Disease/pharm/quiz/review

Primary vs secondary vs antibody-associated glomerulopathy

Primary= kidney is the only/predominant organ involved, secondary= glomerular injury secondary to systemic disease antibody-associated= deposition of circulating antigen-antibody complexes or antibody reaction to in situ antigens

NephrITIC syndrome

Hypertension, hematuria (blood in urine), oliguria (low urine output), mild to moderate proteinuria, RBC casts, mild azotemia/increase in BUN and creatinine, decreased GFR

NephrOTIC syndrome

Peripheral edema due to proteinuria, hypoalbuminemia, lipiduria, urinary sediment, hyperlipidemia

Acute vs chronic renal failure

Acute: oligouria (reduced) or anuria (no urine flow), recent onset of azotemia (numbers, no symp)

Chronic: prolonged symptoms of uremia, end result of renal parenchymal diseases

Minimal change disease

Most common cause of nephrOTIC syndrome in children, due to podocyte injury, fusion of foot processes

Membranous neuropathy

Most common cause of nephrOTIC syndrome in adults, mostly primary, subepithelial (between GBM and epithelial cells) immune complex deposition

MPGN

Traintrack appearance on some stains

Type 1= subendothelial immune complex deposits

Type 2= dense-deposit disease

Acute Proliferative glomerulonephritis

Immune mediated, common in children 1-4 weeks after a group A streptococcal infection, glomerular hypercellularity with electron-dense subepithelial hump

RPGN

Epithelial crescents, rapid decline in renal function, 90% require dialysis or transplant

IgA Nephropathy

Most common glomerular disease worldwide, mesangial deposition of IgA

ADPKD

Adult onset, bilateral, expanding cysts that destroy renal parenchyma, inherited, berry aneurisms and liver cysts common

Pyelonephritis

Bacterial infection of kidney and renal pelvis, often ecoli, flank pain, fever, chills, bladder irritation, scarring and deformity of pelvis/calyces, blunting of papillae, interstitial fibrosis, thyroidization, most common route of infection= ascending

Hydronephrosis

Caused by obstruction of urinary flow at any level of tract, dilation of renal pelvis and calyces with atrophy of renal parenchyma, uni or bilateral

Wilms’ Tumor/Nephroblastoma

4th most common pediatric malignancy in US, mostly sporadic occurance, blasternal, stromal, and epithelial components

Renal Cell Carcinoma

80-90% of renal malignancies, adults, characteristic yellow-orange module, highly vascular, cystic, and hemorrhagic, most common= clear cell

Membranous nephropathy and post-streptococcal glomerulonephritis are similar in that they both:

Both are immune mediated glomerular disorders

The organism most frequently implicated as the cause of acute pyelonephritis is:

Escherichia coli

Which change would you expect to find in a dehydrated person deprived of water for 24 hours? 

Increased water permeability of the collecting duct

A 3-year old girl presents with generalized edema shortly after recovery from an upper respiratory tract infection. Laboratory studies reveal marled albuminuria, as well as hypoalbuminemia, and hyperlipidemia.  Prior similar episodes responded to adrenal steroid medication.  The most likely diagnosis is: 

Minimal change disease

A person develops a decreased arterial PCO₂ because of hyperventilation.  If this condition persists, what response would one expect by the kidneys? 

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