Renal Flashcards
Most common chronic glomerular disease
Focal segmental mesangial proliferation
Gross hematuria 1-2 days after URTI or GI infection
Normal serum C3
IgA nephropathy (Berger nephropathy)
Caused by mutations inthe genes coding for type IV collagen
Foam cells
Hematuria 1-2 days after URTI
Anterior lenticonus is pathognomonic
Macular flecks, recurrent corneal ulcerations, GBM thicking and thinning, sensorineural deafness
Alport syndrome
Microscopic hematuria and isolated thinning of the GBM on EM
Thin basement membrane disease
“Lumpy bumpy” deposits of Ig and complement on GBM and mesangium
Depressed C3
Acute poststreptococcal GN
Hematuria in AGN develops __ after an antecedent streptococcal pharyngitis and __ after a streptococcal pyoderma
1-2 weeks after pharyngitis
3-6 weeks after pyoderma
The best antibody titer to document cutaneous streptococcal infection
anti-DNAse B level
Most common cause of membranous glomerulopathy worldwide
Malaria
Spikelike pattern of granular deposits of IgG and C3 on the epithelial side of the GBM
Thickening of the GBM
Manifests as nephrotic syndrome
Membranous glomerulopathy
Treatment of membranous glomerulopathy
Immunosuppressive therapy with an extended course of prednisone
Lobar pattern of diffuse mesangial expansion, endocapillary proliferatin, increase in mesangial cells and matrix
Glomerular capillary walls are thickened
Type I MPGN (most common)
Dense deposit disease
Not mediated by immune complex
Severely depressed complement levels
C3 nephritic factor is present in many patients
Type 2 MPGN
Pulmonary hemorrhage and glomerulonephritis
Antibodies directed against specific epitopes of type IV collagen
Continuous linear deposition of IgG along the GBM
C3 is normal, (+) anti-GBM antibody
Good pasture disease
Microangiopathic hemolytic anemia, thrombocytopenia, renal insufficiency. Diagnosis?
Hemolytic uremic syndrome
Definition of nephrotic range proteinuria
> 40 mg/m2/hr
or first morning protein:crea of >2-3:1
Nephrotic syndrome patient who continues to have proteinuria of 2+ or greater after 8 weeks of steroid therapy
steroid resistant
Nephrotic syndrome patient who relapses while on alternate-day steroid therapy or within 28 days of completing a successful course of prednisone
Steroid dependent
Nephrotic syndrome patient who responds well to prednisone therapy but relapses at least 4 times in a 12-month period
Frequent relapser
Cumulative threshold dose of cyclophosphamide above which oligo- or azoospermia occurs in boys is __
> 250 mg/kg
Most common organism causing spontaneous bacterial peritonitis
streptococcus pneumoniae
Vaccines can be administered after corticosteroid therapy has been discontinued for how long?
1 month
USG >1.020 UOsm >500 mOsm/kg UNa <20 mEq/L FENa <1% (<2.5% in neonates) Prerenal, intrinsic renal or postrenal?
Prerenal
USG <1.010 UOsm <350 mOsm/kg UNa >40 mEq/L FENa >2% (>10% in neonates) Prerenal, intrinsic renal or postrenal?
Intrinsic renal
Vitamin D for renal osteodystrophy in patients with low 25-D levels
ergocalciferol
Vitamin D for renal osteodystrophy in patients with normal 25-D level but elevated PTH
calcitriol
In girls, first UTI occurs by the age of __
5 yr
In boys, first UTI occurs by the age of __
1 yr
In girls, 75-90% of UTIs are caused by these 3 pathogens
E. coli
Klebsiella
Proteus
If the testis has not descended by __, it will remain undescended
4 mo
The congenital undescended testis should be treated surgically not later than __
9-15 mo