Jonathan Shared "Path Block 2" - 37 Picmonics

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Path Block 2

Nephrotic Syndrome
Signs and Symptoms
Massive Proteinuria > 3.5g per Day
Edema
Increased risk of infection
Thromboembolism
Hyperlipidemia
Fatty casts
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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
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2 mins
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
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
Diabetic Glomerulonephropathy
Pathophysiology
Nonenzymatic Glycosylation of Glomerular Basement Membrane
Nonenzymatic Glycosylation of Arterioles
Hyperfiltration
Increased GFR
Histological Findings
Hyaline Arteriolosclerosis
Mesangial Expansion
Type IV Collagen Deposition
Kimmelstiel Wilson Lesions
Presentation
Nephrotic
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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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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
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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
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
E. coli Overview
Characteristics
Gram-Negative
Bacillus
Purple Colony with Metallic Green Sheen
Lactose-Fermenting
Pink on MacConkey Agar
Disease
Diarrhea
Lipid A Septic Shock
P Pili Pyelonephritis and Cystitis
K Capsule Neonatal Meningitis
K Capsule Pneumonia
H Antigen Flagella
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2 mins
Staphylococcus saprophyticus
Characteristics
Gram-Positive
Cocci
Catalase-Positive
Coagulase-Negative
Novobiocin-Resistant
Urease-Positive
Disease
Urinary Tract Infections (UTI's)
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1 min
Proteus Mirabilis
Characteristics
Gram-Negative
Bacillus
Oxidase Negative
Urease-Positive
Swarming Motility
Non-lactose Fermenting
Symptoms
Urinary Tract Infection
Struvite Crystals
Staghorn Kidney Stones
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2 mins
Enterococci
Characteristics
Gram-Positive Cocci
Catalase Negative
6.5% NaCl
Grows in Bile
Normal Colonic Flora
Signs and Symptoms
Urinary Tract Infection
Subacute Endocarditis
Penicillin Resistant
VRE (Vancomycin Resistant Enterococci)
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2 mins
Wilms' Tumor (Nephroblastoma)
Cause
Malignant Renal Tumor
Assessment
Abdominal Mass
Hematuria
Fever
Hypertension
Interventions
Nephrectomy
Chemotherapy
Radiation
Considerations
Do Not Palpate Abdomen
Children Under 5 Years Old
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2 mins
Squamous Cell Carcinoma of the Skin
Epidemiology
2nd Most Common Skin Cancer
UV Light Exposure
Long-term Immunosuppression
Arsenic Exposure
Signs/Symptoms
Ulcerative Red Lesion
Precursor Actinic Keratosis
Commonly Lower Lip
Diagnosis
Biopsy shows Keratin Pearls
Treatment
Mohs Micrographic Surgery
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2 mins
Epstein Barr Virus
Characteristics
Herpesvirus 4
Double Stranded DNA
Linear
Enveloped
Signs and Symptoms
Infectious Mononucleosis
Virus Attaches to CD21 in B Cells
Nasopharyngeal Carcinoma
Burkitt's Lymphoma
Hodgkin's Lymphoma
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1 min
Haemophilus Influenzae Disease
Disease
Pneumonia
Cherry Red Epiglottitis
Meningitis
Otitis Media
COPD Exacerbation
Thumbprint Sign (on X-ray)
Treatment
Rifampin Prophylaxis
Ceftriaxone
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2 mins
Croup (Laryngotracheobronchitis)
Mechanism
Parainfluenza Virus
Assessment
3 Months to 3 Years
Nighttime
Barking Seal Cough
Inspiratory Stridor
Interventions
Cool Humidified Air
Dexamethasone
Racemic Epinephrine
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2 mins

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