Nephrology/Urology Flashcards
Nephrotic syndrome includes what manifestations?
- Proteinuria
- Hypoalbunemia
- Hyperlipidemia
Acute Glomerulonephritis (Nephritic Syndrome) includes what pt manifestations
- Hematuria (RBC casts)
- HTN
- Edema /Azotemia (High nitrogen in blood)
Nephrotic syndrome includes what 3 etiologies?
Minimal Change
Focal Segmental Glomerulosclerosis
membranous nephropathy
MC Nephrotic syndrome etiology occurring in children: Effacement of podocytes: Tx is Prednisone
Minimal change Disease
Nephrotic syndrome etiology Involves AA, HTN and fibrosis of glomerulus: “Not Steroid responsive”
Focal Segmental Glomerulosclerosis
Nephrotic syndrome etiology Involves thickening of the glomerular basement membrane: 2T immune complex depositions
Membranous Nephropathy
Nephritic Syndrome (AGN) includes what etiologies?
- IgA Nephropathy (Berger’s Disease)
- Post infectious
- Rapidly Progressive GN
- Good Pasture’s
Nephritic Syndrome (AGN) MC after GABHS or Impetigo: Facial Edema: Post-Strep: coca cola urine
Post Infectious GN
Nephritic Syndrome (AGN): Linear IgG depositis, hemoptysis and kidney failure (Hematuria
Good Pasture’s
Nephritic Syndrome (AGN) progresses to ESRD in weeks due to fibrin and protein deposition:
Crescent formation biopsy Tx:
Rapid Progression GN
CS and Cyclophosphamide
MC Nephritic Syndrome (AGN) in adults WW: post URI or GI infection; IgA mesangial deposits: Tx: ACE/ CS
IgA Nephropathy (Berger’s Disease)
Acute Kidney Injury Types
Prerenal (MC). Intrinsic, and post renal.
MCC of prerenal AKI is _______: which leads to_______ if not corrected ? BUN:Cr is?
Hypovolemia (NSAID/IV contrast): Leads to ATN
B:Cr 20:1
Intrinsic types of AKI?
Acute Tubular necrosis (ATN MC type)
Acute tubulointerstitial nephritis (AIN)
Intrinsic AKI caused by hypo/ tension-volemia or aminoglycosides: UA= Muddy Brown casts/Epithelial cell
ATN
AIN is caused by a ________–> to ________ casts?
Hypersensitivity (PCN, NSAID Sulfa: WBC Casts
RBC casts are pathognomonic for ?
Acute Glomerulonephritis
FeNa >2 you think what AKI?
ATN
Low FeNa< 2 you think what type of AKI?
Prerenal
Autosomal Dominant D/O: Abdominal Flank pain /palpable mass, recurrent infections, Hematuria, HTN
Dx: Tx:
Adult Polycystic Kidney Disease
Dx: Renal US Tx: ACEi/ renal transplant
Adult Polycystic Kidney Disease is associated with what Extrarenal common abnormalities
Berry Aneurysms and MVP
MCC and 2nd MCC of ESRD
1st MCC DM-II
2nd MCC HTN
what is the single best predictor of Chronic Kidney Disease?
Proteinuria
Best Diagnostic tool for CKD?
Spot Albumin/U creatinine Ratio (ACR)
“preferred over 24 hour collection”
(ACR <2 Normal; 2-20 micro: >20 nephropathy)
(Albuminuria 24H <30mg=Normal: 30-300mg: >300 neph)
What are the GFR CKD stages?
Stage 0= >90 Stage 1= 60-90 Stage 2= 30-59 Stage 3= 15-30 Stage 4= <15
Non-physiologic excess of ADH from pituitary or ectopic
2T stroke, trauma CNS tumor, ecstasy:
Hyponatremia Na < 120: Isovolemic- no edema:
Dx: Tx:
Syndrome of Inappropriate ADH
Dx: Concentrated urine Tx: H2O restriction < 800ml/day
Hyponatremia - hypertonic saline/Lasix
ADH (vasopressin) deficiency or insensitivity: Large amounts of urine 20L /day: Hypernatremia: Polydipsia
Dx Tx:
Diabetes Insipidus
Dx: Fluid deprivation–> dilute urine
Desmopressin–> reduces urine (central)
Tx: Desmopressin or carbamazepine
Drugs that can cause Diabetes insipidus –> partial or complete insensitivity to ADH?
Lithium or Amphotericin B
Electrolyte imbalance that causes Increased DTRs and prolonged PR and QT interval–> _____?
hypomagnesemia : Torsades
Hypermagnesemia treatment
-Calcium Gluconate