Renal Diseases

Front 1

what are GLOMERULAR diseases?

Back 1

diseases that cause direct injury to the glomerulus.

Front 2

What symptoms are present in GLOMERULAR diseases?

Back 2

-Hematuria
-Proteinuria
-decr. GFR
-Hypertension

Front 3

Which of these symptoms is almost always present?

Back 3

Proteinuria

Front 4

What 5 basic reactions are associated with GLOMERULAR diseases?

Back 4

1. Immune-complex
2. Proliferation of cells
3. Thickening of Basemt memb.
4. Infiltration of PMNs/macroph
5. Sclerosis scars

Front 5

Which basic reaction is most often seen?

Back 5

Immune-complex associated.

Front 6

How do immune complexes cause glomerular disease?

Back 6

By depositing IgA or IgG complexes in the glomeruli.

Front 7

What symptoms appear with Acute Glomerulonephritis?

Back 7

-HEMATURIA
-edema, headaches, low back pain, oliguria.

Front 8

What infection is AGN associated with?

Back 8

Group A streps

Front 9

What pathological process occur in AGN?

Back 9

-Immune complexes deposit
-Mesangial cells proliferate and WBCs infiltrate.
-Glomerulus dmg allows protein and blood into filtrate.

Front 10

What are the lab findings seen in AGN?

Back 10

-Many RBCs - hematuria.
-RBC casts
-Proteinuria!!!
-Hyaline/granular casts
-maybe WBCs

Front 11

What 4 conditions must be present for casts to form?

Back 11

1. Acidic pH
2. Protein
3. Stasis
4. Salt (high sp gr)

Front 12

What is "Crescentic RPGN"?

Back 12

Rapidly Progressive Glomerulo-nephritis. The progression of AGN.

Front 13

What pathological processes occur in RPGN?

Back 13

1. Immune complexes deposit in glomerulus.
2. Macrophages dmg capillary walls.
3. Leaked cells/fibrin form in Bowman's space, damage it.

Front 14

What is worse: RPGN or AGN? Why?

Back 14

RPGN; usually ends in renal failure. APGN can recover.

Front 15

What type of disorder is Goodpastures?
Who is it seen in?

Back 15

Autoimmune.
Young males.

Front 16

What are the complications that occur in goodpasture's, and why?

Back 16

Renal and pulmonary.
B/c an antibody develops against alveolar and basement membranes.

Front 17

What is the prognosis of Goodpastures?

Back 17

Poor - usually progresses to CGNor renal failure.

Front 18

What is the main pathology in Membranous Glomerulonephritis?

Back 18

Diffuse thickening of the basement membrane.

Front 19

Why is MGM bad?
(2 reasons)

Back 19

1. Vessels get obliterated and glomerulus can't function.
2. Major cause of Nephrotic syndrome in adults.

Front 20

What are the lab findings in MGM?

Back 20

-RBCs
-Casts
-Protein

Front 21

What is the name of the most common cause of GN?

Back 21

Bergers Disease - IgA Nephropathy

Front 22

What lab findings accompany berger's disease?

Back 22

-Episodes of macrohematuria
-Asymptomatic microhematuria
-Varied degrees of proteinuria.

Front 23

What is focal proliferative Glomerulonephritis?

In what age group?

Back 23

Increased mesangial cells but only in SOME nephrons.

16-35 yr olds

Front 24

What makes minimal change disease so... minimal?

Back 24

the glomerulus looks NORMAL but the podocyte pores are enlarged.

Front 25

What are the 2 characteristic symptoms of minimal change disease?

Back 25

Edema
MASSIVE protein.

Front 26

Why is minimal change disease important to diagnose?

Back 26

It is the major cause of nephrotic syndrome in children.

Front 27

What is the definition of "Nephrotic Syndrome"?

Back 27

the protein losing kidney.

Front 28

What pathologically causes nephrotic syndrome?

Back 28

Damaged membrane has increased permeability of capillary walls; Electric charges in podocytes altered, protein/lipids escape into filtrate.

Front 29

What are the 4 lab symptoms of general nephrotic syndrome?

Back 29

1. Severe proteinuria
2. Hypoalbuminemia
3. General edema
4. Hyperlipidemia

Front 30

What major microscopic lab finding is seen with Nephrotic syndrome but NOT GN?

Back 30

Oval Fat Bodies

Front 31

What disease most often causes nephrotic syndrome?

Back 31

immune complex

Front 32

What is chronic glomerulonephritis?

