Term
List the 4 main functions of the kidney |
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Definition
-excretion of waste products -regulation of water/salt -maintenance of acid/base balance -secretion of hormones |
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Term
Is glomerular disease usually acquired or congenital? |
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Definition
usually acquired, rarely congenital |
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Term
What is the difference between primary and secondary glomerular diseases? |
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Definition
-primary: the kidney is the only (or predominant) organ affected -secondary: associated with systemic conditions such as DM, HTN, or SLE |
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Term
Most acquired glomerular disease has an __________ basis |
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Definition
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Term
What is the immune basis of glomerular disease? |
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Definition
-circulating antigen-antibody complexes lodge in the glomerular basement membrane (GMB) -autoantibodies bind to antigens on GBM -These trigger a local inflammatory response involving complement and WBCs, damaging the glomerulus |
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Term
What are the two classifications of glomerular disorders? |
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Definition
-those that manifest with predominantly high-level proteinuria (nephrotic syndrome) -those that manifest with predominantly high-level hematuria (nephritic syndrome) |
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Term
What are 6 signs and symptoms of nephrotic syndrome? |
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Definition
-massive proteinuria (>3.5 g/day) -hypoalbuminemia -severe edema -hyperlipidemia -lipiduria -diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction |
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Term
What is the most common cause of nephrotic syndrome in adults? |
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Definition
focal and segmental glomerulosclerosis (FSGC) |
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Term
What is FSGC, is it usually primary or secondary? What is the tx? What is the prognosis? |
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Definition
-may be primary -secondary event with other diseases (HIV, heroin use, IgA nephropathy, maladaption to nephron loss, congenital disorders) -response to corticosteroid is poor -Prognosis is poor: 50% suffer renal failure after 10 years |
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Term
What is usually the initiating event in FSGC? how does sclerosis develop? |
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Definition
-damage to the podocyte -deposition of hyaline masses in the glomeruli represents the entrapment of plasma proteins and lipids in the foci of injury where sclerosis develops |
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Term
Is recurrence of FSGC common post transplant? |
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Definition
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Term
What is the most common cause of nephrotic syndrome in children? |
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Definition
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Term
How does minimal change disease develop? What can be seen on microscopic exam? What is the tx? |
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Definition
-insidious development in otherwise healthy kids -minimal light microscopic changes with some effacement of foot process and podocytes -more than 90% of cases respond to a short course of corticosteroids |
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Term
What causes membranous neuropathy? (MN) |
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Definition
autoimmune reaction to an unknown renal antigen |
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Term
What is physically happening in MN? |
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Definition
-subepithelial immune deposits -thickening of GBM -subepithelial spikes of GBM between the immune deposits -little or no inflammation |
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Term
How does MN develop? What is the tx? |
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Definition
insidious does not respond well to corticosteroid therapy |
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Term
What are 4 common signs and symptoms of nephritic syndrome? |
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Definition
hematuria oliguria with azotemia proteinuria hypertension |
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Term
What is nephritic syndrome most commonly caused by? |
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Definition
-proliferation of cells within the glomeruli -leukocyte infiltration -inflammatory response injures capillary walls -RBC escape into the urine -Hemodynamic changes cause reduction in GFR |
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