Im Renal Glomerular Dz Usmle 2

Front 1

Dx:
Edema, lipiduria, foamy urine, hypoalbuminemia, hyperlipidemia, hypercoagulation, protein in urine

Back 1

Nephrotic syndrome

Front 2

Dx:
"Maltese crosses" in urine

Back 2

cholesterol in urine

(Nephrotic syndrome)

Front 3

Why does the nephrotic syndrome pt have edema?

hypercoaguability?

Back 3

Edema - decrease ion serum proteins and oncotic pressure

Hypercoag - loss of Proteins C and S and antithrombin III

Front 4

Dx:
child w/ epithelial foot process loss on EM

Tx?

Back 4

Minimal Change Dz

Tx: steroids

Front 5

Dx:
glomerular scarring involving limited number of glomeruli w/ IgG and complement deposition

Most common in what patients?
(5)

Back 5

Focal Segmental Glomerulosclerosis

Common in (Halt MID Stream):
HIV;
Men (younger) w/ HTN
IV drug users;
DM;
Sickle cell

Hint 5

Halt MID Stream

Front 6

What can Focal Glomerulosclerosis lead to?
(2)

Tx?

Back 6

HTN and Chronic Renal Dz

Tx: Cyclophosphamide

Front 7

First line of Tx for all Nephrotic syndrome

Back 7

Protein and NaCl restriction

Front 8

Dx:
MCC of Nephrotic Syndrome in adults that is slow to progress and has little response to steroids

Etiology? (6)

Back 8

Membranous Glomerulonephritis

Etiology (SHIT):
SLE / Syphilis;
HBV / HCV;
Idiopathic;
Tumor

Front 9

Rule of thirds for Membranous GN

Back 9

1/3 get CRF

1/3 have spontaneous remission

1/3 remain nephrotic w/o pregression

Front 10

Tx for Membranous GN
(2)

Back 10

Cyclophosphamide

Chlorambucil

Front 11

Dx:
Abrupt onset hematuria w/ RBC casts, smoky-brown urine, proteinuria, hypertension, edema and azotemia (low GRF)

Back 11

Acute Glomerulonephritis

(Nephritic syndrome)

Front 12

Dx:
presents 2 weeks after pharyngitis or impetigo w/ dark urine and edema

Back 12

Poststrep. GN

Front 13

Deposition of what causes glomerular damage in poststrep GN?

Tx?

Back 13

Deposition of IgG, C3 and C4 in a grandular pattern

Tx underlying infection

Front 14

Dx:
hematuria immediately after an infection or exercise

Back 14

IgA nephropathy

(Berger's Dz)

Front 15

what (and where) is the immune complex deposition of IgA nephropathy?

Back 15

Mesangeal deposition of IgA and C3

Front 16

Dx:
immune deposits on BM cause it to look double-layered

what is it associated w/?
(2)

Back 16

Membranoproliferative

("Tram-track" appearance)

Assoc w/:
Hepatitis C
Cryoglobinemia

Front 17

How is type I membranoproliferative different then type II?

Back 17

Type I:
slowly progressive

Type II:
low serum C3 due to Auto-Ab vs C3

Front 18

Tx of Membranoproliferative for adults (2) and kids

Back 18

Adults:
ASA
Dipyridimole

Kids:
Steroids

Front 19

Dx:
Fulminant renal failure w/ proteinuria, hematuria and RBC casts and epithelial cell proliferation in glomeruli
(2 names)

Back 19

Rapidly Progressive GN

(Cresentric GN)

Front 20

(3) types of Rapidly Progressive GN

Back 20

1. Pauci-Immune RPGN

2. Immune complex RPGN

3. Anti-glomerular BM Ab Dz

Front 21

Serum marker for Pauci-Immune RPGN

Back 21

ANCA positive

(Wegner's = c-ANCA)
(polyarteritis nodosa = p-ANCA)

Front 22

Etiology of Immune Complex RPGN
(5)

Back 22

SPLIT:
Syphilis;
Post-strep GN;
Lupus nephritis;
IgA nephritis;
Tumors

Hint 22

SPLIT

Front 23

another name for Anti-GMB Ab disease

what cells cause problem?

Back 23

Goodpasture's disease

Cytotoxic T-cells (CD-8)

Front 24

Tx for all RPGN
(2)

what percent go on to end-stage renal disease?

Back 24

Tx:
steroids
cyclophosphamide


80%

Front 25

Renal involvement w/ Lupus type I - V

Which has "wire-loop" abnormality?

Back 25

I: no renal involvement
II: Focal-Segmental
III: Focal-Proliferative
IV: Diffuse Proliferative (most severe - wire-loop)
V: Membranous

Front 26

MCC of End-Stage Renal Dz

What is the early manifestation?

What do Bx show?

Back 26

Diabetes

starts w/ microalbuminuria

Bx: Kimmelstiel-Wilson nodules

Front 27

Dx:
palpable purpura on buttocks and legs of kids, abdominal pain, vomiting, hematuria and GI bleeding

Back 27

Henoch-Schonlein purpura

Front 28

Dx:
Tubule plugging w/ Bence-Jones proteins

what electrolyte disorder from Dx also leads to kidney trouble?
What causes pt to go into CRF?

Back 28

Multiple myeloma

Hypercalcemia

E.Coli infection of kidney from abnormal Ab production