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65 Cards in this Set
- Front
- Back
what are GLOMERULAR diseases?
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diseases that cause direct injury to the glomerulus.
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What symptoms are present in GLOMERULAR diseases?
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-Hematuria
-Proteinuria -decr. GFR -Hypertension |
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Which of these symptoms is almost always present?
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Proteinuria
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What 5 basic reactions are associated with GLOMERULAR diseases?
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1. Immune-complex
2. Proliferation of cells 3. Thickening of Basemt memb. 4. Infiltration of PMNs/macroph 5. Sclerosis scars |
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Which basic reaction is most often seen?
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Immune-complex associated.
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How do immune complexes cause glomerular disease?
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By depositing IgA or IgG complexes in the glomeruli.
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What symptoms appear with Acute Glomerulonephritis?
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-HEMATURIA
-edema, headaches, low back pain, oliguria. |
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What infection is AGN associated with?
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Group A streps
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What pathological process occur in AGN?
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-Immune complexes deposit
-Mesangial cells proliferate and WBCs infiltrate. -Glomerulus dmg allows protein and blood into filtrate. |
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What are the lab findings seen in AGN?
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-Many RBCs - hematuria.
-RBC casts -Proteinuria!!! -Hyaline/granular casts -maybe WBCs |
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What 4 conditions must be present for casts to form?
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1. Acidic pH
2. Protein 3. Stasis 4. Salt (high sp gr) |
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What is "Crescentic RPGN"?
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Rapidly Progressive Glomerulo-nephritis. The progression of AGN.
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What pathological processes occur in RPGN?
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1. Immune complexes deposit in glomerulus.
2. Macrophages dmg capillary walls. 3. Leaked cells/fibrin form in Bowman's space, damage it. |
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What is worse: RPGN or AGN? Why?
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RPGN; usually ends in renal failure. APGN can recover.
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What type of disorder is Goodpastures?
Who is it seen in? |
Autoimmune.
Young males. |
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What are the complications that occur in goodpasture's, and why?
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Renal and pulmonary.
B/c an antibody develops against alveolar and basement membranes. |
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What is the prognosis of Goodpastures?
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Poor - usually progresses to CGNor renal failure.
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What is the main pathology in Membranous Glomerulonephritis?
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Diffuse thickening of the basement membrane.
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Why is MGM bad?
(2 reasons) |
1. Vessels get obliterated and glomerulus can't function.
2. Major cause of Nephrotic syndrome in adults. |
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What are the lab findings in MGM?
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-RBCs
-Casts -Protein |
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What is the name of the most common cause of GN?
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Bergers Disease - IgA Nephropathy
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What lab findings accompany berger's disease?
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-Episodes of macrohematuria
-Asymptomatic microhematuria -Varied degrees of proteinuria. |
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What is focal proliferative Glomerulonephritis?
In what age group? |
Increased mesangial cells but only in SOME nephrons.
16-35 yr olds |
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What makes minimal change disease so... minimal?
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the glomerulus looks NORMAL but the podocyte pores are enlarged.
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What are the 2 characteristic symptoms of minimal change disease?
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Edema
MASSIVE protein. |
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Why is minimal change disease important to diagnose?
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It is the major cause of nephrotic syndrome in children.
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What is the definition of "Nephrotic Syndrome"?
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the protein losing kidney.
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What pathologically causes nephrotic syndrome?
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Damaged membrane has increased permeability of capillary walls; Electric charges in podocytes altered, protein/lipids escape into filtrate.
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What are the 4 lab symptoms of general nephrotic syndrome?
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1. Severe proteinuria
2. Hypoalbuminemia 3. General edema 4. Hyperlipidemia |
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What major microscopic lab finding is seen with Nephrotic syndrome but NOT GN?
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Oval Fat Bodies
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What disease most often causes nephrotic syndrome?
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immune complex
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What is chronic glomerulonephritis?
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-Continual/permanent dmg
-80% have previous disorder |
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What are the lab findings in chronic glomerulonephritis in
-Blood -Urine |
Blood: increased creat/BUN, decreased Ca.
Urine: RBCs, protein, ALL casts, WBCs, ISOSTHENURIC sp gr. |
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What is the sp gr seen in CGN?
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1.010
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How does vascular disease cause kidney damage?
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Atherosclerosis - intrarenal arteries have reduced blood flow
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What lab findings accompany renal vascular disease?
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-Slight/mod protein
-NOTHING on micro -May see RBC casts LATER when in renal failure. |
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What 3 things cause TUBULAR DISEASE?
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-Ischemia
-Toxins -Drugs |
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What is the main pathologic occurence in ATN?
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Loss of large numbers of RTE cells.
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What are causes of ATN?
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-Renal ischemia
-Exogenous toxins -Endogenous toxins -Drugs |
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what are the 3 stages of ATN?
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1. Oliguric
2. Diuretic 3. Recoveru |
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What are the 3 types of interstitial nephritis?
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1. acute pyelonephritis
2. chronic pyelonephritis 3. acute interstitial nephritis |
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what is acute pyelonephritis?
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An infection caused by the ascention of bacteria in the lower UT, or carried by the bloodstream.
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what are clinical symptoms of acute pyelonephritis?
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sudden onset of fever, chills, nausea, polyuria, urinary frequency.
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what are lab findings of acute pyelonephritis?
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WBCs, WBC CASTS!!!!! clumps, RBCs, RTEs.
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what would be a common cause of acute pyelonephritis?
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GNB - ecoli
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how do wbc casts form?
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diapedesis - response to inflammation.
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How does chronic pyelonephritis develop?
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From recurrent/chronic infections - cause chronic inflammation, renal scarring.
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What are lab findings seen in chronic pyelonephritis?
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-Incr. bun/creat
-Decr. GFR -Minimal proteinuria* -Polyuria/nocturia -WBCs*** and some casts. |
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What causes acute interstial nephritis?
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-Drugs/toxins
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What lab findings are associated with acute interstial nephritis?
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-Hematuria
-Proteinuria -STERILE leukocyturia - no bacteria. |
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What is the definition of Cystitis?
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Inflammation of the bladder and ureters.
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What usually causes cystitis?
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-Bacteria from lower UTI
-Stones -Tumors |
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What are lab findings in Cystitis?
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-WBCs (mostly) -RBCs
-Some protein but from inflammation, not leakage. -Bacteria -NO CASTS!! |
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What types of Urinary calculi can form?
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Primary
Secondary |
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What is the most common type of primary calculi to form?
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Calcium oxalate
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What are secondary calculi?
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stones that form around a focus of necrotic tissue or other things.
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What is ARF?
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Acute suppression of renal function with an associated decrease in the GFR.
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What are the 3 types of ARF?
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Prerenal
Intrarenal Postrenal |
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What is pre-renal ARF?
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Decreased GFR b/c general blood flow is decreased - usually from cardiac output problem.
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What causes intra-renal ARF?
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Glomerular, tubular, or vascular disease.
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What causes post-renal ARF?
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Obstructions
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What is affected in Chronic renal failure? wHY?
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ALL ORGAN SYSTEMS AFFECTED!!!
from the pathophysiology of uremia. |
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what lab findings are seen in CRF in regard to blood?
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-Increased BUN/CREAT
-Acidosis w/ incr. K, P, Sulfate -Decreased Ca2+ and protein |
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What lab findings are seen in CRF in regard to urine?
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-Dilute
-Proteinuria -RBCs/WBCs/RTEs -ALLLLL CASTS |
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what are 2 types of kidney tumors?
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-Renal
-Wilm's |