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43 Cards in this Set
- Front
- Back
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When are RBC casts seen?
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glomerular inflammation in nephritic syndromes
ischemia malignant hypertension |
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When are WBC casts seen?
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tubulointerstitial disease
acute pyelonephritis glomerular disorders |
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When are granular/muddy brown casts seen?
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Acute tubular necrosis
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When are waxy casts seen?
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Advanced renal disease/ CRF
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Acute PSGN
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Nephritic
LM - enlarged, hypercellular, PMNs, lumpy bumpy EM - subepithelial humps IF - granular pattern |
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Membranoproliferative
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Nephritis
EM- subendothelial humps, tram track |
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Rapidly progressive crescentic glomerulonephritis
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Nephritic
LM and IF - crescent shape |
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Goodpastures
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Nephritic
Type II hypersensitivity IF - linear pattern, anti-GBMK |
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IGA nephropathy
Berger's disease |
Nephritic
IF and EM - mesangial depositis of IgA |
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Alport's syndrome
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Nephritic
Split basement membrane Collagen IV mutation deafness and ocular disorders |
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Nephrotic syndrome
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massive proteinuria (frothy urine)
hypoalbuminemia peripheral and periorbital edema hyperlipidemia |
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Membranous glomerulonephritis
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Nephrotic - most common nephrotic of adults
LM - diffuse capillary and basement membrane thickening IF - granular EM- spike and dome |
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Minimal change disease
lipiod nephrosis |
Nephrotic
LM - normal glomeruli EM - foot process effacement |
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focal segmental glomerular sclerosis
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Nephrotic
LM - segmental sclerosis and hyalinosis |
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Diabetic nephropaty
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Nephrotic
LM - Kimmelstiel-Wilson nodular lesions, basement membrane thickening, mesangial expansion, glomerular sclerosi |
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SLE nephropathy
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LM - membranous glomerulonephritis pattern, wire-loop lesion with subendothelial deposists
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Calcium kidney stones
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Radiopaque
oxalate crystals can result form antifreeze or vitamin C abuse colorless octahedron/ envelope or dumbells |
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Ammonium magnesium phosphate
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Struvite.
Radiopaque or radiolucent worsend by alkauria (proteus, Staph, klebsiella) Rectangular prisms - coffin-lid |
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Uric acid
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Radiolucent
yellow- red/brown rhombus/diamond |
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Cystine
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2ndary to cystinuria
Radioopaque flat, yellow, hexagons |
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Transitional renal cell carcinoma
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most common tumor of urinary tract
Risks - Phenacetin Smoking Aniline dyes Cyclophophamide |
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Chronic pyelonephritis
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Coarse, asymmetric corticomedullary scarring, blunted calyx
eosinophilic casts due thyroidization of kidney |
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Diffuse cortical necrosis
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Acute generalized infarction of cortices of both kidneys
vasospasm and DIC obstetric catastrophes, septic shock |
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Renal papillary necrosis
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SEen with
Diabetes mellitus Acute pyelonephritis Chronic phenacetin use (acetominophen) Sickle cell anemia |
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Fanconi's syndrome
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Defect in proximal tubule transport of amino acids, glucose, phosphate, uric acid protein and electrolytes
Complications include rickets, osteomalacia, hypokalemia, metabolic acidosis |
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Dialysis cysts
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cortical and medullary cysts resulting form long-standing dialysis
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Medullary cystic disease
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Medullary cysts.
Small kidneys on ultrasound poor prognosis simple cysts are only in the cortex and are benign |
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MEdullary sponge disease
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collecting duct cysts
good prognosis no cysts in cortex, medulla only sometimes stones seen on uti |
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Hyponatremia
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disorientation, stupor coma
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Hypernatremia
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Neurologic - irritability, delirium, coma
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Hypochloremia
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Secondary to metabolic alkalosis.
Hypokalemia, hypovolemia, inc aldo |
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Hypercholermia
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secondary to non-anion gap acidosis
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Hypokalemia
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U waves on ECG
flattened T waves arrhythmias paralysis |
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Hyperkalemia
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Peaked T waves
wide QRS arrhythmias |
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Hypocalcemia
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Tetany
Neuromuscular irritability |
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Hypercalcemia
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Delirium
Renal stones Abd pain |
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Mannitol
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Osmotic diuretic
Increases tubular fluid somolarity, producing inc urine flow Used in shock, drug overdose, dec intracranial/intraocular pressure Toxicitiy pulmonary edema, dehydration Contraindicated in anuria, CHF |
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Acetazolamide
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Carbonic anhydrase inhibitor
Causes self-limited NaHCO3 diuresis and reduction in total body HCO3 stores USed in glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness Toxicities Hyperchloremic metabolic acidsois Neuropathy NH3 toxicity, sulfa allergy |
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Furosemide
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Sulfonamide loop diuretic. Inhibits cotransport Na,K, 2Cl systsem of thick ascending loop of Henle
Abolishes hypertonicity of medulla, preventing urine concentration. Toxicities Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), gout OH DANG |
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Ethacrynic acid
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Phynoxyacetic acid derivative
Works the same way as furosemide, but not a sulfa Can be used in gout, unlike furosemide |
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Hydrochlorothiazide
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Thiazide diuretic
Inhibits NaCl reabsorption in ealry distal tubule, reducing diluting capacity of the nephron. Dec Calcium excretion Used for HTN, CHF, idiopathic hypercalciuria, nephrogenic diabetes insipidus Toxicity Hypokalemic metabolick alkalosis, hypnatremia, hyperglycemia, hyperlipidemia, hyperurcemia, Sulfa |
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K sparing diuretics
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Spironolactone, Triamterene, Amiloride, eplerenone
Spironolactone is a competitive aldosterone receptor antagonist in the cortical collecting tubule Triamterene and amiloride act at the same part of the tubule by blocking Na channels in CCT Used for hyperaldosteronism, K depletion, CHF Toxicity - hyperkalemia spironolactone - gynecomastia, antiandrogens |
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Wilm's tumor
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Most common primary renal tumor in children, b/n ages 2-5
sporadic most common Genetic type - autosomal dominant inheritance on chr 11, WLT gene WAGR syndrme Wilms tumor, aniridia (absent iris), genital abnormalities, MR Beckwith-Wiedemann syndrome - Wilm's tumor, enlarged body organs, hemihypertorphy of extremities Causes hypertension. unilateral flank mass. good prognosis |
