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Clin Med Lab 2 - Exam 1 > Poststreptococcal Glomerulonephritis > Flashcards

Poststreptococcal Glomerulonephritis Flashcards

1
Q

what type of strep causes psgn

A

GABS

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2
Q

where is psgn mc

A

developing countries

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3
Q

rf for psgn

A

4-15 yo

elderly

male

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4
Q

mc cause of acute nephritis worlwide

A

psgn

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5
Q

psgn develops __ weeks after an impetigo infxn

A

3-6

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6
Q

psgn develops __ weeks after a pharyngitis infxn

A

1-3

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7
Q

__ can be the only symptom of psgn

or the pt can have full __

A

microscopic hematuria

nephritic syndrome

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8
Q

symptoms of nephritic syndrome (5)

A

red/brown urine

proteinuria

edema

htn

elevated serum creatinine

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9
Q

mc presenting symptoms of nephritic syndrome

A

generalized edema

gross hematuria

htn

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10
Q

systemic sx of psgn (4)

A

ha

malaise

anorexia

flankl pain

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11
Q

what will UA for psgn show (3)

A

RBCs

red cell clasts

proteinuria

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12
Q

elevated renal values in psgn

A

BUN

Cr

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13
Q

in psgn, serum complement will be __

bc __

A

low

acute immune rxn

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14
Q

in psgn, what 3 serology tests are indicative of recent strep infxn

A

ASO (anti streptolysin O)

anti-DNAse

streptozyme

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15
Q

what do you think when you see “honey colored crust” type rash around the mouth

A

strep impetigo infxn

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16
Q

severe symptom of psgn

A

pulmonary htn

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17
Q

why would we do strep serology over culture

A

w. normal swab test, it is unlikely that pt will still be positive for strep

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18
Q

when does complement return to normal

A

6-8 weeks

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19
Q

dx for psgn (2)

A

clinical findings

proof of recent GAS infxn

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20
Q

what diagnostic test is not commonly performed for psgn

A

renal bx

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21
Q

when would you perform renal bx for psgn

A

concern for:

lupus nephritis

IgA nephropathy

or other intrinsic renal issue

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22
Q

goals of psgn tx

A

eradicate residual nephritogenic bacteria

supportive care

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23
Q

there is no specific therapy for psgn, but __ especially needs to be taken care of

A

volume overload

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24
Q

abx for psgn

A

penicillin

  • only drug shown to reduce rates of acute rheumatic fever*
  • alternate first line: Amoxicillin*
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25
Q

tx for psgn for mildly penicillin allergic pt

A

cephalexin (Keflex)

26
Q

abx for pt w. severe penicillin allergy

A

azithromycin

27
Q

why do some not recommend abx for psgn

A

they don’t alter the course of the disease

strep infxn already came and went

28
Q

abx for psgn might help to prevent

A

person to person spread

29
Q

most pt’s recover completely from psgn; 3 long term complications for pt’s who do not (3)

A

HTN

recurrent proteinuria

renal insufficiency

30
Q

when does Cr normalize in psgn

31
Q

pt usually diureses w.in __ of psgn infxn

32
Q

hematuria usually resolves in __ of psgn infxn

A

3-6 months

33
Q

which sx resolves the slowest in psgn

A

proteinuria

34
Q

rheumatic fever results from an __ rxn to GAS infxn

A

autoimmune

35
Q

mc cause of heart disease in kids in developing countries

A

rheumatic fever

36
Q

mc pt population w. rheumatic fever

37
Q

usual onset of rheumatic fever post GAS infxn

38
Q

mc presentation pattern in rheumatic fever (2)

A

acute febrile illness → joint manifestations and/or carditis

neurologic/behavioral manifestations → chorea

39
Q

symptoms of rheumatic fever

A

JONES:

joint pain

o (heart) - carditis

nodular sq lesions

erythema/rash

sydenhams chorea

40
Q

what sx is seen in 90% of pt w. rheumatic fever

A

fever

duh!

41
Q

signs of carditis in rheumatic fever (4)

A

dyspena

orthopnea

cp

palpitations

42
Q

describe the joint pain associated w. rheumatic fever (2)

A

large joints

migratory

43
Q

joint pain associated w. rheumatic fever has a dramatic response to

A

nsaids/salicylates

44
Q

describe syndenham’s chorea (4)

A

uncontrolled jerky movements

limbs, face, tongue

usually worse on one side

stop wile sleeping

45
Q

describe the nodular lesions associated w. rheumatic fever

A

painless

resolve in 1-2 weeks

46
Q

the rash associated w. rheumatic fever is called

A

erythema marginatum

47
Q

you can’t use jones criteria without

A

evidence of strep infxn

48
Q

in jones criteria, you need __ major

OR

__ major plus

__ minor

A

2 major

OR

1 major PLUS 2 minor

49
Q

major jones criteria (5)

A

joints → arthritis

carditis and valvulitis

subcutaneous nodules

erythema marginatum

CNS → usually Sydenham’s

50
Q

minor jones criteria (4)

A

arthralgia

fever

apr

prolonged PR on ekg

51
Q

4 main cardiac/ekg findings of rheumatoid fever

A

pr prolongation → AV block

pancarditis

mitral valve regurgitation

S3

52
Q

valve mc affected by rheumatic fever

53
Q

tx for acute rheumatic fever

A

abx

NSAIDs → for arthritis

manage carditis

54
Q

nsaid mc used for rheumatoid fever arthritis

A

aspirin

also naproxen

55
Q

NSAIDs for rheumatoid fever arthritis should be taken until

A

all joint sx have resolved

56
Q

prophylactic abx for rheumatic fever

A

penicilin or clindamycin

57
Q

abs directed hypersensitivity rxn against antigen on cells or extracellular materials (ex basement membrane)

58
Q

Ab-Ag complexes activate complement via classic pathway, causing cell lysis or extracellular tissue damage

A

type II hypersensitivity run

59
Q

Ab Ag complexes promote tissue damage thru complement activation - alternate pathway

A

type III hypersensitivity run

60
Q

Ab Ag complexes deposited in tissues

A

type III hypersensitivity run

61
Q

acute rheumatic fever is a __ hypersensitivity rxn

post streptococcal glomerulonephritis is a __ hypersensitivity rxn

A

acute rheumatic fever: II

psgn: III

Clin Med Lab 2 - Exam 1 (7 decks)

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