Proteinuria Flashcards
1
Q
def.
A
> 150mg protein/ day
2
Q
4 general classes
A
- glomerular
- increased permeability - tubular
- small proteins are usually reabsorbed
- less severes - overflow
- increased production (myloma) overwhems filtering capactiy - Other
- UTI
- fever, heavy exertion
- preg
3
Q
4 key features of nephrotic syndrome + 2 others
A
- urine proteint > 3.5G/25hrs
- hypoalbuminemia - can’t keep up with losses
- edema - first complaint
- hyperlipidemia - hepatic LDL and VLDL synthesis
also - hypercoag state
- risk of infection due to loss of Igs
4
Q
underlying problem in nephrotic syndrome
A
glomerular disease
5
Q
6 main causes
A
- primary glomerular
- membranous
- Focal segmental glomerulosclerosis
- minimal change - systemic
- DM, collagen vascular, SLE, RA, henoch scheinlen, - amyloidosis
- drugs/toxins
- infection
- multiple myeloma, malignant HTN
6
Q
tests for nephrotic
A
- urine dip
- albumin - urinalysis
- RBC casts suggest GN
- WBC casts - pyelo and interstitial
- Fatty casts nephrotic - test for microalbuminuria
- can be sign of diabetic nephropathy - other to determina etioligy
7
Q
Tx of symptomatic
A
further testing always required
- Tx underlying
- ACEi
- diuretics for edema
- limit dietary protein
- lipid lower
- vaccinate
8
Q
Tx of symptomatic
A
further testing always required
- Tx underlying
- ACEi
- diuretics for edema
- limit dietary protein
9
Q
4 general classes
A
- glomerular
- increased permeability - tubular
- small proteins are usually reabsorbed
- less severes - overflow
- increased production (myloma) overwhems filtering capactiy - Other
- UTI
- fever, heavy exertion
- preg
10
Q
4 key features of nephrotic syndrome + 2 others
A
- urine proteint > 3.5G/25hrs
- hypoalbuminemia - can’t keep up with losses
- edema - first complaint
- hyperlipidemia - hepatic LDL and VLDL synthesis
also - hypercoag state
- risk of infection due to loss of Igs
11
Q
underlying problem in nephrotic syndrome
A
glomerular disease
12
Q
6 main causes
A
- primary glomerular
- membranous
- Focal segmental glomerulosclerosis
- minimal change - systemic
- DM, collagen vascular, SLE, RA, henoch scheinlen, - amyloidosis
- drugs/toxins
- infection
- multiple myeloma, malignant HTN
13
Q
tests for nephrotic
A
- urine dip
- albumin - urinalysis
- RBC casts suggest GN
- WBC casts - pyelo and interstitial
- Fatty casts nephrotic - test for microalbuminuria
- can be sign of diabetic nephropathy - other to determina etioligy
14
Q
Tx of asymptomatic
A
- transient - none
- persistent - furhter testing - BP, urine sediment
15
Q
Tx of symptomatic
A
further testing always required
- Tx underlying
- ACEi
- diuretics for edema
- limit dietary protein
