Quiz 1 Flashcards
Signs and Symptoms of PSGN
- Prior group A strep infx
- Pharyngitis or rash(impetigo)
- Latent period 1-3 weeks post pharyngitis
- 3-6 weeks after skin infx
- fever,confusion
- HTN, periorbital edema
- hematuria
- HA N/V Malaise
Signs and Symptoms of Acute Interstitial Nephritis (AIN)
- acute onset of decrease in renal function days-2weeks post admin of meds or infx
- fever, rash
- hematuria
- oliguria
- N/V and malaise
- Decreased urine concentration
- Decreased GFR
Signs and Symptoms of Acute Tubular Necrosis (ATN)
- uremic pruritis
- pericardial friction rub
- asterixis
- HTN
- Edema
- Oliguria depening on extent of tubular damage
Signs and Symptoms of Pre-renal renal failure
- Dehydration
- Thirst
- Diziness
- Mental Status change
- Poor skin turgor
- Collapsed neck veins
- dry mucous membranes
- hypotensive
- orthostatic bp changes
- tachycardia
Signs and Symptoms of Intrinsic Renal Failure
- salient hx of URI
- Diarrhea
- Ab/Iv drug
- back pain
- gross hematuria
- fever(PN)
- Maculopapular Rash (interstitial nephritis
- Dehydration
- Shock
Signs and Symptoms of Post-Renal Renal Failure
- Renal Pain and tenderness
- Lower abdominal pain
- Post surgery urine leak
- Over-hydration
- Edema
- Ileus with abdominal distention
- Enlarged prostate on DRE
- Distended bladder
Lab Results for AIN
- UA: Hematuria, proteinuria, high WBC, WBC casts,NO bacteria, eosinophilia
- CBC: eosinophilia, impaired renal function, increased creatinine
- FENa >1% tubular damage
Lab Results for PSGN
-UA:cola colored urine
-oliguria, RBC,
-RBC casts,
-proteinuria <3.5
Serology:
-streptozyme test 5 antib
-decreased C3/CH50
-C4 and C2 may be normal
Lab Results for Acute Tubular Necrosis
-UA: mild proteinuria, hematuria, RTE and RTE casts with tubular fragments, other casts
Labs: elevated BUN/Creatining. Decreased GFR
Lab results for Pre-Renal Renal Failure
-oliguria SG>1.20 Urine Sodium: <20mEq/L HIGH BUN/creatinine >20:1(azotemia) No changes in urine sediment
Lab results for Intrinsic Renal Failure
UA: -SG<1.010 if tubular cause -SG>1.020 if glomerular cause -Osmolality <300 -Urine Sodium >3o=tubular <20=glomerular -Granular casts(ATN,GN, AIN) -WBC casts(PN) RBC casts(PSGN) eosinophiluria(AIN) -High BUN and CREATININE -Low BUN/creatinine ratio -high cystatin C early on
Lab Results for Post Renal Renal Failure
SG>1010 early<1010 late Urine Na: <20 early, >40 late -high BUN creatinine -BUN/Cr 10-20 Ua: crystals or hematuria
Treatment for PSGN
- Antibitotic for infx
- Edema o HTN(loop diur)
- botanical diuretics include dandelion leaf, nettles, watermelon, castor oil for edema
- limit protein/sodium
- bed rest
- curcuma/echanacea
- quercitin/bromelain
- vit c to bowel tolerance
- Vit E 800 IU
- Constitutional Hydrotherapy
Treatment for Acute Interstitial Nephritis
- Normal renal fxn usu occurs with discontinuation of cauasitive agent
- lowprotein, low K, low Na diet
- Anti-inflammatories/antiox
- Renafood
- natural treatment for offending agent
- prednisone
- dialysis if severe
Treatment for Acute Tubular Necrosis
- Correct ischemic cause or remove toxic exposure
- Manage ARF
- Chelation once sx managed
- NAC to prevent radiation nephropathy (600-1200 mg bid)
- Cisplatin: induced nephropathy- lipoic acid, NAC, ginko, capsaicin, selenium, quercetin
- Protectivies: silybum marianu, ginko, cordyceps, urtica seed, CoQ10, Selenium, Vit C
