Final Flashcards
What are the common sxs of Nephrotic syndrome?
Nephrotic syndrome
HTN, edema, oliguria, weight gain, foamy urine, cough, DOE, changes in immune response, changes in bleeding (clotting factors).
What are the 4 primary Nephrotic syndromes that are idiopathic and histologic in nature?
Minimal Change Disease
Focal Segmental Glomerulosclerosis (FSGS)
Membranous Nephropathy
Membranoproliferative Glomerulonephritis (MPGN)
How is primary Nephrotic syndrome diagnosed?
Severe proteinuria (>3.5g)
Describe one of the secondary causes of Nephrotic syndrome, and its sxs.
Lupus Nephritis
Skin/joint sx, anemia, photosensitivity, pericardial or pleural effusion. Renal biopsy shows “wire loop” lesions.
Describe another secondary cause of Nephrotic syndrome, and its sxs.
Amyloidosis. Associated with chronic inflammatory disease like RA. Monoclonal paraprotein found in serum or urine.
What does the acronym “CRAB” mean?
Calcium, renal failure, anemia, bone lesions
What is the most common cause of Acute Interstitial Nephritis (AIN)?
Drug hypersensitivity.
B-lactam antibiotics (penicillins, cephalosporins, rifampin) Macrolides, sulfonamides, Cipro, NSAIDs, thiazide diuretics, allopurinol, phenytoin, captopril, cimetidine, PDE-5 inhibitors, rifampin, PPIs, Indinavir, acyclovir
What are the sxs of AIN?
- Acute onset of decrease in renal function days to 2 weeks post administration of meds or infection.
- Fever, rash, hematuria, oliguria, N/V, malaise, flank pain.
- Decreased urine concentration, decreased GFR, eosinophils, no bacteria.
What are some findings on observation of a pt with Uveitis?
Retinal hemorrhages, ciliary injections, dilated pupil (+ eye pain and redness, photophobia)
What are some toxins known to cause Acute Tubular Necrosis (ATN)?
Contrast, cisplatin, lithium
What is the most common type of acute renal failure? Name things that contribute to it.
Pre-renal (50-60%)
- Decreased intravascular volume (hemorrhage, dehydration, pancreatitis, burns, trauma)
- Changes in vascular resistance ( sepsis, anaphylaxis, drugs [ACEI, NSAIDs], renal artery stenosis
- Low CO (CHF, PE, pericardial tamponade)
Pt (prostate owner) has acute urinary retention, peroneal/ lower pelvic pain, not urinating, and has a fever. What is it you are worried about in terms of their diagnosis? What are you worried about in terms of a complication? What do you not want to do on DRE?
Acute bacterial prostatitis
Worried about postrenal renal failure
Do not do a prostate massage
A person recovering from acute renal failure comes to see you, what are some things you could do to offer them support?
- Support emunctories
- Antioxidants and anti-inflammatories
- Botanical Medicine:
- Rheum palatum
- Salvia miltiorrhiza
- Cordyceps sinensis
- Urtica seed
- Silymarin
- Support for reperfusion (silymarin, garlic)
- Hydrotherapy (wet sheet wraps, constitutional)
- Remove food allergens from diet
- Manage and monitor hypertension (ACEi or botanicals)
- Counsel on adequate protein intake (0.5.0.8 g/kg body weight)
- Monitor vitals
- Homeopathy
Name 5 Nephritic syndromes.
Nephritic syndromes
- Post-streptococcal Glomerulonephritis (PSGN)
- Wegner’s Granulomatosis
- Churg-Strauss Syndrome
- Anti-GBM Antibody (Goodpasture’s Syndrome)
- IgA Nephropathy (Berger’s Disease)
What are the common symptoms of Nephritic syndromes?
- Inflammation of the glomeruli
- Oliguria
- Cola-colored urine (hematuria)
- HTN
- Mild proteinuria
What causes Post-Streptococcal Glomerulonephritis?
Strep infection leads to development of circulating immune complexes. Type III or II hypersensitivity rxn)
How do you treat Post-Streptococcal Glomerulonephritis?
- Supportive care
- Penicillin or erythromycin for infx
- Loop diuretic/ furosemide for HTN/edema
- Limit protein and sodium
- Cucuma and boswelia
- Quercetin / Bromelain / Fish oil
- Vit C / Vit E
- Constitutional hydrotherapy / Wet sheet wrap
What is the most common cause of Pyelonephritis?
Ascending infection (e coli)
What are the lab findings in Renovascular HTN (ESRD)?
High plasma renin
What is the diagnostic criteria for Autosomal Dominant Polycystic Kidney Disease (ADPKD)?
Age 15-39 at least 3 cysts in both kidneys
Age 40-59 2 cysts in both and positive FHx
Palpable nodular kidney
(CT is diagnostic)
What is Vesicoureteral Reflux (VUR)?
Malposition or incompetent closure of UVJ allows for urine to reflux from the bladder. Congenital or acquired (scarring in adults, obstruction)
Name risk factors for Bladder Cancer.
- Smoking
- Males
- Age >69
- Chronic UTI
- Schistosoma infection
Risk factors for urologic carcinoma you would investigate all of the following except
- Family history
- Her fluid intake
- Her psychiatric history
- Her birthplace
Psychiatric history
Homeopathic remedies for renal cysts
Baryta carb and medorrhinum
