Nephrology

Question 1

edema, elevated BUN/Cr, proteinuria, HIV

Dx? histology?

Answer 1

HIV associated nephropathy (HIVAN)

Focal segmental glomerulosclerosis (FSGS)

Question 2

polycystic kidney disease Dx criteria?

Answer 2

age 15-29 : 3 or more cysts in each kidney
age 30-59 : 2 or more cysts in each kidney
age >60 : 4 or more cysts in each kidney

ADPKD-1, ADPKD-2 genetic studies are only done in equivocal cases.

Question 3

post-streptococcal glomerulonephritis
Tx ?
Px?

Answer 3

admission
antihypertensives
fluid restriction
high carb low protein diet

95% resolve within 4 weeks.

Question 4

thrombocytopenia 
petechia 
anemia 
ARF
hallucination 
fever

Answer 4

thrombotic thrombocytopenic purpura

Tx plasma exchange

Question 5

proteinuria and hypertension two weeks after URI.

Dx? and Tx?

Answer 5

Poststreptococcal glomerulonephritis

Tx. admission
antihypertensives
fluid restriction
high carb low protein diet

Px. 95% resolve within 4 weeks.

Question 6

gross or microscopic hematuria 1-2 days after URI.

Dx? and Tx?

Answer 6

IgA nephropathy

Tx. supportive 
antihypertensives if needed : ACEi ARB
Omega-3 fatty acids. .
Immunosuppressants. In some cases, corticosteroid 
Statin therapy. 
Diuretics.

Px . recurrence happens. some develop into ESRD. Proteinuria in nephrotic range = a bad Px factor

Question 7

child, facial edema, proteinuria

Dx?

Answer 7

minimal change disease (nephrotic syndrome)

Steroid