Term
| What are three causes of nephritic syndrome? |
|
Definition
-acute post infectious glomerulonephritis
-IgA nephropathy
-Hereditary nephritis |
|
|
Term
| Who does acute post-infectious glomerulonephritis effect typically? When? |
|
Definition
-typically children (3-14 yo)
-usually 1-4 weeks after streptococcal infection of the pharynx or skin (post-streptococcal glomerulonephritis) |
|
|
Term
| Name the common characteristics of acute post-infectious glomerulonephritis |
|
Definition
-proliferation, swelling of glomeruli
-infiltration of leukocytes
-subepithelial immune complexes ("humps") |
|
|
Term
| name some common signs and symptoms of acute post infectious glomerulonephritis |
|
Definition
onset abrupt with "smoky" tea-colored urine (hematuria), mild edema, oliguria, fever, nausea, nephritic syndrome
(sore throat, face bloat, pee coke) |
|
|
Term
| What is the most common primary glomerulonephritits world wide? |
|
Definition
| -IgA nephropathy (Berger Disease) |
|
|
Term
| What is the 'who' and 'when' for Berger Disease? |
|
Definition
-children and young adults
-1-2 days after URI |
|
|
Term
| In Berger disease, _______ deposits in _______, causing _______ |
|
Definition
|
|
Term
| Describe the course of Berger disease. What is the prognosis? |
|
Definition
-recurrent, variable course
-Slow progression to renal failure in 25-50% of pt's during a 20 year period |
|
|
Term
| Break down Berger Disease into 6 steps |
|
Definition
1. Genetic predisposition
2. URI or GI exposure to pathogen
3. Deposition of IgA immune complexes in mesangium
4. Activation of alternate complement pathway
5. GLomerular injury
6. Hematuria |
|
|
Term
| What is a pyelonephritis? |
|
Definition
| a bacterial infection of the kidney |
|
|
Term
| What are two different ways that acute pyelonephritis can occur? |
|
Definition
-usually ascending infection following UTI
-may be hematogenous infection following septicemia |
|
|
Term
| What are some symptoms of pyelonephritis? |
|
Definition
| -flank pain, fever, frequent urination with dysuria |
|
|
Term
| What do the kidneys look like in pyelonephritis? What is in the tubules? |
|
Definition
-enlarged, swollen, with yellow abscesses
-acute inflammatory infiltrates (PMNs) in the tubules |
|
|
Term
| What is used to treat acute pyelonephritis? |
|
Definition
| Antibiotic therapy (ciprofloxacin) |
|
|
Term
| What causes chronic pyelonephritis? What does it do to the kidney? |
|
Definition
-may evolve from recurrent acute pyelonephritis
-scarring, gradual renal insufficiency |
|
|
Term
| Can kidney stones occur anywhere in the urinary tract? where are they most common? |
|
Definition
| yes, they are most often in the kidney |
|
|
Term
| Of what are most kidney stones made? |
|
Definition
| most (80%) are formed from calcium oxalate or calcium oxalate mixed with calcium phosphate |
|
|
Term
| How do people get rid of their kidney stones? |
|
Definition
| -small stones may be excreted, but larger ones may require surgery |
|
|
Term
| What percentage of people get a kidney stone in there lifetime? Which sex is it more common in? WHat age group is most typically affected? Name 4 complications common. |
|
Definition
-5%
-Men
-20-30 yo
-Obstruction, pain, infection, hydronephrosis |
|
|
Term
| What is hydronephrosis? How does it develop? |
|
Definition
| Dilation of the renal pelvis due to parenchymal atrophy from urine outflow obstruction. May be sudden or slowly developing |
|
|
Term
| Hydronephrosis can be congenital or acquired, what causes each of these? |
|
Definition
-congenital: urethral atresia
-acquired: stones, tumors, neurogenic (bladder paralysis), pregnancy related (mild and reversible) |
|
|
Term
| What type of cancer is a renal cell cancer? |
|
Definition
| Malignant neoplasm (adenocarcinoma) arising from renal tubules |
|
|
Term
| What is a major risk factor for renal cell cancer? |
|
Definition
|
|
Term
| What does a renal cell adenocarcinoma look like? |
|
Definition
| golden-yellow tumor with zone of hemorrhage and necrosis |
|
|
Term
| Do renal cell adenocarcinomas often metastasize? |
|
Definition
| yes, widely: lung, bone, liver, brain |
|
|
Term
| What is the classic triad for renal cell adenocarcinoma? |
|
Definition
| hematuria, flank pain, palpable mass |
|
|
Term
| What is the prognosis for renal cell adenocarcinoma? |
|
Definition
| depends on the stage of the tumor, but 5 year survival about 40% (if metastatic- 5%) |
|
|
Term
| What is the tx for renal cell adenocarcinoma? |
|
Definition
-radical nephrectomy
-metastases often resistant to chemo and radiation |
|
|
Term
| What is the most common renal cell cancer? What causes it? |
|
Definition
-Clear cell carcinoma
-homozygous loss of VHL tumor suppressor gene |
|
|
Term
| Describe a papillary renal cell carcinoma: what is it due to? Is it bilateral or unilateral? |
|
Definition
-activating mutation of MET oncogene
-tend to be bilateral and multiple |
|
|
Term
| What is the most common solid tumor in infants and young children? |
|
Definition
|
|
Term
| Are wilms tumors often present at birth? When are they usually detected? |
|
Definition
| -yes present at birth, detected at 2-4 years |
|
|
Term
| From what are Wilms tumors derived? Are they malignant? |
|
Definition
-embryonic renal tissue (blastema)
-highly malignant, but curable with surgery and new chemo drugs |
|
|
Term
| What two genes are often involved in the development of a Wilms tumor? |
|
Definition
-WT1 gene: deletion (WAGR syndrome); dominant mutation (DDS)
-WT2 gene: disorder of genomic imprinting (BWS) |
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