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31 Cards in this Set
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- Back
- 3rd side (hint)
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What is nephrOtic syndrome?
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proteinuria > 3.5 g/d
anasarca lipiduria with hyperlipidemia low alb hypercoag |
proteiny
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What is the general treatment for nephrotic syndrome?
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protein and salt restriction, diuretics, statins
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What is nephrItic syndrome?
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acute onset hematuria
low GFR, oliguria hypertension edema |
bloody
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Name 3 nephrOtic glomerulopathies.
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Minimal change disease
Membranous glomerulopathies Membranoproliferative glomerulonephritis |
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Name 5 nephrItic glomerulonephropathies.
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Poststrep glomerulonephritis
Crescentic glomerulonephritis Berger's disease Henoch-Schonlein purpura Multiple myeloma |
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Describe the UA in nephrOtic syndrome.
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High proteinura, +/- hematuria
no cells fatty casts free fat droplets, oval fat bodies |
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Describe the UA in nephrItic syndrome.
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proteinura +/-, high hematuria
RBCs and WBCs RBC and granular casts |
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Describe the UA in chronic disase.
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+/- proteinuria +/- hematuria
+/- cells waxy and pigmented granular casts |
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Minimal Change Disease
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NEPHROTIC
young children very responsive to prednisone with excellent Px |
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Focal Segmental Glomerulosclerosis
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NEPHROTIC
similar to MCD. Idiopathic form normally in young HTNive males. Also associated with heroin, HIV, diabetes, sickle cell. Tx - prednisone + cyclophosphamide Px poor. |
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Membranoproliferative glomerulonephritis
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NEPHROTIC
Type I - slowly progressive Type II - aggressive. Ab against C3 convertase = C3 nephrotic factor --> decreased C3. Tx - prednisone +/- plasmapheresis or interferon-a Px - poor. |
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Poststreptococcal glomerulonephritis
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NEPHRITIC
Follows Group-A beta-hemolytic strep, or any other infxn weeks later. Labs - urine red cells and casts, azotemia, low C3, high ASO titer. Imaging - coarse granular IgG or C3 deposits. Dz normally self-limiting. |
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Crescentic glomerulonephritis
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NEPHRITIC
Progresses to renal failure w/i wks-mos Can be part of PIGN/systemic dz Goodpasture's = glomerulonephritis with pneumonitis (lung sx usually first) in men in mid-20s. + antiGBM Abs smooth, linear deposition of IgG Tx - prednisone + plasmapheresis. |
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Berger's Disease
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NEPHRITIC
Most common worldwide nephropathy. IgA deposition in mesangium. Si/Sx - recurrent hematuria with low-grade proteinuria, concurrently with infxn. 25% --> renal failure 75% harmless. Tx - prednisone for acute flares |
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Renal involvement in Multiple myeloma
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NEPHRITIC
light chains --> tube plugging, hyperCa --> damage, myeloma cells --> invade kidney. susceptibility to encapsulated bacteria --> chronic renal failure. |
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What kind of nephropathy is seen in diabetes?
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1st - microalbuminuria
* can slow progression from here with ACEI and tight glycemic and HTN ctrl. As dz progresses, only Tx is transplant. Most common cause of ESRDz in US. Bx - pathognomonic Kimmelstiel-Wilson nodules. |
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What kind of nephropathy is seen in HIV?
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*usually seen in HIV from IV drug use*
Focal Segmental Glomerulonephritis (NEPHROTIC) Early antiretrovirals may help. |
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How do you Dx and Tx renal amyloidosis?
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Dx - birefringence with Congo red
Tx - transplant, but can recur. |
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What are the five types of renal involvement in lupus?
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I - none
II - mesangial dz III - focal proliferative IV - diffuse proliferative V - mebranous dz |
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Renal involvement in SLE - Type II
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Mesangial disease with focal segmental glomerular pattern.
Tx - usually none. |
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Renal involvement in SLE - Type III
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Focal proliferative dz.
Tx - agressive prednisone +/- cyclophosphamide |
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Renal involvement in SLE - Type IV
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Diffuse proliferative dz
The most severe form of lupus nephropathy. both nephrotic and nephritic. LM - wire-loop abnormality. Tx - prednisone + cyclophosphamide, ?transplant. |
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Renal involvement in SLE - Type V
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Membranous dz.
Looks like other primary membranous nephropathies (nephrotic.) Tx - ?prednisone |
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What are the key DDx points for HUS?
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Hx of diarrhea, child.
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What are the key DDx points for HSP?
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Rash, abd pain, arthritis, melena
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What are the key DDx points for TTP?
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CNS changes, young adult
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What are the key DDx points for ITP?
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Antiplatelet antibodies.
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What are the Si/Sx and Tx in HUS?
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PHx of E. coli
Low RBC Low plt Hemolysis on periph smear ARF, hematuria Tx - supportive |
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What are the Si/Sx and Tx in HSP?
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PHx URI
Normal RBC, plt, and peripheral smear Hematuria A/w rash, abd pain, arthritis, melena Tx - supportive |
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What are the Si/Sx and Tx in TTP?
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Low RBC
Low plt Hemolysis on peripheral smear ARF, proteinuria CNS changes Tx - plasmapheresis, NSAIDs. DONT GIVE PLATELETS. |
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What are the Si/Sx and Tx in ITP?
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PHx viral infxn
Normal RBC Low plt no kidney manifestations + antiplt abs Tx - steroids for bleeding (plt <20,000), splenectomy if refractory. |
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