (↑ BUN & Creatinine) - ↓ Glomerular filtration rate (< 25 mL/min) - Isosthenuria = (-) renal concentrating ability - increased telescoped Sediments
RENAL FAILURE / END STAGE RENAL DISEASE -ESRD
45
- May form in the calyces and pelvis of the kidney, ureters, and bladder - Lithotripsy uses high-energy shock waves to break kidney stones into pieces -BEST: SURGERY
RENAL CALCULI/RENAL LITHIASIS
46
RENAL CALCULI/RENAL LITHIASIS Conditions Favoring the Formation of Renal Calculi:
"PChemU" pH Chem concentration Urinary stasis
47
Primary UA Finding RENAL CALCULI/RENAL LITHIASIS?
Microscopic hematuria, why? bc gina damage ang lining sa bladder, syempre mga bato, labi na mga large calculi, magasgas si bladder
48
RENAL CALCULI - Major constituent of renal calculi - Very hard, dark in color with rough surface -CHUCO MUCHO IN CLUMPS
Calcium oxalate calculi
48
RENAL CALCULI - Associated w/ increased intake of foods w/ high purine content, and w/ UKD - Yellowish to brownish red & moderately hard -HOT SHOTS OF KFC
Uric acid & Urate calculi
49
RENAL CALCULI -Yellow-brown, greasy & resembles an old soap - Least common calculi - SMALLER THAN A COIN
Cystine calculi
50
RENAL CALCULI - Pale & friable - MARUPOK/POP-CORN
Phosphate calculi
51
RENAL CALCULI common in DRUGS
Sulfonamide calculi
52
RENAL CALCULI - Accompanied by urinary infections involving ureasplitting bacteria (Proteus vulgaris) - Branching/staghorn calculi resembling antlers of a deer --- pelvis of kidney nga na form -MURAG MENTOS
Triple phosphate calculi
53
RENAL CALCULI frequency of Calcium calculi?
75%
54
RENAL CALCULI frequency of Cystine calculi?
2%
55
METHODS FOR CALCULI ANALYSIS?
"ORIEM" o Optical crystallography o Radiograph diffraction o Infrared spectroscopy o Electron beam analysis o Mass spectroscopy
57
tram track appearance of the glomerulus
Membranoproliferative glomerulonephritis (MPGN)

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