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Medicine Clerkship > Proteinuria/hematuria, Glomerular/tubulointerstitial Dz > Flashcards

Proteinuria/hematuria, Glomerular/tubulointerstitial Dz Flashcards

1
Q

etiologies of hematuria

A

glomerular disease and post-renal causes (trauma, stones, cancer)

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2
Q

etiology of nephritiv vs nephrotic syndomes

A

nephtritic = glomerular inflammation

nephrotic = loss of GBM negative charge

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3
Q

S/s nephritic vs nephrotic

A

nephritic:

  • hematuria
  • oliguria
  • HTN
  • azotemia
  • proteinuria (3.5 g)
  • edema
  • hypoalbuminemia
  • hyperlipidemia
  • hypercoagulability
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4
Q

glomerular cellularity nephritic vs nephrotic

A

nephritic = hypercellular glomeruli

nephrotic = normo-hypocellularity

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5
Q

casts assc w/ nephritic vs nephrotic

A

nephritic = RBC casts

nephrotic - fatty casts

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6
Q

analgesic nephropathy presents as

A

Nephritic syndrome × chronic pain

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7
Q

good pastures, nephritic or nephrotic?

A

nephritic

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8
Q

wegners nephritic or nephrotic?

A

nephritic

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9
Q

alport, nephritic or nephrotic?

A

nephrotic

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10
Q

minimal change dz, nephritic or nephrotic?

A

nephrotic

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11
Q

HBV, HCV, HIV cause nephritic or nephrotic?

A

nephrotic

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12
Q

NephrOtic syndrome × Hodgkin lymphoma =

A

minimal change disease

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13
Q

NephrOtic syndrome × HIV:

A

FSGN

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14
Q

NephrOtic syndrome × HCV

A

MPGN

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15
Q

NephrOtic syndrome × HBV

A

MGN (membranous GN)

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16
Q

nephrOtic syndrome in kids
following a viral infx

How to dx and treat?

A
  • Dx EM (foot process effacement)

* Tx steroids

17
Q

Dx with light microscopy showing segmental sclerosis

A

FSGN

Think HIV pt. STERIOD RESISTENT

18
Q

Dx LM (diffuse GBM thickening), EM (“spike and dome” appearance)

assc with what Hx?

A

Membranous glomerulonephritis

drugs, infx, SLE, solid tumors

19
Q

nephritic syndrome following
URI or gastroenteritis;
associated w/ Henoch-Schonlein
(palpable) purpura in kids

How to Dx?

A

IgA nephropathy

LM shows mesangial deposits and IF with IgA stain

20
Q

XR ∆type 4 collagen → split
GBM (nephritic and nephrOtic
syndromes), deafness, ocular
and nerve disorders

A

ALports

21
Q

Dx microalbuminuria, LM (mesangial expansion, Kimmelsteil-Wilson nodules)

Treatment?

A

Diabetic nephropathy (nephrOtic)

ACEi

22
Q

Dx LM (“wire loops”), EM (subendothelial deposits), IF (“full house”)

A

Lupus nephropathy

23
Q

Dx EM (“tram tracks” or “dense deposits”)

A

Membranoproliferative GN (MPGN)

24
Q

coke-colored urine and
periorbital edema in a kid w/
strep throat or cellulitis

how to dx and treat?

A

PSGN

  • Dx ↑ASO, LM (“lumpy-bumpy” appearance)
  • Tx reassurance
25
Q

anti-GBM → attacks glomeruli
and alveoli → hematuria +
hemoptysis

How to Dx

A

Goodpastures

Dx LM (crescent shaped), IF (linear staining)

26
Q

drug allergy → acute renal
railure, rash, fever, eosinophilia

how to dx? MC etiologies

A

Acute interstitial nephritis (AIN)

Dx with UA
Etiologies = gentamycin, IV dye, Hb/Mb

27
Q

slowly progressive nephritis →
asx, but can lead to progressive
scarring, renal failure, and ESRD

A

Chronic interstitial nephritis

28
Q

damage to renal papillae → necrosis → slough off and cause _____

How to Dx? etiologies?

A

Renal Papillary necroris
causes… ureteral obstruction

Dx with excretory urogram

Etiology: analgesic nephropathy (chronic NSAID/Tylenol use), diabetic nephropathy, sickle cell, obstruction, txp rejection

29
Q

Defects in RTA type 1 vs 2 vs 3 vs 4 and acidic or alkaline urine + TREATMENT

A

1: (distal) CD cannot excrete H+ (alkaline Urine) | IV HCO3-
2: (proximal) cannot reabs HCO3- (alkaline urine) Tx underlying cause
3: none
4: (hyperK): either hyperaldo or lack of response to aldo (acidic urine) | fludrocortisone

30
Q

RTA assc with hypophos and rickets

A

type 2: (proximal) cannot reabs HCO3- (alkaline urine)

31
Q 
AR ∆neutral amino acid
transporter → ↓neutral amino
acids → ↓tryptophan for niacin
synthesis → pellagra (3 Ds –
diarrhea, dermatitis, dementia)

Tx?

A

Hartnup syndrome

niacin replacement

32
Q

Defects in Fanconi syndrome? + TX?

A

proximal tubule dysfxn → defective transport of glucose, amino acids, HCO3-, phosphate → glucosuria, aminoaciduria, type 2 RTA, hypophosphatemic rickets, etc.

Tx electrolyte replacemetn

Medicine Clerkship (20 decks)

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