• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/18

Click to flip

18 Cards in this Set

  • Front
  • Back
What is the pathogenesis of thrombotic microangiopathy syndrome and what typical findings does it lead to? (4)
Microvascular thrombosis -> Multifocal ischemia of target organs + consumption of platelets + Destruction of RBC's -> CNS dysfunction + Acute renal failure + thrombocytopenia + hemolytic anemia
What is the differential diagnosis for thrombotic microangiopathy syndrome?
Thrombotic thrombocytopenic purpura: idiopathic, SLE, HIV, meds
Hemolytic-uremic syndrome: post E. coli infection
Preeclampsia
Scleroderma crisis
Malignant hypertension
What is the main pathogenic mechanism in most cases of thrombotic microangiopathy?
Antibody to ADAMTS-13 which normally breaks down large vWF. This increases the concentration of vWF and therefore increases platelett adhesion and thrombosis in small vessels. Also get endothelial cell damage due to subendothelieal edema and fibrin/RBC fragments
What is nephroangiosclerosis?
Renal hypertension resulting in vascular narrowing, ischemia and glomerular drop-out and consequently interstitial fibrosis
Can hypertension cause end-stage renal disease on it's own?
Possibly in those who are genetically susceptible (Black African males)
What is ischemic renal disease?
Ischemia in kidney due to significant large and medium artery narrowing (atherosclerotic renal disease, fibromuscular dysplasia)
What causes a cholesterol embolus and what is it's effect on renal function?
Complication of atherosclerosis, if acute get systemic dysfunction and if chronic get gradual deterioration in renal function
How do you treat TTP? (3)
Plasmapharesis
Antiplatelet therapy (TPA)
Prednisone
How do you treat HUS? (2)
Supportive Care
Plasmapharesis
What is the most common type of mutation in polycystic kidney diseease?
autosomal dominant mutation of polycystin gene(s) on chromosome 16
What are the pathological consequences of PKD mutation? (5)
Renal cysts: crowd out normal tissue leading to chronic kidney disease
Cysts in other organs: liver, pancreas, ovary
Intracranial aneurysm
Mitral valve prolapse
Diverticulosis
What is the pathogenesis of PKD?
Polysystins on tubular epithelial cilia are absent which reduces intracellular calcium causing activation of MAP/ERK signalling and increases chloride driven fluid secretion and cyst formation
How do you treat PKD? (3)
Control hypertension
Prepare for ESRD
Monitor for complications
What is the pathogenesis of chronic pyelonephritis?
Vesico-ureteral reflux of infected urine under pressure which can result in secondary FSGS
What disease is characterized by high blood calcium and heavy kappa light chain globulinuria?
Multiple myeloma
How does hypercalcemia affect the kidneys? (5)
Causes vasoconstriction of afferent arterioles of glomerulus resulting in decreased blood flow and GFR
Inhibits reabsorption of Na+ in LOH causing volume depletion
Reduces effect of ADH causing nephrogenic diabetes insipidus
Can cause kidney stones
Can cause nephrocalcinosis (precipitation of clacium phosphate)
What effects does multiple myeloma have on bone marrow and kidney?
Bone Marrow: anemia, lytic bone lesions, release of calcium (hypercalcemia)
Kidney: damage to glomeruli by excessive light chains causing amyloid pattern of kidney injury
What is the treatment of rmultiple myeloma (generally)? (3)
Treat cancer
Treat complications (esp. hypercalcemia)
Supportive Care