Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
17 Cards in this Set
- Front
- Back
Acute Interstitial (Hypersensitivity) Nephritis
|
ARF with interstitial inflammatory cells
Causes: idiopathic (no Ephils), drugs, infections, etc. Drug causes include: NSAIDs, Methicillin, Anti-biotics, Diuretics Mechanism is ALLERGIC Acute deterioration of renal function (improves on cessation of drug use) Treatment is supportive Stop drug --> usually fully reversible |
|
Chronic Interstitial Nephritis
|
CRF with mixed infiltrate in interstitium
Tubular atrophy and fibrosis Mechanism is Physical/Chemical or Ischemic Main causes: drugs (NSAIDs, lithium), UTO, stones, PCKD Asymmetrically scarred, shrunken kidneys Remove inciting agent Support renal failure |
|
Acute Pyelonephritis
|
Usually due to bacterial infection
Ascending infections affect pelvis Hematogenous infections affect cortex Presents as fever, chills, flank pain Predisposed: pregnant women, diabetics, catheters Ascending --> E. Coli; Hematogenous --> Staph Aureus Acute inflammatory infiltrate of tubules Treatment is anti-biotics |
|
Chronic Pyelonephritis
|
Infections secondary to vesicuretereal reflux
Small kidneys with coarse scars, dilated papillae, atrophy Non-specific interstitial infiltrate Tubular atrophy with "THYROIDIZATION" Fibrosis, Glomerulosclerosis Treatment is support and treatment of hypertension Prophylactic anti-biotics to prevent UTIs |
|
Acute Tubular Necrosis
|
Most common cause of ARF
ARF secondary to tubular damage Causes: ischemic, POST-TRANSPLANT, toxic, obstructive Phases: oliguric, diuretic, regenerative Histo -- Prox. tubular epithelial cell degeneration, interstitial edema Mitotic activity in regenerative phase Treatment is supportive 30% return to normal renal function Poor prognostic factors: severe oliguria |
|
Papillary Necrosis
|
Predisposed: analgesic use (PHENACETIN), diabetics, sickle cell pts.
Histo -- acute inflammation in papillae, with necrosis |
|
Urolithiasis
|
5% of women; 10% of men
40 - 70% recur 50% symptomatic within 5 yrs. SEVERE PAIN Etiology: idiopathic (75%), Infection (15%), Hypercalciuria |
|
Autosomal Dominant Polycystic Kidney Disease (ADPKD)
|
Very large cystic kidneys
NO dysplasia ALL portions of neprhon involved (bilateral) Declining renal function --> 50% ESRD Cysts also in liver, spleen, and pancreas (do NOT affect function) MV prolapse (25%), Cerebral aneurysms (10-20% [15% of deaths]) PKD 1, 2, 3 encode polycystins (85%, 15%, <1%) Effect cell-cell and cell-matrix interactions |
|
Autosomal Recessive Polycystic Kidney Disease (ARPKD)
|
Large, SMOOTH kidneys
Narrow cysts perpendicular to capsule Involves COLLECTING DUCTS Often fatal @ birth or postnatally Pancreatic and hepatic cysts (DO affect function) PKHD1 gene encodes fibrocystin |
|
Dialysis Related Cysts
|
75% after 5 yrs on dialysis
Form stones --> hematuria RCC in 5-10% BOTH cortical and medullary |
|
Benign Simple Cystic Disease
|
Translucent cysts on surface of cortex
NO clinical significance 50% once older than 50 |
|
Multicystic Renal Dysplasia
|
Usually UNILATERAL
Multiple cysts of variable size Misshapen kidney Most common cause of abdominal mass in newborns |
|
Acute Cellular Rejection
|
Most common form
Usually within first 3 months (can occur any time) Presents with rising creatinine and fever Histo -- tubulitis, interstitial inflammation Treat wih increased immunosuppression Can have a vascular component |
|
Acute Humoral Rejection
|
Affects capillaries
Can use fluorescent Abs to C4d to diagnose Also, increased donor-specific Abs Rarely, severe with necrotizing arteritis |
|
Chronic Allograft Nephropathy
|
Most frequent cause of graft loss today
Creatinine SLOWLY rises Non-specific tubular atrophy, interstitial inflammation, glomerular sclerosis |
|
Calcineurin-Inhibitor Toxicity
|
Causes NODULAR HYALINIZATION of arterioles
Also, causes changes identical to chronic rejection |
|
Recurrent disease in grafts
|
Type II MPGN (100%)
Diabetic GN (>90%) IgA Nephropathy (40-60%) FSGN (35%) Loss of graft is rare in all of them EXCEPT for FSGN (10-30%) |