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Flashcards in Renal Diseases Deck (35)
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1

What is glomerulonephritis?

GN generally refers to damage of the renal glomeruli by deposition of inflammatory proteins in the glomerular membranes as a result of an immunologic response

2

What is the most common cause of glomerulonephritis?

IgA GN

3

Who do we most commonly see GN in?

Children 2-12 yo

4

What does focal and diffuse GN mean?

Focal- characterized by involvement of less than 50% of the glomeruli

Diffuse- affects most glomeruli

5

What are the clinical features of GN?

Hematuria is present; urine is often tea colored. Oliguria or anuria is present. Edema of the face/eyes in the AM and Feet/ankles in the PM.

6

What are the laboratory findings for GN?

Antistreptolysin-O titier is increased in 60-80% of cases and should be considered if there is a possibility of a recent strep infection.

UA reveals hematuria (>3) also RBCs will often be mis-shapen (acanthocytes), RBC casts will be present as well as proteinuria. Serum compliment C3 will be decreased.

7

How do we treat GN?

Steroids and immunosuppressive drugs may be used to control inflammatory response, which is responsible for the damage. They are generally not needed in PSGN.

8

What is nephrotic syndrome?

nephrotic syndrome is defined as excretion of more than 3.5g of protein in 24 hrs. It manifests with hypoalbuminemia, lipiduria and hypercholesterolemia, and edema.

9

What are the clinical findings of nephrotic syndrome?

facial edema, weight gain, maliase, oliguria

10

What are the laboratory findings for nephrotic syndrome?

UA shows hypoalbuminemia, lipiduria and hypercholesterolemia. The urine also appears foamy.

11

What is the key finding on microscopic UA for nephrotic syndrome?

oval fat bodies

12

How do we treat nephrotic syndrome?

ACE inhibitors should be used early in the course of the disease. Judicious use of diuretics is recommended to reduce fluid accumulations.

13

What are the common types of nephritic syndromes?

Pauci
IgA
Goodpastures
Lupus
Rapid progressing

14

What are the key features of nephritic syndrome?

RBC and RBC casts

15

What are the key elements of Lupus?

+ ANCA and ds DNA, as well as a malar rash and low C3

16

How do we diagnoses Lupus?

renal biopsy

17

What are the key elements of goodpastures?

Also affects lung cells, its seen mainly in male smokers
hemoptysis

18

How do we treat goodpastures?

plasmaphoresis, immunosuppressants

19

What are the key elements of Pauci-immune?

Wegners
Not immune complexed
Vasculidities are complex multi organ disorders
+ ANCA

20

What are the key elements of IgA?

slow progressive disease
often asymptomatic
microscopic or gross hematuria
+mild protein
deposits Iga on glomerular membrane

21

What are the key elements of rapidly progressing GN?

biopsy will show cresents

22

What are the key features of nephrotic syndrome?

>3.5 proteinuria
hypoalbuminemia
edema
hyperlipidemia

23

What is the most common cause of nephrotic syndrome?

DM

24

What are categories of nephrotic syndrome?

Minimal change disease
Focal and segmental GN
Membranous nephropathy
Membranoproliferative nephropathy

25

What are the key elements of minimal change disease?

renal function is normal, edema is present
UA = +4 protein, hyaline casts
Circulating factor -> Podocyte injury -> proteinuria

26

What are the key elements of focal and segmental GN?

not mediated by immune complexes
proteinuria and hypotension
heroin, HIV, sickle cell can trigger it
Tx with steroids

27

What are the key elements of membranous nephropathy?

idiopathic
due to antibody PLAZR
50% develop ESRD

28

Which type of syndrome is associated with Hep C?

membranoproliferative

29

What is polycystic kidney disease?

PKD is characterized by growth of numerous cysts in the kidneys. The cysts are made of epithelial cells from the renal tubules and collecting system. The cysts replace the mass of the kidney, reducing function and leading to kidney failure.

30

What is the most common PKD?

ADPKD, it usually presents bilaterally