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44 Cards in this Set
- Front
- Back
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Azotemia |
elevation of BUN and Creatinine, due to decreased GFR |
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Prerenal Azotemia |
occurs during hypoperfusion of the kidney
(CHF, shock, hemorrhage) |
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Postrental Azotemia |
Occurs when urinary outflow is compromised |
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Uremia |
signs of azotemia, include: metabolic, hemtologic, cardiovascular, and endocrine effects |
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Nephrotic Syndrome |
>3.5g/day proteinurea, hypoalbuminemia, hyperlipidemia, and edema |
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Nephritic Syndrome |
hematuria, mild to moderate proteinuria, hypertension, due to glomerular injury |
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Rapidly Progressive Glomerulonephritis |
nephritic syndrome with rapid decline in GFR |
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Phases of Renal Failure |
1. Diminished Renal Reserve- 50% GFR 2. Renal Insufficiency- 20-50% GFR 3. Chronic Renal Failure- <20% GFR 4. End Stage renal Disease- <5% GFR |
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Horseshoe Kidney |
Most common congenital anomaly
Kidney is abnormally located in lower abdomen due to Inferior Mesenteric artery |
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Renal Agenisis |
may be unilateral or bilateral (Potters sequence)
Unilateral- asymptomatic until later in life when hyperfiltration injury may occur
Bilateral- incompatible with life, causes oligohyrdaminos (no amniotic fluid) leads to facial deformation hypoplasia of the lungs, and extremity deformity |
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Dysplastic Kidney |
noninheritied- characterized by cysts and abnormal cartilage.
Typically only affects a single kidney. |
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Polycystic Kidney Disease |
Inherited- bilateral enlarged kidneys
leads to enlarged kidneys with cysts in both cortex and medulla.
AR- infantile, associated with hepatic fibrosis AD- adult form, due to AKPD1/2 cysts develop overtime. |
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Medullary Cystic Kidney Disease |
leads to small kidneys and fibrosis of the medulla over time. |
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ARF |
Acute Renal Failure
hallmark Azotemia, with oliguria |
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Acute Tubular Necrosis |
(Intrarenal Azotemia)- injury and necrosis of tubular epithelium
Can be ischemic: decreased blood supply often prerenal azotemia
nephrotoxic: drugs, chemicals damage proximal tubule |
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Acute Interstitial Nephritis |
drug induced hypesensitivity
NSAIDs, Penicillin, diuretics |
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Renal Papillary Necrosis |
necrosis of renal papillae
presents with gross hematuria and flank pain
Analgesic Abuse Diabetes Sickle Cell Pyelonephritis |
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Nephrotic Syndrome |
Hypoalbuminemia- pitting edema (decreased osmotic pressure) Hypogammaglobulinemia- increased infection Hypercoaguable state- loss of AT III Hyperlipidemia- beefs up blood |
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MCD |
Minimal Change Disease- common in children
No immunofluorescence, it is an effacement of foot process (podocytes)
Treat with Steroids |
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FSGS |
Focal Segment Glomerulosclerosis
Commonly seen in AfroAmericans/Hispanics Assoc- w/ AIDs/Heroin/SickleCellDisease
Some glomeruli/some parts of it
No IF, w/ effacement of podocytes
Poor response to steroids |
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Membranous Nephropathy |
commonly seen in White adults
HepB/C, tumors, SLE, or drugs
Thick glomerular membranes w/ granular IF
Subepithelial deposit with "spike and dome" Poor response to steroids |
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Membarnoproliferative Glomerulonephritis |
Thick "tram-track glomerular membranes w/ granular IF
Type I- subendothelial (HBV/HCV) Type II- intramembranous assoc. w/ C3 nephritic factor which stabilizes C3 convertase |
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Diabetes Mellitus |
high serum glucose leads to glycosylation of membrane and hyaline arteriolosclerosis
Efferent artierole is most affected leading to high GFR
ACE Inhibitors can slow progression |
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Systemic Amyloidosis |
most commonly involved organ in amyloidosis
deposits in mesangium and results in nephrotic
Apple green birefringence and Congo Red Stain |
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Nephritic Syndrome |
Characterized by inflammation and bleeding
<3.5g/day = limited protienuria RBC Casts in urine= hematuria |
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PSGN |
Postreptoccal Glomerulonephritis
arises after infectino with Group A Beta Hemolytic strep of skin or phaynx
M protien for kidney... present 2-3 weeks after with hematuria, HTN, and periorbital edema.
Granular IF, subepithelial humps |
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Rapidly Progressive Glomerulonephritis |
nephritis that progresses quickly to renal failure
Crescents in the bowman space (fibrin and macs)
clinical picture and IF determine etiology |
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Linear IF Pattern |
Goodpasture Syndrome: antibody against collagen in glomerular and basement membranes
seen in young adults |
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Granular |
Immune Complex Deposition
PSGN or diffuse proliferative glomerulonephritis
common type of renal disease in SLE |
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Negative IF |
Pauci Immune (immune limited)
wegener granulomatosis, microscopic polyangitis, Churg-Strauss Syndrome
c-ANCA and p-ANCA |
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IgA Nephropathy |
Berger Disease
IgA deposits in the mesangium, most common
Follows mucusal infections |
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Alport Syndrome |
familial defect in type IV Collagen (x-linked)
thins and splits glomerular basement membrane |
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UTI |
Urinary Tract Infection
bladder, ureter, kidney, urethra
Arises due to ascending infection, increased risk in Females
Sex, urinary stasis, and catheters increase risk |
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Cystitis |
Infection of the Bladder
Dysuria, polyuria, suprapubic pain
Urinalysis: cloudy w/ >10 WBC Dipstick: + pyuria Culture: greater than 100000
E. Coli, Staph Sapro, K. Pneumonae, Proteus Mirabillis |
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Pyelonephritis |
infection of the kidney- systemic symptoms
fever, flank pain, WBC Casts, leukocytosis
E. Coli, Entero Faecalis, Klebsiella |
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Chronic Pyelonephritis |
interstital fibrosis and atrophy of tubules due to multiple infections
vesicoureteral reflux or obstruction (BPH) |
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Nephrolithiasis |
precipitation of urinary solute as a stone
risk factors= high concentration of solute, low urine volume
Colicky pain with hematuria and flank pain |
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Calcium Oxalate |
most common type in adults
hypercalcemia and Crohns disease
Hydrocholothiazide |
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AMP |
Ammonium Maganesium phosphate
Second most common, alkaline urine leads to stone
staghorn caliculi in the calyces. Need surgery to remove |
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Uric Acid |
third most common, does not show up on X-Ray
Often seen in patients with Gout
Treat: Hydration, and alkalinization of urine |
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Cysteine |
seen in children, genetic defect in tubules that decreases reabsoprtion of cysteine
May form staghorns |
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Angiomyolipoma |
Hamartoma of bloodvessels, muscle, and fat |
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Renal Cell Carcinoma |
malignant epithelial tumor of the tubules
Hematurie, Palpable mass, and Flank pain
Can present with left sided varicocele due to left renal vein block. |
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Wilms Tumor |
malignant kidney involving the blastema (immature mesenchyme) |
