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Renal/GU > Nephrotic Syndrome > Flashcards

Nephrotic Syndrome Flashcards

1
Q

What are the key presentations for nephrotic syndrome?

A

Proteinuria, hypercholesterolaemia, hypoalbuminaemia

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2
Q

How does proteinuria present?

A

Frothy urine, infection

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3
Q

How much protein is there in the urine?

A

> 3,5g per 24 hours

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4
Q

How does hypercholesterolaemia present?

A

Xanthelasma, xanthomata, atherosclerosis

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5
Q

How does hypoalbuminaemia present?

A

Oedema, fatigue, dyspnoea, leukonychia

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6
Q

What are the steps in nephrotic syndrome pathology?

A

Inflammation –> damage to podocytes –> increased liver activity –> reduced oncotic pressure

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7
Q

What causes inflammation?

A

Immune cells, complement, HTN, atherosclerosis, medications/immunisations, infection

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8
Q

What does podocyte damage lead to?

A

Protein leakage

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9
Q

Why does liver activity increase?

A

To increase albumin

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10
Q

What happens due to increased liver activity?

A

Cholesterol and coagulation factors increase

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11
Q

What happens due to reduced oncotic pressure?

A

Oedema, blood volume decrease, RAAS stimulation, exacerbation

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12
Q

What blood tests would you do?

A

U&E, FBC, LFT, CRP, Calcium, glucose

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13
Q

What urine tests would you do?

A

MSU, dipstick

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14
Q

What imaging would you do?

A

USS of kidney, CXR

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15
Q

What would you screen for?

A

HIV, HBV, HCV

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16
Q

What is the gold standard investigation?

A

Needle biopsy and microscopy

17
Q

How do you manage nephrotic syndrome generally?

A

12 weeks corticosteroids - prednisolone

18
Q

How do you manage oedema?

A

Low salt intake, low protein diet

19
Q

How do you manage hyperlipidaemia?

A

Statins if prolonged

20
Q

How do you manage the hypercoagulable state?

A

Prophylactic anticoagulants like apixaban, LMWH, warfarin

21
Q

How do you manage infection?

A

Antibiotics

22
Q

What is the main cause of nephrotic syndrome in kids?

A

Minimal change disease

23
Q

What are causes of nephrotic syndrome in adults?

A

Membranous glomerulonephritis, focal segmental glomerulosclerosis, diabetic nephropathy, SLE, amyloidosis, Hep B or C, HIV

Renal/GU (15 decks)

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