Urology/Renal (5%) Flashcards
Acute glomerulitis is an immunologic inflammation of the glomeruli causing ____ and _____ leakage into the urine
protein and RBCs
If a pt has HTN, hematuria (RBC casts), dependent edema (proteinuria), and azotemia, what underlying condition is present?
Acute glomerulonephritis
Azotemia is a medical condition characterized by abnormally high levels of nitrogen-containing compounds (<em>urea, creatinine, various body waste compounds, and other nitrogen-rich compounds</em>) in the blood
What is the most common cause of AGN in adults, worldwide?
IgA Nephropathy (berger’s disease)
_________ is a similar disease to IgA nephropathy (berger’s disease) but associated with generalized IgA vasculitis
Henoch schonlein purpura
Berger’s disease often affects young (males/females) within days after _______ or _______ infection
males
URI or GI
Post infectious glomerulonephritis classically presents as a ____-____ y/o (boy/girl) with ______ edema up to 3 weeks after Strep with scanty, ________ urine
2-14 y/o
boy
facial
cola-colored/dark
Rapidly progressive glomerulonephritis (RPGN) is associated with a (poor/good) prognosis with _____ formation on bx
poor
crescent
crescents formed due to fibrin & plasma protein deposition collapsing the crescent shape of Bowman’s capsule
How to treat IgA nephropathy?
ACE Inhibitors, +/- Corticosteroids
What two body systems does Goodpasture’s dz affect?
Kidney
Lung
Post infectious acute glomerulonephritis is most commonly seen after what infxn?
GABHS
What two conditions present with + ANCA antibodies and a ack of immune deposits?
Microscopic Polyangiitis (vasculitis of small renal vessels): +P-ANCA
Granulomatosis with Polyangiitis (Wegener’s): necrotizing vasculitis +C-ANCA
Tx for rapidly progressive glomerulonephritis?
Corticosteroids + Cyclophosphamide
Any cause of AGN can present with RPGN, which 2 ONLY PRESENT with RPGN?
Goodpasture’s dz
Vasculitis
How to tx Goodpasture’s dz?
High dose corticosteroids + cyclophosphamide + plasmaphersis
How to dx a pt with acute glomerulonephritis?
Gold standard?
Urinalysis (UA): hematuria (RBC casts), dysmorphic RBCs, proteinuria (usually <3g/d but may be in the nephrotic range), high specific gravity > 1.020 osm, ± WBCs
Increased BUN, increased Creatinine to varying degrees
Renal biopsy gold standard (not needed if poststrep suspected)
T/F: Glomerulonephritis is usually self-limited with a good prognosis
TRUE
except in cases of RPGN
What are risk factors associated with cystitis in children/neonates?
vesicourethral reflux, newborns with FUO (fever of unknown origin)
Other: DM, catheter
What is the most common organism to cause cystitis?
E. coli
What are some sx a pt may experience with cystitis?
dysuria, increased frequency, urgeny, hematuria, suprapubic discomfort
In a pt with pyelonephritis, what sx may be present?
fever, tachycardia, back/flank pain, +CVA tenderness, N/V
How to dx a pt with cystitis?
UA
Diptick
What are medication options for management of uncomplicated cystitis?
Nitrofurantoin
Fluoroquinolones
Trimethoprim-sulfamethoxazole
What is complicated cystitis?
underlying condition with risk of therapeutic failure: sx >7 days, pregnancy, DM, immunosuppression, indwelling catheter, anatomic abnormality, elderly, males
Tx for complicated cystitis?
Fluoroquinolone PO or IV, Aminoglycosides
If a pt with cystitis is pregnant, what tx options are there?
Amoxicillin, Augmentin, Cephalexin, Cefpodoxime, Nitrofurantoin, Fosfomycin, Sulfisoxazole is safe except in last days of pregnancy (Increased kernicterus)
Tx for pyelonephritis?
Fluoroquinolone PO or IV, Aminoglycoside x14 days (7 days may be used in healthy, young women)
