Neurology Flashcards
Glomerulonephritis:
1-post streptococcal glomeruolonephritis:
History
.URTI in the last 1-2 weeks
Glomerulonephritis
Organism……..
group A- beat hemolytic streptococci
Glomerulonephritis
Cp:
Oliguria
Edema
Glomerulonephritis
HTN
Tea-colored urine
Glomerulonephritis
Labs:
Hematuria and mild protenuria
Glomerulonephritis
Inv of choice
…renal biopsy
Glomerulonephritis TTT:
FIRST STEP
..admission
Glomerulonephritis Diet
increased carbohydrate and decrease protein
Anti-hypertensive drugs and fluid restriction for Glomerulonephritis is..
..most imp step
Glomerulonephritis Fate
over 95 % complete recovery
IgA nephropathy (Berger)
Most common type of )___________
Most common cause of _________ in kids
Most common type of glomerulonephritis
Most common cause of renal failure in kids
Berger’s History
.URTI in the last 1-2 days
Berger’s Cp
HTN
Labs (Berger’s)
.hematuria ( GROSS) and proteinuria…..best is biopsy
TTT (Beger’s)
.cortisone and control blood pressure
Renal affection 1-2 days of URTI =
Renal affection after 1-2 weeks =
Most common cause of renal failure in pediatrics =
Renal affection 1-2 days after URTI………IGA nephritis
Renal affection after 1-2 weeks……….post strep. Glomerulonephritis
Most common cause of renal failure in pediatrics…..IGA
nephritis
Thin basement membrane nephropathy: (benign hematuria) :
Is the most common cause of?
Most common cause of persistent glomerular bleeding in children and adults
Thin basement membrane nephropathy
Signs and symptoms:
Hematuria
Blood pressure, kidney function…… normal.
Mild proteinuria
Thin basement membrane nephropathy
Treatment
only reassurance.
Thin basement membrane nephropathy
Prognosis:
excellent prognosis.
Alport syndrome:
X-linked
Triad ( hematuria, ocular abnormalities and deafness)
hemolytic uremic syndrome :
Cause
:( E-coli O157-H7)
hemolytic uremic syndrome :
Source
..undercooked meat, unpasteurized milk
hemolytic uremic syndrome :
History
.bloody diarrhea
hemolytic uremic syndrome :
Age
Kids
Cp:
5- 7 days of infection…….intravascular hemolysis
Sudden pallor and irritability
hemolytic uremic syndrome :
Kidney affection
.oliguria and renal in sufficiency
THROMBOTIC THROMBOCYTOPENIC PURPURA:
More in kids or adults?
Affected?
more in the adult
The same scenario but the CNS is the most commonly
Affected……neurological symptoms and fever
THROMBOTIC THROMBOCYTOPENIC PURPURA
Labs:
Low platelets
Schistocytes
Anemia
THROMBOTIC THROMBOCYTOPENIC PURPURA
TTT
plasmapharesis …….ttt of choice
Never to give platelets
Henoch schonlein purpura pathology:
IGA NEPHRITIS
THROMBOTIC THROMBOCYTOPENIC PURPURA
CP:
1-Hematuria
2-abdominal pain
3-joint pain esp. knee
4-rash ( maculopapular) affecting buttock and knee (vasulitis
THROMBOTIC THROMBOCYTOPENIC PURPURA
History
URTI
THROMBOTIC THROMBOCYTOPENIC PURPURA
Complication
Intussusceptions vvvvvv imp
THROMBOTIC THROMBOCYTOPENIC PURPURA
Fate
..usually resolve spontaneously
THROMBOTIC THROMBOCYTOPENIC PURPURA
TTT
USUALLY NONE
THROMBOTIC THROMBOCYTOPENIC PURPURA
Resistant cases…
.cortisone is the drug of choice
Proteinuria:
Orthostatic:
Age
usually kids and adolescent
Proteinuria
First step
.repeat the test
Proteinuria If still (+)
24 h urine collection
Proteinuria
TTT
….reassure
Proteinuria Transient:
Causes:
.fever, exercise, dehydration, cold exposure, seizure
Proteinuria Transient
Fate
resolve spontaneously…..reassure
What if this proteinuria is recurrent…..biopsy …vvvv imp???
Proteinuria and hematuria in kids with URTI
Proteinuria and hematuria in kids with URTI
First step
repeat the test after recovery from the URTI
Nephrotic syndrome marked?
marked edema esp. periorbital
Nephrotic syndrome Cp:
Most common type
Nephrotic syndrome Labs:
Proteinuria ++++
Hypoalbuminemia
Hyperlipidemia
Nephrotic syndrome Renal functions
usually normal
Nephrotic syndrome Complications:
1-Infections
Nephrotic syndrome Organism
streptococcus pnemoniae
Nephrotic syndrome Most common area affected
..spontaneous bacterial peritonitis
Nephrotic syndrome 2-thrombophilia…
…esp renal vein thrombosis
Nephrotic syndrome
TTT:
Mild cases
.home management and bed rest
Nephrotic syndrome
Severe cases
hospital admission
Nephrotic syndrome
Diet
increase protein
Nephrotic syndrome
Drug of the choice
steroid
Nephrotic syndrome
If resistant
.immunosuppressive
Vesicoureteral reflux is?
Abnormal backflow of urine from bladder to kidney
Vesicoureteral reflux
Cp:
recurrent UTI infections