nephrology Flashcards
post strep GN
most common acute glomerulonephritis in children > 2
Sx: 8-14 days after skin or pharynx with strep pyogenes
- hematuria, proteinuria, HTN, low complement
Dx: ASO titer, ADB titer
- UA, serum complement levels, renal ultrasound, renal fxn, albumin chole
Tx: fluid restriction, antihtn meds, dietary restriction fo salt
iga nephropathy (berger’s disease)
most common type of chronic glomerulonephritis worlwide
Sx: recurrent gross hematuria associated with respiratory infections
Dx: iga deposits, mesangial proliferation and increased matrix on biopsy
Tx: supportive
- can develop ESRD
HSP nephritis
IgA mediated vasculitis
Sx: palpable purpura on buttocks and thighs, abd pain, arthritis, hematuria
- causes nephritis, can lead to chronic renal failure
MPGN
lobular mesangial hypercellularity and thickening of glomerular basement membrane
Sx: nephritis or nephrotic with gross hematura, HTN, low serum complement
Tx: nothing but steroids –> develop ESRD
membranous nephropathy
most common in adults
minimal change disease
most common nephropathy
- heavy proteinuria, hypoalbuminemia, hypercholesterolemia, edema
- predisposed to thrombosis secondary to hypercoag
- increased risk for encaps organisms like strep pneumo causing SBP, pneumonia, sepsis
Dx: UA, CBC, chem, C3, ANA, ASO, renal ultrasound
Tx: IV with albumin to help volume, no added salt, steroids, risk of infections bad
hemolytic uremic syndrome
acute renal failure with hemolytic anemia and thrombocytopenia
- caused by shiga toxin from undercooked beef, milk juices
Tx: supportive, no abx
- can die from toxic megacolon
alport’s syndrome
progressive hereditary nephritis from type IV collagen defect in glomerular basement membrane
- x linked dom
Sx: HTN/hematuria, hearing loss, ocular abnormalities
Tx: control HTN
most common cause of renal mass in newborn
multicystic renal dysplasia
renal tubular acidosis
Sx:
infants - growth failure and vomiting, can have metabolic acidosis
older children and adults - recurrent calculi, muscle weakness, bone pain, myalgias
hyperchloremic metabolic acidosis with normal serum anion gap
Dx: positive urine anion gap (urine na + urine K - urine chloride)
types of RTA
Distal RTA (type I) - distal renal tubular cells can’t excrete H+
Proximal RTA (type II) - impaired bicarb reabsorption by proximarl renal tubular cells
Type IV - transient acidosis in infants and children, hyperkalemia is hallmark
vesicoureteral reflux (VUR)
urine refluxing from bladder to ureters and renal collecting system
- 30-50% of infants with UTIs
- auto dom
Sx: can have spontaneous resolution with not too bad reflux
- can have pyelonephritis
- reflux nephropathy
Dx: voiding cystourethrogram
Tx: abx, or surgical reimplantation of ureters
urolithiasis
rare in children, look for metabolic disorder unerlying
Dx: electorlytes, BUN, creatinine, calcium, phosph, PTH, uric acid level, venous blood gas, urine testing, imagining
UTI
greater than 6 months more common in girls, < 6 months more common in boys
Cause: e coli (kleb, pseudo, staph, serratia, proteus, entero)
Dx: urine culture gold standard for diagnosis
