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28 Cards in this Set
- Front
- Back
Untreated, this leads to "Tiny Tim's disease":
collecting duct doesn't respond to ADH: RBC casts indicate ______ damage. name for cholesterol-rich cells/casts in urinary sediment of nephrotic syndrome: |
RTA Type 1
nephrogenic DI glomerular hot cross buns, Maltese crosses |
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Narrowing of arteries/arterioles supplying kidney leads to:
systemic ____. too _____ filtrate produced, too _____ Na+, H2O resorbed too _____ renin. |
systemic HTN
too little filtrate too much Na+, H2O too much renin |
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hematuria, RBC casts, mild-moderate proteinuria, oliguria, HTN, mild edema:
What kidney diseases cause nephritic syndrome? excessive permeability of filtration membrane to plasma proteins: nephrotic syndrome = loss of _______ protein from podocytes |
nephritic syndrome
all DPGN, mild-early RPGN, bad IGA, bacterial endocarditis, MPGN nephrotic syndrome nephrin |
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Causes include amyloidosis, diabetic glom disease, MCD, FSGS, membranous GP, MPGN:
Nephrotic syndrome - pts are at risk for thrombosis because of loss of ______. GBM ruptured, crescents of fibrin and cells form in Bowman's space: RPGN I, II, III and immunofluoroescence pattern: |
nephrotic syndrome
AT-III RPGN I - Anti-GBM (Goodpasture's, if it includes lung problems) - linear II - immune complex deposits - lumpy, bumpy fluorescence III - vasculitis - Wegeners, polyarteritis nodosa - no fluorescence |
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Mostly likely cause of asymptomatic hematuria:
has a mutated ________. endothelial damage, platelet microthrombus formation in renal vascular bed --> RBC fragmentation (schistocytes) and renal failure: bacteria infection of kidney --> flank pain, fever, proteinuria, pyuria: |
thin-GBM disease
collagen IV HUS pyelonephritis |
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ARF usually presents as _____ and ______. Also causes hyper________.
Renal HTN results from _____ GFR and ______ renin. PCKD: genetic defect on chromosome ____. pathology of PCKD? group of diseases, with cysts at the corticomedullary junction, severe damage to the cortex: |
oliguria and azotemia, hyperkalemia
decrease GFR, increased renin PCKD - chromosome 16 hundreds of cysts form throughout kidney, crowd normal tissue (undergoes apoptosis) uremic medullary cystic diseases |
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Diffuse vs focal GN:
Global vs segmental GN: Global is usually _____, segmental usually _____, except for _______. |
diffuse - all gloms, focal - <80%
global - entire glom, segmental - part of the glom global - diffuse, segmental - focal, except for glom damage from HTN - focal global. |
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What causes mesangial cell proliferation?
foot process fusion is common cause of _________, and characteristic finding in _____, ________. changes in the glom from ischemia? |
platelet derived growth factor
cause of nephrotic syndrome characteristic in MCD, FSGS corrugation/thickening of GBM and Bowman's basement membrane (crumpling) --> whole glom replaced with collagen - tuft is PAS+ at the vascular pole |
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immunofluorescence pattern for:
Anti-GBM (Goodpasture's) - immune complex: Most common etiology of DPGN: immune response to what antigen? Lab findings of post-strep GN? other causes of DPGN? |
Anti-GBM - linear
immune complex - coarse granular post-strep GN M protein, ASO+, C3 decreased bacterial endocarditis, infected shunts, sepsis |
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Anti-GBM disease with RPGN and lung hemorrhages:
drug that causes Goodpasture's: Anti-GBM - what type of immunofluorescence? Causes of RPGN II? Causes of RPGN III? |
Goodpasture's
penicillamine linear bad immune complex diseases - post strep, etc no immune deposits - systemic vasculitis (Wegeners, Churg-Strauss, bad RA) |
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Tx of RPGN III, segmental necrotizing GN?
major IG in mesangial proliferative GN? immunofluorescence pattern? most common cuase of nephrotic syndrome in adults: immunofluorescence pattern? |
cyclophosphamide, prednisone
IGA "tree in winter" membranous GP finely granular IGG |
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causes of membranous GP?
commonest cause of nephrotic syndrome in children: many adults with MCD usually have _______. Diffuse loss of foot processes, non-selective proteinuria, oliguria, HTN --> CRF: Effect on vessels? |
SLE, NSAIDs, infections - Hep B, syphilis, gold, post-transplant, cancer
MCD Hodgkin's FSGS always hyaline arteriolar sclerosis |
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Common causes of FSGS?