Back 32

-Continual/permanent dmg
-80% have previous disorder

Front 33

What are the lab findings in chronic glomerulonephritis in
-Blood
-Urine

Back 33

Blood: increased creat/BUN, decreased Ca.
Urine: RBCs, protein, ALL casts, WBCs, ISOSTHENURIC sp gr.

Front 34

What is the sp gr seen in CGN?

Back 34

1.010

Front 35

How does vascular disease cause kidney damage?

Back 35

Atherosclerosis - intrarenal arteries have reduced blood flow

Front 36

What lab findings accompany renal vascular disease?

Back 36

-Slight/mod protein
-NOTHING on micro
-May see RBC casts LATER when in renal failure.

Front 37

What 3 things cause TUBULAR DISEASE?

Back 37

-Ischemia
-Toxins
-Drugs

Front 38

What is the main pathologic occurence in ATN?

Back 38

Loss of large numbers of RTE cells.

Front 39

What are causes of ATN?

Back 39

-Renal ischemia
-Exogenous toxins
-Endogenous toxins
-Drugs

Front 40

what are the 3 stages of ATN?

Back 40

1. Oliguric
2. Diuretic
3. Recoveru

Front 41

What are the 3 types of interstitial nephritis?

Back 41

1. acute pyelonephritis
2. chronic pyelonephritis
3. acute interstitial nephritis

Front 42

what is acute pyelonephritis?

Back 42

An infection caused by the ascention of bacteria in the lower UT, or carried by the bloodstream.

Front 43

what are clinical symptoms of acute pyelonephritis?

Back 43

sudden onset of fever, chills, nausea, polyuria, urinary frequency.

Front 44

what are lab findings of acute pyelonephritis?

Back 44

WBCs, WBC CASTS!!!!! clumps, RBCs, RTEs.

Front 45

what would be a common cause of acute pyelonephritis?

Back 45

GNB - ecoli

Front 46

how do wbc casts form?

Back 46

diapedesis - response to inflammation.

Front 47

How does chronic pyelonephritis develop?

Back 47

From recurrent/chronic infections - cause chronic inflammation, renal scarring.

Front 48

What are lab findings seen in chronic pyelonephritis?

Back 48

-Incr. bun/creat
-Decr. GFR
-Minimal proteinuria*
-Polyuria/nocturia
-WBCs*** and some casts.

Front 49

What causes acute interstial nephritis?

Back 49

-Drugs/toxins

Front 50

What lab findings are associated with acute interstial nephritis?

Back 50

-Hematuria
-Proteinuria
-STERILE leukocyturia - no bacteria.

Front 51

What is the definition of Cystitis?

Back 51

Inflammation of the bladder and ureters.

Front 52

What usually causes cystitis?

Back 52

-Bacteria from lower UTI
-Stones
-Tumors

Front 53

What are lab findings in Cystitis?

Back 53

-WBCs (mostly) -RBCs
-Some protein but from inflammation, not leakage.
-Bacteria -NO CASTS!!

Front 54

What types of Urinary calculi can form?

Back 54

Primary
Secondary

Front 55

What is the most common type of primary calculi to form?

Back 55

Calcium oxalate

Front 56

What are secondary calculi?

Back 56

stones that form around a focus of necrotic tissue or other things.

Front 57

What is ARF?

Back 57

Acute suppression of renal function with an associated decrease in the GFR.

Front 58

What are the 3 types of ARF?

Back 58

Prerenal
Intrarenal
Postrenal

Front 59

What is pre-renal ARF?

Back 59

Decreased GFR b/c general blood flow is decreased - usually from cardiac output problem.

Front 60

What causes intra-renal ARF?

Back 60

Glomerular, tubular, or vascular disease.

Front 61

What causes post-renal ARF?

Back 61

Obstructions

Front 62

What is affected in Chronic renal failure? wHY?

Back 62

ALL ORGAN SYSTEMS AFFECTED!!!
from the pathophysiology of uremia.

Front 63

what lab findings are seen in CRF in regard to blood?

Back 63

-Increased BUN/CREAT
-Acidosis w/ incr. K, P, Sulfate
-Decreased Ca2+ and protein

Front 64

What lab findings are seen in CRF in regard to urine?

Back 64

-Dilute
-Proteinuria
-RBCs/WBCs/RTEs
-ALLLLL CASTS

Front 65

what are 2 types of kidney tumors?

Back 65

-Renal
-Wilm's