Nephritic/nephrotic syndrome

Question 1

3 most important nephritis for test are post infectious, lupus and granulomatosis with polyangiitis

Answer 1

ok

Question 2

Antibiotics do not help post infectious glomerulonephritis and most common in kids (makes sense b/c kids get strep)

Tests for it?
Finding on hits?

Tx?

Answer 2

Antistrep O if previous strept throat, but if previous skin impetigo, DNAse B will be there (for strep throat and Strep B)

Histo is subepithelial humps are bumpy ALSO MESANGIAL is crazy cellular (can’t see capillaries)

Self limiting treatment

Question 3

General treatment for nephritic syndrome?

Answer 3

steroids, acei’s and statins over and over

Question 4

Most common nephrotic in children?

Tx?

Answer 4

Minimal change edema

pretty normal biopsy

Steroids

Question 5

Membranous nephropahty on biopsy?

Answer 5

Spike and Dome and thickening of membrane (MEMBRANE makes sense)

Domes!! spikes of super thick membrane bumping up

Question 6

Hep b associated with what nephropathy?

Answer 6

Membranous nephropathy (used to be most common)

Question 7

Tram track appearance is in what nephrotic syndrome? What causes the syndrome?

Answer 7

Membranoproliferative glomerulonephritis

Infection or autoimmune disease and is TRAM TRACK appearance as membrane thickens

Lupus can cause it
Hep B and C (more common with C)

Think B is before C and membranous is shorter than menmbranoprolipherative

Question 8

Diabetes affect on kidney?

Answer 8

Diabetic nephropathy with KIMMELSTEIN wilson nodule

Round pink nodule. Dense mesangium without many cells

Question 9

What causes hyaline casts?

Answer 9

Nonpathologic. Comes with dehydration

Question 10

Red cell casts?

Answer 10

Glom bleeding

Question 11

White cell asts?

Answer 11

Pyelo or tubular interstitial disease or glomerular disorder

Question 12

What causes epithelial casts?

Answer 12

Acute glom nephritis causign desquamation of glomeruli

Question 13

What causes granular casts?

Answer 13

ATN!!! breakdown of other casts usually. They are brown

Question 14

Casts are nonspecific, but might push in a certain direction if question stem/history are helpful

Answer 14

oh ok

Question 15

FENa for prerenal?

Answer 15

less than 1%

Intrinsic or post renal is more than 2%

Question 16

Calculation of FENa?

Answer 16

(Urin Na/Serum Na)/(Urin cr/serum Cr)

Question 17

Chronic kidney disease meds?

Why beta blockers!

Answer 17

BP CONTROL and LIPID with statins and ANEMIA iron and expo Vit D, Phos-Lo, Aspirin!!!!

Diuretics to get edema out
ACEi or ARB unless high potassium!
Beta blockers to reduce CAD risk!!!
CCB, be careful for edema

Question 18

Dialysis mnemonic?

Answer 18

AEIOU

Acidosis
Electrolytes (POTASSIUM)
Ingestion of toxin
Overload of fluid
Uremia