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
