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Tanner Shared "cam 2 - renal" - 29 Picmonics

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cam 2 - renal

Nephritic Syndrome
Inflammatory
Hematuria
RBC casts
Increased Nitrogen in blood
Oliguria
Hypertension
Proteinuria < 3.5 grams per day
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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
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
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
Pyelonephritis Assessment
Cause/Mechanism
Ascending Urethral Bacteria
Assessment
Dysuria
Fever
Fatigue
Flank Pain
Costovertebral Tenderness
Nausea and Vomiting
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1 min
Pyelonephritis Interventions
Urinalysis
NSAIDs
Antibiotics
Increase Fluid Intake
Avoid Catheterization
Consideration
Urosepsis
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1 min
Nephrolithiasis Diagnosis and Management
Diagnosis
Urinalysis with Culture
Noncontrast CT
Ultrasound
Management
< 10 mm
Supportive Care
10-20 mm
Extracorporeal Shock Wave Lithotripsy
Ureteroscopy
> 20 mm
Surgery
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2 mins
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
Nephrolithiasis Stone Types (Part 1/2)
Calcium Oxalate
Calcium Oxalate
Inflammatory Bowel Disease
Ethylene Glycol
Vitamin C
"Dumbbell", Bipyramidal, or Octahedral-shaped
Radiopaque
Uric Acid
Uric Acid
Gout
Tumor Lysis Syndrome
Rhomboidal, Rosette, or Needle-shaped
Radiolucent
Decreased Urine pH
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2 mins
Nephrolithiasis Stone Types (Part 2/2)
Struvite
Struvite (Ammonium Magnesium Phosphate)
Urinary Tract Infections
"Coffin Lid" Appearance
Radiopaque
Increased Urine pH
Calcium Phosphate
Calcium Phosphate
Hypercalcemia
Wedge-shaped Prisms
Radiopaque
Increased Urine pH
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2 mins
Acute Tubular Necrosis
ETIOLOGY
Ischemic Injury
Nephrotoxic Injury
HISTOLOGY
Granular Muddy Brown Casts
Signs & Symptoms
Intrinsic Renal Failure
Oliguric Phase
Metabolic Acidosis
Hyperkalemia
Increase in BUN and Creatinine
Polyuria Phase
Decrease in BUN and Creatinine
Hypokalemia
Treatment
Supportive Care
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3 mins
Tubulointerstitial Nephritis (USD SSOM)
Acute Drug Induced
Hypersensitivity Type I and IV
Pyuria
Eosinophils
Rash
Acute Renal Failure
Discontinue Drug Use
Analgesic Nephropathy
Chronic Analgesic Use
Caution with Diuretics
Papillary Tip Necrosis
Chronic Interstitial Nephritis
Urothelial Cell Carcinoma
Urate Nephropathy
Chemotherapy
Urate Crystal Formation
Light Chain (Cast) Nephropathy
Multiple myeloma
Bence Jones Protein
Light Chain Casts
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4 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
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
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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
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
Amyloidosis
Etiologies
Primary
Multiple Myeloma
Secondary
Tuberculosis (TB)
Rheumatoid Arthritis
Pathology
Congo Red Stain
Apple Green Birefringence
Complications
Nephrotic Syndrome
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2 mins
Hydronephrosis
Etiology
Obstruction of the passage of urine
posterior urethral valves (PUV) insufficiency
Presentation / Symptoms
Ususally Asymptomatic
Flank Pain
Hypertension
Diagnosis and Treatment
Urinalysis
Ultrasound
Removal of the obstruction
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Autosomal Dominant Polycystic Kidney Disease
Characteristics
Autosomal Dominant
Mutations in PKD1/2
Cystic Enlargement of Renal Tubules
Clinical Features
Chronic Kidney Disease
Hypertension
Mitral Valve Prolapse
Hepatic Cysts
Berry (Saccular) Aneurysms
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3 mins
Horseshoe Kidney
Charactersitics
Fusion of Inferior Renal Poles
Inferior Mesenteric Artery
Normal Renal Function
Associations
Turner Syndrome
Trisomy Syndromes
Diagnosis
Ultrasound
Considerations
Hydronephrosis
Nephrolithiasis
Infection
Increased Risk of Renal Cancer
Excellent Prognosis
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2 mins

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