GU Packet 2

Question 1

What are the clinical hallmarks of glomerular injury

Answer 1

1. Edema
2. Hematuria
3. Increased BUN and Cr; proteinuria
4. Decreased protein in the blood in varying combinations

Question 2

What is nephritic syndrome

Answer 2

inflammatory damage to glomeruli; do not properly filter RBCs so hematuria develops

Question 3

What is nephrotic syndrome

Answer 3

Damage to glomerular filtration system; glomeruli do not filter albumin

Question 4

Qualities of nephritic syndrome

Answer 4

hematuria, proteinuria<3.5, RBC casts, hypoalbuminemia, HTN

Question 5

Qualities of nephrotic syndrome

Answer 5

proteinuria > 3.5

Question 6

What is acute glomerulonephritis (AGN)

Answer 6

acute/sudden inflammation of the glomeruli

Question 7

What is the most common cause of AGN

Answer 7

IgA nephropathy

Question 8

What happens if AGN is not treated

Answer 8

Can progress to chronic GN

Question 9

What are the three most common causes of ESRD

Answer 9

Diabetes, HTN, and AGN

Question 10

What is the clinical presentation of AGN

Answer 10

Hematuria
Oliguria/anuria
Edema
HTN

Question 11

What will UA show in AGN

Answer 11

dark urine
RBC casts
proteinuria (<3.5)

Question 12

How is AGN treated

Answer 12

steroids/immunosuppressants (cyclosporine)
diuretics
dietary managements
ACE inhibitors

Question 13

What are the complications of AGN

Answer 13

AKI/CRF

Question 14

What is the most common cause of AGN

Answer 14

PSGN

Question 15

What is PSGN commonly caused by

Answer 15

nephritic strains of streptococcus pyogenes, GABHS, Group-A strep

Question 16

Pathophysiology of PSGN

Answer 16

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

Question 17

What will be before presentation of nephritis for PSGN

Answer 17

latent period; 1-2 weeks if post strep pharyngitis, 3-6 weeks if post-dermal infection

Question 18

What is the clinical presentation of PSGN

Answer 18

facial swelling
recent strep infection
hematuria/frothy urine
HTN

Question 19

How is PSGN diagnosed

Answer 19

throat and skin culture + for GAS; elevated anti-streptolysin titers

Question 20

What is the treatment for PSGN

Answer 20

self limiting in children
control volume overload (HTN and edema)
treat nephritogenic bacteria w/ Penicillin G

Question 21

What is nephrotic syndrome

Answer 21

Excess loss of protein through the urine; glomeruli are damaged and cannot prevent loss of protein into the filtrate

Question 22

What are the two types of nephrotic syndrome

Answer 22

Primary vs. secondary

Question 23

describe the pathophysiology of nephrotic syndrome

Answer 23

significant proteinuria
hypoalbuminemia
severe edema
hyperlipidemia
foamy urine (potentially first sx)

Question 24

What are the swelling symptoms of nephrotic syndrome

Answer 24

facial edema
puffy eyelids
scrotal swelling
extremity edema (pitting edema)

Question 25

What may be found to diagnosed nephrotic syndrome

Answer 25

proteinuria fatty casts oval fat bodies (caused by loss of cholesterol in urine)

Question 26

How is the etiology diagnosed in adults for nephrotic syndrome

Answer 26

renal biopsy; only children if no improvement with corticosteroids

Question 27

What should treatment of nephrotic syndrome focus on

Answer 27

treating underlying disease processes and preventing complications

Question 28

What are treatment examples for nephrotic syndrome

Answer 28

ACE inhibitors, diuretics, dietary management, avoid nephrotoxic drugs

Question 29

Explain diabetic nephropathy

Answer 29

kidney damage due to lack of managing diabetes most common cause of proteinuria and chronic kidney disease