Renal

Front 1

Nephritic
1) Sx findngs
2) Proteinuria is usually less than ? g/day
3) what should be included in workup?
4) General tx for every type of nephritis?

Back 1

1) proteinuria, hematuria, azotemia, RBC cast, oliguria, HTN.
2) 1.5g/day.
3) Always measure complement ANA, ANCA, anti-GBM as part of the workup.
4) steroids for inflammation or diuretics for fluid overload.

Front 2

Nephritic Sx: Post-infxn glomerulonephritis
1) What?
2) Signs
3) Labs
4) Tx

Back 2

1) any infxn (2-6wks ago) will do, but GAS infxn is common.
2) tea urine, oliguria, fluid overload.
3) ASO titer, low serum C3 (immune complex used up) that normalizes at 6+ wks.
4) diuretic support till eventual recovery.

Front 3

Nephritic Sx: IgA nephropathy
1) What?
2) Signs
3) Labs
4) Tx

Back 3

1) follows resp or GI infxn. Rarely with HSP.
2) hematuria of any kind.
3) normal C3
4) steroids; ACEi if proteinuria.

Front 4

Nephritic Sx: Wegener's Granulomatosis
1) What?
2) Signs
3) Labs
4) Tx

Back 4

1) Resp + kidney
2) fever, wt loss, hematuria, resp sx, pulmonary lesion bleed (hemoptysis).
3) c-ANCA, renal biopsy (necrotizing).
4) high dose steroid and cytotoxic agents. High recurrence.

Front 5

Nephritic Sx: Goodpasture's Sx
1) What?
2) Signs
3) Labs
4) Tx

Back 5

1) Rapidly progressing w/ pulm hemorrhage.
2) Hemoptysis, dyspnea, resp failure. NO upper resp tract involvement (sinuses and stuff unlike wegener's).
3) Anti-GBM deposits.
4) Plasma-exchange therapy, steroids. May ESRD.

Front 6

Nephritic Sx: Alport's Sx
1) What?
2) Signs
3) Labs
4) Tx

Back 6

1) Hereditary (onset at 5-20yrs old).
2) hematuria + sensorineural deafness + eye problem.
3) GBM
4) renal failure.

Front 7

Nephrotic Sx
1) proteinuria parameters?
2) definitive diagnosis?
3) general tx strategy?

Back 7

1) >3.5g/day, hypoalbumin (<3g/dL), hyperlipid.
2) definitively diagnosed by renal biopsy for etiology.
3) protein/salt restrict, diuretic, anti-lipid. ACEi.

Front 8

Nephrotic Sx: Minimal Change Disease
1) What?
2) Signs
3) Labs
4) Tx

Back 8

1) kids, idiopathic, NSAID, hodkins tumors.
2) sudden edema
3) light microscopy is normal vs EM shows fusion of epithelial foot.
4) steroids pretty much clears it.

Front 9

Nephrotic: Focal Segmental Glomerulosclerosis
1) What?
2) Signs
3) Labs
4) Tx

Back 9

1) idiopathic, IVD use, HIV.
2) typical patient is african american w/ uncontrolled HTN.
3) microscopic hematuria, biopsy shows sclerosis in capillary tufts.
4) ACEi/ARB, prednisone, cytotoxic agents.

Front 10

Nephrotic: Membranous nephropathy
1) What?
2) Signs
3) Labs
4) Tx

Back 10

1) common in caucasians due to malignancies and immune complex (ass w/ HBV, syphillis, malaria, gold).
2) ?
3) spike and dome appearance (deposit of IgG and C3 at basement membrane-hence membranous).
4) Prednisone + cytotoxic drugs

Front 11

Nephrotic: Diabetic Nephropathy
1) What?
2) Signs
3) Labs
4) Tx

Back 11

1) Diffuse hyalinazation + nodular glomerulosclerosis. 2) Poorly controlled DM w/ evidence of retinopathy and neuropathy, hence also nephropathy.
3) Thickened GBM and increased mesangial matrix.
4) Control DM, ACEi/ARB

Front 12

Nephrotic: Lupus Nephritis
1) What?
2) Signs
3) Labs
4) Tx

Back 12

1) both nephritic and nephrotic.

3) mesangial prolif + immune complex deposition.
4) Prednisone + cytotoxic to slow progression.

Front 13

Nephrotic: Renal Amyloidosis
1) What?
2) Signs
3) Labs
4) Tx

Back 13

1) yep
2) pt may have multiple myeloma or other inflammatory stuff.
3) nodular sclerosis, amyloid (apple green birefringence w/ Congo red stain).
4) Prednisone.

Front 14

Nephrotic: Membranoproliferative nephropathy
1) What?
2) Signs
3) Labs
4) Tx

Back 14

1) nephritic and nephrotic, often due to HCV, SLE, endocarditis, cryoglobulinemia.
2) ?
3) Tram-track (double layered basement membrane) w/ C3 deposits.
4) steroid + cytotoxic to slow it.