Kidney And Urinary Tract

Front 1

What is complete or bilateral renal agenesis?

Back 1

1) Rare and not compatible with life
2) Involves the absence of both kidneys
3) Results in oligohydramnios (decreased amniotic fluid)
4) Multiple fetal anomalies

Front 2

What is unilateral renal agenesis?

Back 2

1) Much more common than complete renal agenesis
2) Absence of one kidney

Front 3

What is renal ectopia?

Back 3

Abnormal location of a kidney, frequently in the pelvis

Front 4

What is a horseshoe kidney?

Back 4

1) Refers to two kidneys joined at their lower poles
2) May caues urinary tract obstruction because of impingement of the ureters

Front 5

What are congenital anomalies of the ureters?

Back 5

1) May be doubled
2) Doubled ureters may affect the ureters alone or may be part of the duplication of the entire urinary collecting system on one side

Front 6

What is nephrotic syndrome?

Back 6

1) Increased basement membrane permeability
2) Permitting the urinary loss of plasma proteins
3) Particularly low-weight proteins, such as albumin

Front 7

What are the clinical manifestations of nephrotic syndrome?

Back 7

1) Massive proteinuria
2) Hypoalbuminemia
3) Generalized edema
4) Hyperlipidemia and hypercholesterolemia

Front 8

What is massive proteinuria regarding nephrotic syndrome?

Back 8

1) More than 4 g of protein per day
2) UNACCOMPANIED by increased urinary red cells or white cells.

Front 9

What is hypoalbuminemia regarding nephrotic syndrome?

Back 9

1) Results from proteinuria
2) Often marked by a serum concentration of less than 3g/100ml

Front 10

Describe generalized edema regarding nephrotic syndrome.

Back 10

Results from decreased plasma colloid oncotic pressure.

Front 11

What is hyperlipedemia and hypercholesterolemia regarding nephrotic system?

Back 11

Caused by increased hepatic lipoprotein synthesis.

Front 12

What is minimal change disease?

Back 12

1) Lipoid nephrosis
2) Young children mostly, but not only
3) Prototypical nephrotic syndrome
4) Lipid-laden cortices
5) Normal-appearing glomeruli by light microscopy
6) Normal electron microscopic findings except for disappearance of epithelial foot processes (fused together)
7) Responds well to adrenal steroid therapy

Front 13

What is focal segmental glomerulosclerosis?

Back 13

1) Similar to minimal change, but in older patients.
2) Sclerosis within capillary tufts of deep juxtamedullary glomeruli with focal or segmental distribution
3) Involvement of PART of SOME of the glomeruli

Front 14

What is membranous glomerulonephritis?

Back 14

1) Major primary cause of nephrotic syndrome
2) Immune complex dz of unknown etiology
3) Mostly teenagers and young adults
4) Suspect when nephrotic is with azotemia
5) Greatly thickened capillary walls visible as a 5-10 fold increase in BM thickness
6) Electron dense immune complexes in intramembranous and epimembranous locations
7) Spike and dome appearance resulting from the extension of basement membrane between and around the immune deposits.
8) IgG or C3 immunofluorescence (general characteristic of immune complex diseases)
9) Slowly progressive; little response to steroid therapy
10) Can cause renal vein thrombosis
11) Sometimes associated with HepB, syphilis, or malaria infection, gold salts, penicillamine, malignancy

Front 15

What is diabetic nephropathy?

Back 15

1) Nephrotic syndrome
2) Increase in thickness of GBM & Vascular BM
3) Increases in mesangial matrix leading to diffuse glomerulosclerosis and nodular glomerulosclerosis

Front 16

What is Renal amyloidosis?

Back 16

1) Cause of nephrotic syndrome
2) Subendothelial and mesangial amyloid deposits
3) Birefringence under polarized light
4) Criss-cross fibrillary pattern of amyloid by EM
5) Associated with chronic inflammatory dzs (RA, MM)

Front 17

What is Lupus nephropathy?

Back 17

1) Renal component of SLE; often determines the overall prognosis in patients with SLE
2) Often as nephrotic syndrome;
3) Can also have major nephritic features
4) Five types of subclassifications

Front 18

What is type I Lupus nephropathy?

Back 18

No observable renal involvement

Front 19

What is type II lupus nephropathy?

Back 19

1) Mesangial form
2) Focal and segmental glomerular involvement with an increase in # of mesangial cells and quantitative increase in matrix
3) Slight proteinuria and minimal hematuria
4) Little clinical consequence

Front 20

What is type III lupus nephropathy?

Back 20

1) Focal proliferative form
2) Usually involves less than half of the glomeruli
3) Can cause extensive damage to individual glomeruli

Front 21

What is type IV lupus nephropathy?

Back 21

1) Most severe form of disease
2) Often associated with combo of nephrotic and nephritic syndromes
3) Involves almost all of the glomeruli
4) Includes glomerular changes, such as marked inflammation with small focal thrombosies and mesangial proliferation, all resulting in extensive scarring
5) Wire-loop abnormality, due to immune complex deposition gross thickening of GBM
6) Endotheliam cell proliferation
7) Marked subendothelial immune complex deposition

Front 22

What is type V lupus nephropathy?

Back 22

Indistinguishable from primary membranous glomerulonephritis

Front 23

What is nephritic syndrome?

Back 23

1) Inflammatory rupture of the glomerular capillaries with resultant bleeding into the urinary space
2) Proteinuria and edema may be present, but are usually mild

Front 24

What are the clinical findings of nephritic syndrome?

Back 24

1) Oliguria
2) Azotemia
3) Hypertension
4) Hematuria
5) Red cell casts
6) Smokey brown urine