Kathryn Shared "Path II" - 19 Picmonics

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Path II

Nephrotic Syndrome
Signs and Symptoms
Massive Proteinuria > 3.5g per Day
Edema
Increased risk of infection
Thromboembolism
Hyperlipidemia
Fatty casts
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Focal Segmental Glomerulosclerosis
Most Common Cause of Nephrotic Syndrome in Hispanics 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
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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
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3 mins
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
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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
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2 mins
Nephritic Syndrome
Inflammatory
Hematuria
RBC casts
Increased Nitrogen in blood
Oliguria
Hypertension
Proteinuria < 3.5 grams per day
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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
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2 mins
Rapidly Progressive Glomerulonephritis
Nephritic
Crescent Shape
Crescents Consist of Fibrin and C3b
With Macrophages
Goodpasture's Syndrome
Wegener's Granulomatosis
Microscopic Polyangiitis
Poor Prognosis
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2 mins
Berger's Disease (IgA Nephropathy)
Nephritic
IgA Nephropathy
Immune Complex Deposit in Mesangium
Increased Synthesis of IgA
Most Common Cause of Nephritic Syndrome
Overlapping Features with Henoch–Schönlein Purpura
Presents with Pharyngitis, URI or Acute Gastroenteritis
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1 min
Henoch-Schonlein Purpura
Most Common Childhood Vasculitis
Follows Pharyngeal or Respiratory Infection
Palpable Purpura on Legs and Buttocks
Arthralgia
Intestinal Hemorrhage
Black Stool (Melena)
Associated with IgA Nephropathy
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2 mins
Alport Syndrome
Pathophysiology
Nephritic
X-linked
Mutation in Type IV Collagen
Diagnosis
Split Basement Membrane
Basket Weave Appearance
Signs and Symptoms
Ocular Disorders
Deafness
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2 mins
Systemic Lupus Erythematosus (SLE) Diagnosis and Clinical Features
IM DAMN SHARP acronym
Immunoglobulins
Malar rash
Discoid rash
Antinuclear antibody
Mucositis
Neurologic disorders
Serositis
Hematologic disorders
Arthritis
Renal disorders
Photosensitivity
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2 mins
Systemic Lupus Erythematosus (SLE) Mechanism, Treatment and Complications
Mechanism and Characteristics
Systemic Autoimmune Disease
9:1 female to male ratio
Treatment
Glucocorticoids
NSAIDS
Hydroxychloroquine
Cyclophosphamide
Complications
Lupus nephritis
Libman-Sacks Endocarditis
Secondary Antiphospholipid Antibody Syndrome
Other
Drug-induced lupus
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2 mins
Sickle Cell Anemia (Mechanism)
Intrinsic Normocytic Hemolytic Anemia
Point Mutation
Autosomal Recessive
African-American
Dehydration or Decreased O2
Newborns Asymptomatic
Heterozygote Malarial Resistance
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2 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis)
Mechanism
Autoimmune Destruction of Bile Ducts
Intrahepatic
Cholestasis
Occurs in Middle-Aged Females
Signs and Symptoms
Fatigue
Pruritus
Skin Hyperpigmentation
Hepatomegaly
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3 mins
Primary Sclerosing Cholangitis Mechanisms
Mechanism
Unknown Mechanism
"Onion Skin" Fibrosis
"Beading" of Bile Ducts
Symptoms
Pruritus
Hepatosplenomegaly
Jaundice
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2 mins
Primary Sclerosing Cholangitis Labs and Treatment
Labs
Increased Conjugated Bilirubin
Increased ALK-P
Increased IgM
Associated Pathologies
Ulcerative Colitis
Cholangiocarcinoma
Secondary Biliary Cirrhosis
Treatment
Liver Transplant
Stent
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Primary Biliary Cholangitis (Primary Biliary Cirrhosis) Diagnosis and Treatment
Diagnosis
Positive Antimitochondrial Antibodies
Increased Alkaline Phosphatase (ALK-P)
Increased Cholesterol
Treatment
Ursodiol
Liver Transplant
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2 mins
Methylergonovine (Methergine) and Ergotamine (Ergot Alkaloids)
Mechanism
Smooth Muscle Contraction
Vasoconstriction
Indications
Migraine
Postpartum Hemorrhage
Side Effects
Nausea and Vomiting
Severe Hypertension
Tachycardia
Considerations
2nd Line Agent
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2 mins

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