True or false: oliguria is the term used to describe azotemia + clinical signs & symptoms.
False: uremia is azotemia + clinical signs & symptoms.
Decreased filtration associated with hypertension stimulates the release of which substance?
Renin.
JG-cells control BP.
Causes the release of Ag-II (powerful hypertensive substance).
Increases BP.
Problem is not in BP, but in filtration.
B-hemolytic strep group A is associated with which form of glomerulonephritis?
Acute proliferative glomerulonephritis.
"Acute post-streptococcal glomerulonephritis."
"Acute post-infectious glomerulonephritis."
-Enzymes released by neutrophils = destruction of bacteria & damage to the glomerulus.
-Components of nephritic syndrome are visible.
-Usually develops in young children, although not severe.
Molecular mimicry is associated with which pathology?
Acute proliferative glomerulonephritis.
Molecular mimicry: confusion with the attachment of an antibody to different antigens.
Glomerulus wall & bacteria have similar structures.
May have the same reaction with:
-Staph.
-Pneumonia.
-Measles.
-Chicken pox.
-Hepatitis.
What is the treatment of choice for post-strep glomerulonephritis?
Corticosteroids.
Full recovery within 3-4 weeks.
Worse in adults.
What is the a/k/a for rapidly progressive glomerulonephritis?
Crescenteric glomerulonephritis: rapid & progressive loss of renal function.
Death within weeks/months after onset.
Due to proliferation of normal parietal epithelial cells in Bowman's Capsule (hyperplasia).
Prognosis depends on the number of crescents found in the biopsy.
Crescenteric glomerulonephritis results in the physical compression of which 2 structures?
1. Glomerulus.
2. Arterioles.
Leads to loss of arterioles.
= dramatic irreversible impairment of function.
Group I Rapidly Progressive Glomerulonephritis (Anti-GBM) is associated with Type II Hypersensitivity Reactions, meaning it is mediated by what?
Antibodies.
50% idiopathic.
Anti-GBM is associated with which syndrome?
Goodpasture's Syndrome: characterized by autoaggression against antigens of the aveolar basement membrane & glomerular basement membrane.
Results in inflammation & blood in sputum (hemoptysis).
May result in Cresenteric GMN due to antibodies simultaneously killing the glomerular basement membrane.
How is Good Pasture's Syndrome treated?
Via plasma pheresis.
Type II Rapidly Progressive Glomerulonephritis (a/k/a Immune Complex Deposition) is associated with Type III Hypersensitivity Reactions, & is mediated by what?
Immune complexes.
50-60% idiopathic.
What is the name of a relatively rare disease which targets young women of African descent?
Systemic Lupus Erythematosus: development of autoaggresion against components of the cell membrane, especially in the nucleus.
Autoimmune disorder.
Diagnosis: ANA found in blood.
Involves any organ, but prefers skin = Butterfly Rash.
-lungs, kidneys, cerebral vessels, joints.
High survival rate.
Must continue use of corticosteroids.
What are the 3 factors which promote development of SLE?
1. Exposure to UV-radiation.
2. Sulfa salicyclic medications.
3. Vaccinations.
What age group is affected by Henoch-Schonlein Purpura?
#1 cause of gross hematuria = most common cause among all kidney disorders.
-Loin pain.
What percentage of urinary tract infections develop into chronic renal failure?
25-30%.
Buerger's Disease: inflammation of vessels that supply nerves with blood. "Thromboangitis obliterans"
Affects young males.
Vasculitis of middle & small size arteries.
-Radial & tibial A's.
Only disease associated with inflammation of arteries & veins @ the same time.
Associated with heavy smoking.
HLA antigen found in patient.
What is the major symptom of Buerger's Disease? *India, Israel, Japan.
Instep claudication: periodic spasm of arteries associated with exertion... starting with Raynaud's Phenomenon: spasm of vessels for distal fingers & toes.
Narrowing of the lumen of vessels = decreased blood supply.
No problem with sitting or standing... start to walk & legs need more blood = pain in calf.