8. Renal/Genitourinary

Question 1

Acute Glomerulonephritis

General cause/4 type/MC cause/Sx/Dx/Tx

Answer 1

• General cause: Inflammed glomerulo -> plugged -> can’t pee
• 4 Type/ MC cause
  
  • IgA nephropathy - hx of URI
  • Membranoproliferative Glomerulonephriti - nondiabetic w/ malignancy
  • Goodpasture - vasculitis
  • Poststrepto coccal - GAS (hx of impetigo, strep throat)
• Sx: Edema
• Dx
  
  • Hematuria (RBC cast)
    
    • IgA - begins 1-2 day after URI
    • Poststrep - weeks later
  • For Good pasture - Anti-GBM antibodies through biopsy
• Tx:
  
  • IgA or good pasture: prednisone
  • Poststrep - Supportive

Question 2

Nephrotic syndrome

Cause/Patient/Sx/Dx/Tx

Answer 2

• Cause: glumerular damage cause protein loss
• Patient: Children (2-8 age minimal change)
  
  • HIV, drug, obese AA man - Focal Segmental
• Sx: edema, loss urine output
• Dx
  
  • Urine collecting 24hr - proteinuria
  • UA - Oval fat bodies
  • Hypoalbumin - 3.4>
• Tx: Prednisone, ACEI (proteinuria), diuretic (edema)

Question 3

Acute pyelonephritis

Cause/Sx/PE/Dx/Tx

Answer 3

• Cause: E Coli
• Sx: Fever, flank pain, painful urination
• PE: CVA tenderness
• Dx: UA - WBC cast
• Tx: FQ (cipro), Amox (pregnancy)