Membranoproliferative GN Type I: immunofluorescence pattern? GBM appearance? Difference in MPGN Type II? most common serious glomerular disease? treatment for IGA nephropathy? |
AIDS nephropathy, heroin nephropathy, reflux
MPGN Type I: coarse granules GBM - train tracks MPGN II - C3 only, no IG, "worms" on immuno idiopathic IGA nephropathy glucocorticoids, fish oil |
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purpuric dermal lesions on LE, butt, abd pain, GI bleed, arthalgia, renal abnormalities:
Renal failure is the cause of death in 30-40% of people with ______. Lupus class with immune-complex deposits in mesangial space, maybe mesangial proliferation: Lupus with no renal lesion: |
Henoch-Schonlein purpura
SLE Lupus Class II Lupus Class I |
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Lupus with massive deposits of wire-loop immune complexes, necrosis of gloms, pts typically have acute nephritic syndrome:
Lupus with immune complexes in various places, focal/segmental proliferation: Lupus with nephrotic syndrome, mixed histology: |
Lupus Class IV
Lupus Class III Lupus Class V |
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Most common cause of ESRD?
changes in kidney? amyloidosis pts often get __________. mild, common family of illnesses, usually present as asymptomatic hematuria during childhood: presence of marginally soluble proteins the gel in cold or local hemoconcentration of a glom: |
diabetic GS
hyperfiltration, thickened GBM, increased mesangial matrix (diffuse GS) nephrotic syndrome thin GBM disease (NOWELL'S LAW) cryoglobulinemia |
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X-linked, deafness, progressive nephritis, defect in collagen IV:
tiny kneecaps, hypoplasia of the fingernails, chunks of Type III collagen in glom, mutant LMX1B gene: What causes Pierson's syndrome? (congenital nephrotic syndrome) |
Alport's
nail-patella syndrome mutant B-2 laminin |
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Major causes of nephrotic syndrome?
most common cause of urine turning red? Common systemic cause of Fanconi's syndrome? Defective Na/K/2Cl cotransporter in ascending limb, low K+, metabolic alkalosis, normal BP: |
diabetes, amyloidosis, membranous GP, FSGS/MCD, MPGN
exercise Wilson's disease Bartter's |
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Super-avid Na-Cl co transporter in DCT, low Ca++, K+, metabolic alkalosis:
Super-avid Na+ retention, K+ loss, distal nephron - bad HTN ARF caused by damage to tubular epithelial cells: two types of ATN? |
Gitelman's
Liddle's acute tubular necrosis ischemic: hemorrhage, septic shock, contrast media nephrotoxic: heavy metals (Hg), organic solvents (CCl4, ethylene glycol), antimicrobials |
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fever, flank pain, PMN's and WBC casts in urine:
What drug can cause papillary necrosis? Most common cause of acute drug-induced nephritis? Other drugs? Most common cause of outpatient renal shutdown? |
acute pyelonephritis
ASA most common: methicillin others: Sulfa, rifampin, cyclosporine, PCN, Lasix, TZ's NSAID use |
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hydropic change in PCT cells, microcalcifications, giant mitochondria, necrosis of smooth muscle: Which drug?
Hypokalemic nephropathy: Pt can't ________ urine. proteins found in tubules that precipitates in plasma cell myeloma: |
cyclosporine
hypoK+: pt can't concentrate urine Bence-Jones protein |
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rapidly progressive interstitial nephritis, occurs in well-defined areas of Romania, Yugoslavia, Bulgaria:
collecting duct can't respond to ADH: Gout occurs when a pt has high ________ in the body. Treatment drug for gout? |
Balkan nephropathy
nephrogenic DI gout: high uric acid colchicine |
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Major mechanism for essential HTN?
What protein is often elevated in HTN, regardless of etiology? essential HTN is the most common cause of ___________ in the kidney. Appearance of kidney in HTN? |
general arteriolar vasoconstriction, inability to get rid of salt load
endothelin Arteriolar nephrosclerosis "sandpaper" |
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HTN causing papilledema and necrosis of vessels:
What two diseases often end in malignant HTN? What drug can easily cause it? How does renal artery stenosis cause HTN? |
malignant HTN
Scleroderma, adult HUS cocaine increased renin secretion |
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platelet clumping in small renal vessels --> microangiopathic hemolysis, thrombocytopenia, ARF:
Difference between HUS and DIC? most important cause of renal shutdown in kids? bacterial known for causing HUS? |
HUS
HUS - normal fibrinogen, PT, PTT childhood HUS EHEC O157:H7 |
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Kidney stones usually form in ______.
Most common? hypercalcemia in pt first presenting with kidney stone is probably due to _______. Mg/NH4+/PO4 stones usually indicative of: |
renal pelvis
Ca oxalate parathyroid adenoma Proteus infection - urea-splitting |
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Which gene is almost always deleted in clear-cell RCC?
Where do RCC's develop? Why is it unusual for a carcinoma? about 50% of RCC's mets to the renal vein to the _________, causing RHF: |
VHL anti-oncogene (Von Hippel Landau)
PCT cell mets by the bloodstream triscuspid valve |
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common pediatric tumor, WT1 deletion:
explain "nuclear unrest" in Wilms tumors: |
Wilm's tumor
nuclei appear anaplastic, but no abnormal mitotic figures |