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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) School Study Aid
Nephrotic Syndrome
- Signs and Symptoms
- Massive Proteinuria > 3.5g per Day
- Edema
- Increased risk of infection
- Thromboembolism
- Hyperlipidemia
- Fatty casts
1 min
Minimal Change Disease
- Pathophysiology
- Nephrotic
- Most Common in Children
- May be Triggered by Recent Infection or Immune Stimulus
- Diagnosis
- On Electron Microscopy (EM) See Foot Process (Podocyte) Effacement
- On Light Microscopy (LM) See Normal Glomeruli
- Loss of Negative Charge
- Selective Loss of Albumin
- Treatment
- Responds to Corticosteroids
2 mins
Focal Segmental Glomerulosclerosis
- Most Common Cause of Nephrotic Syndrome in Hispanic People and African Americans
- Associated with Sickle Cell Disease and HIV
- Associated Interferon Therapy and Heroin Abuse
- Histopathology
- LM Segmental Sclerosis and Hyalinosis
- EM Focal Damage of Visceral Epithelial Cells
- IF Negative
- Signs & Symptoms
- Microscopic Hematuria
- Nonselective Proteinuria
- Considerations
- Poor Prognosis
2 mins
Glomerulonephritis Assessment
- Mechanism
- Group A Beta-Hemolytic Streptococcal Infection
- Signs and Symptoms
- Hypertension
- Hematuria
- Proteinuria
- Oliguria
- Generalized Edema
- Increased BUN and CR
- Flank Pain
2 mins
Acute Glomerulonephritis Interventions
- Rest
- Restrict Salt and Fluid Intake
- Restrict Protein
- Antihypertensives
- Diuretics
- Antibiotics
2 mins
IgA Nephropathy (Berger's Disease)
- Classification
- Nephritic
- Epidemiology
- Most Common Glomerulonephritis
- Higher Prevalence in East Asians
- Clinical Presentation
- Synpharyngitic Hematuria after URI or GI Infection
- Proteinuria
- Pathogenesis
- Alternative Complement Pathway Activation (C3)
- Increased Synthesis of IgA
- Pathology
- Mesangial IgA Immune Complex Deposition on Biopsy
- Treatment
- RAAS Blockade is First Line
- Steroids for High-risk
2 mins
Post Streptococcal Glomerulonephritis
- Pathophysiology
- Nephritic
- Children
- Signs and Symptoms
- Edema
- Cola Colored Urine
- Follows Group A Streptococcal pharyngitis or Skin Infection
- Diagnosis
- Neutrophils
- Immunofluorescence (IF) Granular
- Lumpy Bumpy Appearance on Immunofluorescence (IF)
- Subepithelial Immune Complex Humps
2 mins
Membranoproliferative Glomerulonephritis
- Nephritic-Nephrotic Syndrome
- Type I
- Subendothelial Immune Complexes
- Hepatitis C Virus
- Granular IF
- Tram Tracks Caused by Splitting of the GBM
- Ingrowth of Mesangium
- Type II
- Dense Deposit Disease
- C3 Nephritic Factor
2 mins
Membranous Glomerulonephritis
- Characteristics
- Nephrotic
- Diagnosis
- LM Thickening of Capillary and Glomerular Basement Membrane (GBM)
- EM Spike and Dome Appearance with Subepithelial Deposits
- IF Granular
- Primary
- Phospholipase A2 Receptor Autoantibodies
- Secondary
- NSAIDS
- Gold
- Solid Tumors
- Hepatitis B Virus (HBV)
- Lupus
3 mins
Rapidly Progressive Glomerulonephritis
- Pathogenesis
- Nephritic Syndrome
- Crescent Shape
- Crescents Consist of Fibrin and C3b
- With Parietal Cells, Monocytes, and Macrophages
- IMMUNOFLUORESCENCE
- Linear Immunofluorescence
- Negative Immunofluorescence
- Granular Immunofluorescence
- Etiology
- Goodpasture Syndrome
- Granulomatosis with Polyangiitis (Formerly Wegener's)
- Microscopic Polyangiitis
- Prognosis
- Poor Prognosis
3 mins
Anti-glomerular Basement Membrane Antibodies
- Glomerulonephritis
- Goodpasture's Disease
- Linear immunofluorescence
- Hemoptysis
- Hematuria
1 min
Microscopic Polyangiitis
- Pathophysiology
- Necrotizing Small Vessel Vasculitis
- Signs and Symptoms
- Lungs, Kidneys, and Skin Commonly Affected
- Palpable Purpura
- Rapidly Progressive Cresentic Glomerulonephritis
- Diagnosis
- Lesions are Same Age
- Non-granulomatous
- Minimal Nasopharyngeal Involvement
- P-ANCA
- Treatment
- Corticosteroids
- Cyclophosphamide
2 mins
Granulomatosis with Polyangiitis (GPA) Characteristics
- Pathophysiology
- Small Vessel Vasculitis
- Necrotizing
- Lungs and Upper Airway
- Crescentic Glomerulonephritis
- DIAGNOSTICS
- c-ANCA
- X-ray
- Multiple Nodules in Lungs
- Treatment
- Cyclophosphamide
- Corticosteroids
- Rituximab
3 mins
Granulomatosis with Polyangiitis (GPA) Symptoms
- Upper Respiratory Tract
- Saddle Nose
- Perforation of Nasal Septum
- Chronic Sinusitis
- Otitis Media
- Mastoiditis
- Lower Respiratory Tract
- Cough
- Dyspnea
- Hemoptysis
- Kidney
- Rapidly Progressive Glomerulonephritis
- Hematuria
- RBC Casts
2 mins
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