Nephro Flashcards
Most common cause of death in SLE
Lupus nephritis
SLE peak incidence
15-45
Male vs female: SLE
Female
Male vs female: Lupus nephritis
Equal
Children vs adults: Lupus nephritis is worse
Children
Male vs female : Lupus nephritis is worse
Male
Hallmark of lupus nephritis
Deposition of circulating immune complexes and in situ formation of others
Subendothelial vs subepthelial: Circulating immune complexes
Subendothelial (and mesangial)
Subendothelial vs subepthelial: Complexes formed in situ
Subepithelial
Subendothelial deposits in SLE nephritis form
Wireloops
Mgt of SLE: Induction/emergency
Methylprednisolone
Mgt of SLE: Maintenance
Prednisone
Most common drugs used in the mgt of SLE (4)
1) Steroids
2) Cyclophosphamide
3) Mycophenolate mofetil
4) Azathioprine
Drug for SLE that causes hemorrhagic cystitis
Cyclophosphamide
Pathognomonic lesion of DM nephropathy
Kimmelsteil-Wilson Lesion
% of Type 2 DM that already have nephropathy when diagnosed
20%
30-40% of Type 2 DM develop diabetic nephropathy within __years of diagnosis
10
When microalbuminuria is observed in 40% Type 1 DM patients
Next 5-10 years of disease
Normal urine protein
150 mg/day
Microalbuminuria
150-300 mg/day
Macroalbuminuria
> 300 mg/day
BP ctrl recommended for DM
Less than 130/80 mmHg
First line of therapy for all patients with diabetes and htn
ACEI
Alternative to ACEI in treatment of Htn in pxs with DM and Htn who also have asthma exacerbations
ARB
Most important and commone type of tubulointerstitial inflammation
Acute pyelonephritis
Most common organism obtained in urine culture of patients with pyelonephritis
E. coli
2 routes in the devt of pyelonephritis
1) Ascending
2) Hematogenous
Most common route in the devt of pyelonephritis
Ascending
Important morphologic hallmark of acute pyelonephritis (3)
1) Patchy interstitial suppurative inflamm
2) Intralobular aggregates of neutrophils
3) Tubular necrosis
Pyelonephritis: Caseous necrosis
Tuberculous
Pyelonephritis: Proteus mirabilis
Xanthogranulomatous pyelonephritis
Drug that can cause tubulointerstitial nephritis via interstitial immunologic reaction
Methicillin
Form of adult polycystic kidney disease associated with polycystic liver disese
Juvenile
Syndrome: 1) Hemangioblastoma or hemangioma of cerebellum, brain stem or retina
Von Hippel-Lindau
Internist’s tumor
Renal cell CA
90-95% of renal neoplasms arise from
Kidney
Response of renal cell CA to radio and chemotherapy
Resistant
4 hereditary syndromes associated with renal cell CA
1) VHL
2) HPRC
3) FRO
4) HRC