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
