Midterm

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1

Acute Glomerulonephritis

Physical results: mild protein, positive blood

Microscopic results: dysmorphic RBCs, WBCs, RTEs, and RBC, hemoglobin, granular casts (occasionally WBC and RTE casts)

2

Chronic Glomerulonephritis

Physical results: HEAVY protein, positive blood, and a low, FIXED specific gravity

Microscopic results: RBCs, WBCs, All types of casts, especially granular, waxy, and broad, RTE cells

3

Nephrotic Syndrome

Physical results: SEVERE protein,, positive blood

Microscopic results: Lipiduria - oval fat bodies, casts, especially fatty, waxy, and renal, RTE cells, and RBCs

4

acute, rapidly progressive, membranous, minimal change disease, focal segmental, membranoproliferative, IgA nephropathy, and chronic

8 types of Glomerulonephritis

5

Acute Glomerulonephritis - Poststreptococcal

antibody mediated acute nephrotic syndrome; cellular proliferation of glomerulus, leukocyte infiltration, and interstitial swelling

6

Rapidly Progressive Glomerulonephritis

antibody mediated, often anti-GBM acute nephrotic syndrome; cellular proliferation to form characteristic crescents of glomerulus; leukocyte infiltration, fibrin deposition, GBM disruptions

7

Membranous Glomerulonephritis

antibody mediated nephrotic syndrome; basement membrane thickening because of immunoglobulin (Ig) and complement (C) deposits; loss of foot processes

8

Minimal Change Disease

T cell immunity dysfunction - loss of glomerular polyanions nephrotic syndrome; loss of foot processes

9

Focal Segmental Glomerulosclerosis

Unknown cause, possibly a circulating systemic factor; protein variable subnephrotic to nephrotic syndrome; sclerotic glomeruli with hyaline and lipid deposits (focal and segmental); diffuse loss of foot processes; focal IgM and C3 deposits

10

Membranoproliferative Glomerulonephritis

immune complex of complement activated nephrotic syndrome or hematuria or proteinuria; cellular proliferation (mesangium); leukocytic infiltration; IgG and complement deposits

11

IgA Nephropathy

IgA mediated with complement activation recurrent hematuria and proteinuria; deposition of IgA in mesngium; variable cellular proliferation

12

Chronic Glomerulonephritis

variable pathogenic chronic renal failure; hyalinized glomeruli

13

Acute Tubular Necrosis

Physical results: mid protein, positive blood, low specific gravity

Microscopic results: RBCs, WBCs, Renal epithelial cells, proximal tubular cells - toxic ATN, collecting tubular cells - ischemic ATN, casts: renal cell, granular, waxy, and broad

14

Cystinuria and Cystinosis

Physical results: positive blood and mild protein

Microscopic: RBCs and cystine crystals

15

Renal Tubular Acidosis

Physical results: pH>5.5

Unremarkable microscopic findings

16

Fanconi's Syndrome

Physical results: moderate protein and positive glucose

Microscopic unremarkable

17

Cystitis

Lower urinary tract infection

18

Acute Pyelonephritis, Chronic Pyelonephritis, and Acute Interstitial Nephritis

Three types of upper urinary tract infections

19

Acute Pyelonephritis

Mild protein, blood, positive leukocyte esterase, positive nitrite, normal to low specific gravity

Microscope reveals WBCs and clumps, macrophages, bacteria, casts (WBC and granular, renal, waxy), RBCs and renal epithelial cells

20

Chronic Pyelonephritis

Moderate protein, positive leukocyte esterase, low specific gravity

Microscope reveals WBCs and macrophages, and casts (granular, waxy, broad, few WBC, and renal cell)

21

Acute Interstitial Nephritis

Mild protein, blood, leukocyte esterase usually positive

Microscope reveals WBCs and macrophages (Eosinophils on differential), RBCs, Casts (leukocyte, granular, hyaline, and renal cell), and crystals (drug crystals if drug induced disease)

22

Acute Pyelonephritis

bacterial infections involving renal tubules, interstitium, and renal pelvis; caused by a) movement of bacteria from lower to upper urinary tract or b) localization of bacteria from bloodstream in kidney

23

Chronic Pyelonephritis

persistent inflammation of renal tissue causes permanent scarring that involves renal calyces and pelvis; most common cause is reflux nephropathies

24

Acute Interstitial Nephritis

allergic response due to acute rejection of transplanted kidney or drug reactions; fever and eosinophilia

25

Acute Renal Failure

decreased GFR, azotemia, and oliguria or anuria

26

Chronic Renal Failure

progressive (always renal and irreversible) loss of renal function leading to end stage renal disease; decreased GFR <25, protein, blood, isothenuria, abundance and variety of casts especially waxy and broad

27

Prerenal

overflow proteinuria; too much protein in plasma and passes into urine; septicemia, hemoglobinuria, and myoglobinuria, MM BJ proteins

