Nephrology Flashcards
How does minimal change disease present?
nephrotic syndrome. This patient has presented with facial oedema associated with hypoalbuminemia and proteinuria
Give causes of minimal change disease
drugs: NSAIDs, rifampicin
Hodgkin’s lymphoma, thymoma
infectious mononucleosis
What is the pathophysiology of minimal change disease
T-cell and cytokine-mediated damage to the glomerular basement membrane → polyanion loss
the resultant reduction of electrostatic charge → increased glomerular permeability to serum albumin
What does renal biopsy show in minimal change disease?
Normal glomeruli on light microscopy
electron microscopy shows fusion of podocytes and effacement of foot processes
What is the management of minimal change disease?
Management
oral corticosteroids: majority of cases (80%) are steroid-responsive
cyclophosphamide is the next step for steroid-resistant cases
How do we manage ascites?
Spironolactone is a potassium-sparing diuretic that is the recommended first-line therapy for managing ascites in patients with liver cirrhosis.
How does transitional cell carcinoma of the bladder present?
Painless haematuria
Would you expect hypo or hypercalcaemia in CKD?
Hypo
How does HSP present?
Henoch-Schonlein purpura classically presents with abdominal pain, arthritis, haematuria and a palpable purpuric rash over the buttocks and extensor surfaces of arms and legs
What is spironolactone?
Aldosterone antagonist
How does HUS present?
Haemolytic uraemic syndrome is generally seen in young children and produces a triad of:
acute kidney injury
microangiopathic haemolytic anaemia
thrombocytopenia
How do we manage HUS?
treatment is supportive e.g. Fluids, blood transfusion and dialysis if required
there is no role for antibiotics, despite the preceding diarrhoeal illness in many patients
