Flashcard Set Preview
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| 1 |
Most reliable method to quantify proteinuria
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24 hr. urine sample
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Abnormal Protein urine level and nephrotic range
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Abnormal: >150mg in 24hr> 3.5g/24hr= NEPHROTIC RANGE proteinuria
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How to reduce proteinuria?
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1. ACEIs (-pril)Caution if pt is hyperkalemia and/or has rising Cr. (rise >...
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Normal Range of GFR?
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Normal 150-250L/24hr. Or 100-120mL/min/1.73 m²
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ARF s/s is decreased urine production, what is the normal range of urine production?
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Normal UO is 0.5cc – 1 cc/kg/hr.Anuria < 100cc/dayOliguria 100-400cc/day
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ARF general presentations (17)
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ThirstOliguria (poly)DizzinessHypotensionN/V/DAbdominal painIleusDiaphoresisOrthopneaPNDPericardial...
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MCC of Acute Renal Failure
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prerenal azotemia- due to renal hypoperfusion{Azotemia is an elevation of blood urea nitrogen...
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| 8 |
Casts seen in UA for Prerenal Azotemia
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UA : benign or hyaline casts
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| 9 |
GOLD STANDARD for the diagnosis of Renal Artery Stenosis
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Renal angiography
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| 10 |
MC form of Intrinsic Renal Failure and MC cause?
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Acute Tubular Necrosis 85% (ATN) and MC is ischemia (hypoperfusion) and other is toxic exposure...
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| 11 |
MC drugs associated with Exogeneous Toxicity causing ATN?
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ATN occurs in ~10-30% of patients receiving aminoglycosides-micin, -mycin, - kacinGentamicin...
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| 12 |
How to prevent exogeneous toxic ATN in with contrast dyes (2)
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Prevention1. IV fluids – 1L 0.9 % NS 12 hrs. before and after procedure2. N –acetylcysteine...
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| 13 |
Endogenous Nephrotoxins: Myoglobinurina (rhabdomyolysis)what is seen in UA? and What is the...
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1. Urine appears dark brown, but no red cells present2. Hydration
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| 14 |
Endogenous Nephrotoxins: Multiple Myeoloma What is seen in UA?
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Bence Jones protein in urineFinding this protein in the context of end-organ manifestations...
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| 15 |
Urine sediment findings for prerenal and ATN/Intrinsic
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1. prerenal (bland or non-specific)2. Muddy Brown Casts
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| 16 |
Acute Interstitial Nephritis: MCC and MC offenders (10)
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80% of cases are drug induced (hypersensitivity reactions)M.C. offenders:NSAIDS, PCNs, cephalosporins,...
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| 17 |
Glomerular diseases (3 Main Syndromes) NEED TO KNOW
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Nephritic syndromeEDEMA, HEMATURIA, HYPERTENSION (facial)Nephrotic syndromePeripheral EDEMA,...
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| 18 |
Name 5 Nephritic Syndromes (BOARDS)
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1.Postinfectious Glomerulonephritis2.IgA nephropathy (Berger’s disease)3.Henoch-Schonlein...
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Postinfectious glomerulonephritis (MCC)
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M.C.C. Group A β-hemolytic streptococciOther causes : S. aureus, Hepatitis...
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Postinfectious glomerulonephritis (UA and color of urine in S/S)
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Tea-colored (cola-colored) urineUA +RBCs, RBC casts
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| 21 |
Postinfectious glomerulonephritis Tx (2)
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SUPPORTIVEAntihypertensivesSalt restrictiondiureticsABXSteroids have NOT been shown to improve...
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| 22 |
M.C. form of acute Glomerular Nephropathy in US
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IgA Nephropathy (AKA Berger's Disease) M>F, children and young adultsPrimary renal disease...
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| 23 |
IgA nephropathy (S/S in the urine color and UA)Dx of choice for IgA nephropathy? (1)
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GROSS HEMATURIA (may be microscopic)Brown rather than red urineOnset 48-72 hrsUA- +RBCDX:(Renal...
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| 24 |
IgA Nephropathy (Tx and Px)
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SupportiveBP – ACEIs are preferred, ARBsSTEROIDS ARE BENEFICIAL+/- fish oil +/- Mycophenolate...
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| 25 |
Henoch-Schönlein purpura (A small-vessel vasculitis) MC in what population?
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MC in children (M>F)
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| 26 |
Henoch-Schonlein purpura (S/S 5)
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1. Purpura (mostly lower extremities)/legs and buttocks2. Hematuria3. Abdominal pain (nausea,...
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| 27 |
Henoch-Schonlein Purpura (Labs and Tx)
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HSP is a clinical Dx, BUN possibly elevated if Renals are involved in the dz.Treatment1.Supportive...
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| 28 |
Rapidly Progressive Glomerulonephritis (3 groups)
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Classified pathologically into 3 categories:1) Pauci – immune disease (50%)Wegener granulomatosis...
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Wegener's granulomatosis (small vessel vasculitis)
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Granulomatous inflammation and necrotizing inflammation primarily of the RESPIRATORY TRACT...
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| 30 |
Wegener's granulomatosis (S/S)
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ConstitutionalUpper Resp sxLower resp sxOcular sx (protosis)HemoptysisCNSRenal- HEMATURIA
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| 31 |
Wegener's granulomatosis Lab findings
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ANCA 90%Light microscopy-crescentic glomerulonephritis
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| 32 |
Wegener's granulomatosis Tx (2)
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1. High Dose steroids then taper off (methylpre follwed ybe prednision2. immunosuppressants-Cyclophosphamide...
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| 33 |
Lupus nephritis s/s and Tx
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Classic butterfly malar rash, senstive to light, joint sx, cardiac failure, etc. psychosis,...
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| 34 |
Goodpasture’s syndrome (clinical entity of 2 disorders)
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Acute glomerulonephritisand pulmonary alveolar hemorrhageOnset of the dz is preceded by URI+anti-GBM...
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| 35 |
Goodpasteurs syndrome MC s/s
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1. MC Hemoptysis (blood tinged to profound bleeding)2. Respiratory failure3. Gross Hematuria...
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| 36 |
Goodpasture's syndrome Labs and TOC (2)
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Labs/studies:+ anti-GBM antibodies (> 90% pTs.) – confirms the dx.sputumCXRTreatment:T.O.C. ...
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| 37 |
Peripheral Edema is the Hallmark S/S of what Dz (1)and what is the Definitive Dx
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Nephrotic SyndromeRenal Biopsy- avoid if possible in children
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| 38 |
4 common Types of Nephrotic Syndrome
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Minimal change diseaseFocal glomerular sclerosisMembranous nephropathyMembranoproliferative...
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| 39 |
Minimal change Dz Facts
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Children>AdultsM>F (chidren)S/S- Thrombosis (PE/Seizure)Tx-Prednisone
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| 40 |
Membranous Nephropathy - MCC of
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MCC of Primary nephrotic syndrome in Adults (50-60y/o)S/S-Nephrotic syndrome, thrombosis renal...
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| 41 |
Focal Segmental Glomerular Sclerosis
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ASX proteinuria or nephrotic syndrome with or without renal insufficiencyTx- Diet control
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| 42 |
Membranoproliferative Glomerulonephritis (MPGN)
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Uncommon cause of chronic nephritis that occurs primarily in children and young adults
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| 43 |
Postrenal failure
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Due to urinary outflow obstruction or intratubular obstructive lesionsUrinary Tract obstructionMCC...
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