Flashcards in Week 2 Deck (47):
Rapidly progressive (Crescentic) glomerulonephritis : Type __: Anti GBM- Idiopathic more than __% of the time. Good pastures syndrome: Characterized by development of autoimmune aggression against __ and __ basement membranes. Antibodies form against antigens of membranes. Type __ hypersensitivity reaction.
Good Pasture's: Alveolar basement membrane- ___ (coughing up blood) Inflammation of this membrane causes the formation of ___ in the __ and they can no longer exchange ___
Good Pasture's: Glomerular basement membrane- here there is destruction of __ around the membranes. This is curable via ___. Blood from the arterioles is centrifuged and the blood cells are removed from the ___ in the plasma then reinjected into the body. Involves which 2 systems?
Rapidly Progressive (Crescentic) Glomerulonephritis: Type 2 (Immune complex deposition): Systemic Lupus Erythematosus- Type __ Hypersensitivity reaction: Classic AI disease that involves young ladies and is more common in __ __. What are some causes?
Rapidly Progressive (Crescentic) Glomerulonephritis: Type 2 (Immune complex deposition) Systemic Lupus Erythematosus: AI reaction against antigens of __ and __. Mostly involves the __(4)__
Rapidly Progressive (Crescentic) Glomerulonephritis: Type 2 (Immune complex deposition) Systemic Lupus Erythematosus: results in serious ___ and possibly ___. Primary manifestation of systemic lupus is the __ __.
Systemic Lupus Erythematosus: Systemic Lupus: Involvement of the __ develops quickly. This is the major cause of death in this disease. Vasculitis of __ vessels is possible in SLE. Survival is __% of the time. Tx is __ (corticosteroid)
Systemic Lupus Erythematosus: Post Infection may be part of type __. Henoch Schonlein Purpura- ( ___ vasulitis)- usually develops in ___.
Boys (in 20s)
Henoch Schonlein is characterized by what 4 syndromes?
Abdominal syndrome is characterized by __ __ of the __ and __ walls (gastroduodenitis)
Cutaneous Syndrome is characterized by __ hemorrhages in the __ and __- leads to __ rash
Articular syndrome is characterized by __ __ or at least __ in the __
Crescentic glomerulonephritis: If the pt has the 1st 3 syndromes, the addition of crescentic glomerular nephritis makes the prognosis worse: __% survival
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: MOST DANGEROUS: Type __ Hypersensitivity reaction- Is characterized by the development of ___. It is inflammation of the vasular wall and manifested by what kind of antibodies?
NO Hypersensitivity reaction
anti-neutrophil plasmocytic auto-antibodies
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: What are the 5 types?
Idiopathic (more than 50%)
IgA Nephropathy (AKA Berger's)
Buerger's (AKA Thromboangitis Obliterans)
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Wegener's Granulomatosus: Develops in middle aged __. Characterized by necrotizing vasculitis of the upper and lower __ tract and rapid progression of __. You see a melting of the __ of the __ which can lead to __ and __ inflammation. Pt is undergoing decay.
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Wegener's Granulomatosus: What will the pt. die from?
Acute renal failure or secodary complications
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Polyarteritis Nodosa: vasculitis of the vessels throughout the body with __ of the arteriole wall, which gives it the name nodosa. Pouching can lead to __ of the wall and __ of the lumen. These nodes are on every __ of the body and causes __. This disease can manifest everywhere but where?
-Lungs and arch of Aorta
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: IgA Nephropathy (Berger's): ___ following __ __ infection. Many cases month after month. Could also be cause by acute __ or __ infection. Pt will experience pain in the __.
loin (lumbar spine)
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: IgA Nephropathy (Berger's): Hallmark is deposition of __ complexes into the immune mesangium. (__% increase). There will also be increased concentration of IgA in the __. Can manifest with __ __ __. If not controlled can switch to __ __
What is the most common glomerular disease worldwide?