28

Renal

glomerular and tubular proteinuria; GFB is defective allowing proteins in plasma to enter ultra filtrate; tubular reabsorption function is altered or impaired

29

Postrenal

develops from inflammatory process in the urinary tract

30

Cystitis

lower UTI inflammation of bladder

31

Pyelonephritis

upper UTI inflammation of kidneys

32

E. coli, Proteus, Klebsiella, Enterobacter, and Staph

5 UTI Pathogens; ESBLs, carbapenems

33

Amino Acid Disorders

an imbalance of urea in the body

34

Cystinosis

inherited disease; cystine is deposited throughout the body and accumulates causing damage and disrupting cellular functions

35

Acute Tubular Necrosis

Physical results: mid protein, positive blood, low specific gravity

Microscopic results: RBCs, WBCs, Renal epithelial cells, proximal tubular cells - toxic, collecting tubular cells - ischemic, casts: renal cell, granular, waxy, and broad

36

MSUD

rare inherited disease in which branched chain amino acids (leucine, isoleucine, and valine) accumulate in the blood, CSF, and urine; has distinctive caramelized sugar odor; can lead to mental impairment or spasticity in infants if not treated

37

Phenylketonuria

inherited disease characterized by increased urinary excretion of a ketone acid; can lead to severe mental impairment; mousy or musty odor of urine, sweat and breath; also have decreased skin pigmentation; all infants screened

38

Alkaptonuria

lack enzyme homogentisic acid oxidase; leads to build up of homogentisic acid in blood, tissues, and urine; urine darkens after becoming alkaline or room temp; leads to arthritis; liver and cardiac disorders; chromatographic assays

39

Tyrosinuria

excess tyrosine in plasma resulting in urine overflow due to undeveloped liver, acquired liver disease; hereditary

40

Melanuria

must be distinguished from alkaptonuria since both produce brown urine but this darkens after exposure to air; serious finding indicating over-proliferation (Malignant Malinoma), the colorless precursor is excreted in urine and oxidized when exposed to oxygen

41

Glomerular

type of renal disease characterized by cellular proliferation, leukocyte infiltration, basement membrane thickening, and sclerotic hyalinization

42

Tubular

type of renal disease caused by necrosis and dysfunction of tubules including: Fanconi, cystinosis, cystinuria, renal glucosuria, renal phosphaturia, and renal tubular acidosis

43

Interstitial

type of renal disease caused by allergic reaction due to allograph rejection

44

Vascular

type of renal disease caused by decreased blood flow, increased blood pressure, arterial stenosis, vasculitis, diabetes, autoimmune disease, and sickle cell disease

45

Renal Calculi

caused by urinary stasis, pH crystals, concentration, foreign body, microscopic hematuria

46

Metabolic Disease

increase in normal solute or presence of abnormal solute

47

amino acids

normal reabsorbed so any amount in urine is abnormal; has limited threshold

48

overflow

increase in threshold levels amino acid disorder

49

no threshold

any increase in plasma amino acid disorder

50

renal

kidney unable to reabsorb in amino acid disorder

51

Primary

amino acid disorder caused by deficient metabolism or reabsorption deficiency

52

Secondary

amino acid disorder caused by renal tubular dysfunction such as Fanconi's or severe liver disease

53

Calcium oxalate, uric acid, leucine, sodium urate, tyrosine, cystine, amorphous urates

7 acidic crystals

54

amorphous phosphates, calcium carbonate, ammonium biurate, calcium phosphate, and triple phosphate

5 alkaline crystals

55

uric acid, calcium oxalate, tyrosine, cystine, triple phosphate, ammonium biurate

6 pathologic crystals

56

hydrogen peroxide and diazonium salt

the two reactions that ascorbic acid strips and inhibits

57

blood and glucose

the two analytes that use hydrogen peroxide affected by ascorbic acid

58

bilirubin and nitrites

the two analytes that use diazonium salt affected by ascorbic acid

59

specific gravity

bromthymol blue ionic polyelectrolyte reaction; interference is radiographic dye

60

pH

double indicator bromthymol blue and methyl red; no interferences

61

protein

error of indicators hydrogen ions and a dye; >9.0 pH interferes

62

blood

pseudoperoxidase - H2O2; yellow to green; H2O2 and bleach cause false positives, ascorbic acid false negatives

63

leukocyte esterase

diazonium salt; beige to violet, >25; increased protein, glucose and specific gravity cause false negatives

64

nitrite

diazonium salt and azo coupling; white to pink; ascorbic acid causes false negatives

65

glucose

double sequential glucose oxidase and H2O2 to peroxidase; false positives caused by bleach and H2O2; false negatives by improper storage and ascorbic acid

66

ketones

nitroprusside reaction; does not detect betahydroxybutyrate

67

bilirubin

diazonium -azo; pink