GU Packet 2 Flashcards
What are the clinical hallmarks of glomerular injury
- Edema
- Hematuria
- Increased BUN and Cr; proteinuria
- Decreased protein in the blood in varying combinations
What is nephritic syndrome
inflammatory damage to glomeruli; do not properly filter RBCs so hematuria develops
What is nephrotic syndrome
Damage to glomerular filtration system; glomeruli do not filter albumin
Qualities of nephritic syndrome
hematuria, proteinuria<3.5, RBC casts, hypoalbuminemia, HTN
Qualities of nephrotic syndrome
proteinuria > 3.5
What is acute glomerulonephritis (AGN)
acute/sudden inflammation of the glomeruli
What is the most common cause of AGN
IgA nephropathy
What happens if AGN is not treated
Can progress to chronic GN
What are the three most common causes of ESRD
Diabetes, HTN, and AGN
What is the clinical presentation of AGN
Hematuria
Oliguria/anuria
Edema
HTN
What will UA show in AGN
dark urine
RBC casts
proteinuria (<3.5)
How is AGN treated
steroids/immunosuppressants (cyclosporine)
diuretics
dietary managements
ACE inhibitors
What are the complications of AGN
AKI/CRF
What is the most common cause of AGN
PSGN
What is PSGN commonly caused by
nephritic strains of streptococcus pyogenes, GABHS, Group-A strep
Pathophysiology of PSGN
7-12 days after initial infection, antibodies are formed against streptococcal antigens and as a result the antigen antibody complexes get stuck on the GBM and cause acute inflammatory response
What will be before presentation of nephritis for PSGN
latent period; 1-2 weeks if post strep pharyngitis, 3-6 weeks if post-dermal infection
What is the clinical presentation of PSGN
facial swelling
recent strep infection
hematuria/frothy urine
HTN
How is PSGN diagnosed
throat and skin culture + for GAS; elevated anti-streptolysin titers
What is the treatment for PSGN
self limiting in children
control volume overload (HTN and edema)
treat nephritogenic bacteria w/ Penicillin G
What is nephrotic syndrome
Excess loss of protein through the urine; glomeruli are damaged and cannot prevent loss of protein into the filtrate
What are the two types of nephrotic syndrome
Primary vs. secondary
describe the pathophysiology of nephrotic syndrome
significant proteinuria
hypoalbuminemia
severe edema
hyperlipidemia
foamy urine (potentially first sx)
What are the swelling symptoms of nephrotic syndrome
facial edema
puffy eyelids
scrotal swelling
extremity edema (pitting edema)
What may be found to diagnosed nephrotic syndrome
proteinuria
fatty casts
oval fat bodies (caused by loss of cholesterol in urine)
How is the etiology diagnosed in adults for nephrotic syndrome
renal biopsy; only children if no improvement with corticosteroids
What should treatment of nephrotic syndrome focus on
treating underlying disease processes and preventing complications
What are treatment examples for nephrotic syndrome
ACE inhibitors, diuretics, dietary management, avoid nephrotoxic drugs
Explain diabetic nephropathy
kidney damage due to lack of managing diabetes
most common cause of proteinuria and chronic kidney disease