Berger's (IgA Nephropathy)
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Buerger Disease: Characterized by vaculitis of the __ and __ sized arteries. Predominant in __ and __ arteries. If it is in the veins will cause __. Will cause inflammation of the __.
Type 3 Rapidly Progressive (Crescentic) Glomerulonephritis: Buerger Disease: Common in people who __ and common in which countries? Characterized by __ syndrome and smoking. Will cause instep claudication- __ on walking, then will stop, walk more, stop again, etc... The muscles need more __ supply but they aren't getting enough because of vessel dysfunction. Results in __ of extremities.
India and Israel
Nephrotic Syndrome: Damage to __. There is decreased permeability of __ and draatically increased permeability of __ (primary probem), especially __. Escape from the blood to the urine.
Massive (heavy) priteinuria is more than __ grams. There is especially loss of __
Nephrotic syndrome is manifested by what 4 things?
Nephrotic Syndrome: Hypoalbuminemia- When the correct levels of albumin are outside and inside the vessel, this creates the __ pressure. When the albumins are allowed to escape into the tissues it creates more pressure in the __. There will be loss in blood __ and __ will try to retain water and the fluid will be retained in the __
Nephrotic Syndrome: Hyperlipidemia/ lipiduria- Body wants to restore the number of proteins so there is an increase in number of __ by the liver resulting in hyperlipidemia and lipiduria. Will cause __ __ to form. Changes the __:__ ratio because of loss of albumin.
Nephrotic Syndrome: Hyperlipidemia/ lipiduria- What are the 3 proteins in blood and in what percentages?
Prevent escape of fluif portion of blood into surrounding tissue
-maintains oncotic pressure
-ratio of albumins to globulin is greater than 1 (55/45)
With Nephrotic syndrome, the ration changes to less than 1
Repair damaged skin
Nephrotic Syndrome: Whata re the primary Glomerular disease that may lead to this?
Minimal change disease (lipoid nephrosis)
Focal Segmental GMN --> Chronic GMN --> Renal Failure
Nephrotic Syndrome: What systemic Diseases may cause this?
What is the most dangerous Nephrotic condition?
Which 2 diseases are associated with Nephrotic Syndrome?
IgA Nephropathy (Berger)
Alport Syndrome: Common in __ __. Posterior Cataract, __ dislocation and corneal __. Also causes __ damage due to nerve deafness.
Acute Pyelonephritis: Definition?
Supprative inflammation of the kidney pelvis and parenchyme
Acute Pyelonephritis: How does the infection get to the kidney?
-Through the blood (must have bacteremia)
-Through lymphatic vessels
-Ascending Route: MC. (through Bladder) Problem with bladder valve allows infection to go back into bladder.
-Common cause is E. coli
What are 2 problems associated witha cute pyelonephritis?
Formation of pus in kidney parenchyme (abcess)
Development of necrotizing papilitis- especially in DM
-will see many WBCs that cover field of vision
-will also see WBC casts
Acute Pyelonephritis manifestations
High fever- and chills: causes shaking
pain of posterior thorax (+ murphys punch)
Bacteria and WBC casts in urinalysis
Increased blood in urine
Abcess of kidney parenchyme
Acute Pyelonephritis can develop __ necrosis or necrotizing __- can cause gross __. More typical for nephropathy is __ __
Acute Pyelonephritis Tx
Antibiotics. Very effective. If pt doesnt recover it becomes chronic pyelonephritis wich can result in chronic renal failure. Treat to full recovery.
MCC of chronic renal failure
-dialysis works for 2-3 years
-kidney replacemen may work but usually not successful
Diabetic Nephropathy: What are the 3 factors?
Renal Vascular lesions
Diabetic Nephropathy: Glomerular lesions cause thickening of ___. Also causes diffuse increase of __ matrix (diffuse glomerulosclerosis). Nodular glomerulosclerosis is characterized by __-__ lesions- ball-like deposits of laminated __ within the mesangium.