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chronic exam 4
Alport Syndrome
Pathophysiology
Nephritic
X-linked
Mutation in Type IV Collagen
Diagnosis
Split Basement Membrane
Basket Weave Appearance
Signs and Symptoms
Ocular Disorders
Deafness
2 mins
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
3 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
1 min
Choriocarcinoma
Germ-cell tumor
Trophoblastic tissue
Hematogenous spread to lungs
Malignant
Theca-lutein cysts
Hydatidiform Mole
hCG
59 secs
Diffuse Proliferative Glomerulonephritis (DPGN)
Nephritic and Nephrotic Syndrome
Associations
Systemic Lupus Erythematosus (SLE)
IgA Nephropathy
Characteristics
Wire Looping
IF Granular
Subendothelial Immune Complexes
Subepithelial Immune Complexes
C3 Deposition
Treatment
Treat Underlying Disorder
Steroids
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
2 mins
K+ Sparing Diuretics
Indications
CHF and Hypertension
Hypokalemia
Hyperaldosteronism
Mechanism of Action
Collecting Tubule
Spironolactone
Competitive Aldosterone Receptor Antagonist
Amiloride and Triamterene
Block Na+ Channels
Side Effects
Hyperkalemia
Gynecomastia
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
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
Nephritic Syndrome
Inflammatory
Hematuria
RBC casts
Increased Nitrogen in blood
Oliguria
Hypertension
Proteinuria < 3.5 grams per day
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
Prostate Adenocarcinoma Characteristics and Presentation
Characteristics
Most Common Cancer in Men
Screening Test if Suspicious
Prostate Specific Antigen (PSA)
Peripheral Zone
Risk Factors
African American
Advanced Age
Presentation
Usually Asymptomatic
Terminal Hematuria
Urinary Retention or Incontinence
Lower Back Pain
2 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
Renal Cell Carcinoma Characteristics
Pathophysiology
Chromosome 3
VHL Gene
Proximal Convoluted Tubule
Risk Factors
Smoking
Nephrolithiasis
Chronic Analgesic Use
Subtypes
Clear Cell
Papillary
Chromophobic
2 mins
Squamous Cell Carcinoma of the Bladder Clinical Features
Risk Factors
Smoking
Chronic Cystitis
Schistosoma
Chronic Nephrolithiasis
Clinical Findings
Painless Hematuria
Urinary Frequency and Urgency
1 min
Testicular Carcinoma Assessment
Cause/Mechanism
Seminoma Germ Cells
Non-Seminoma Germ Cells
Assessment
Painless Scrotal Mass
Testicular Swelling
Acute Pain Rare
Elevated Serum Tumor Markers
Considerations
Males Between 15-35 Years Old
Cryptorchidism
Testicular Self Exam
2 mins
Transitional Cell Carcinoma
Most Common Cause Of Lower Urinary Tract Cancer
Risk factors
Cyclophosphamide
P-SAC
Cigarette Smoke
Azo Dyes, Alcohol, Anilines (Dyes, Rubber)
Older Adult
Signs and Symptoms
Painless Hematuria
3 mins
Tuberous Sclerosis
Characteristics
Autosomal Dominant
Signs and Symptoms
Hamartomas in CNS and Skin
Phakoma
Subependymal Giant Cell Astrocytoma
Seizures
Intellectual Disability (Mental Retardation)
Adenoma Sebaceum
Shagreen Patch
Ash-leaf Spots
Renal Angiomyolipoma
Cardiac Rhabdomyoma
2 mins
Von Hippel-Lindau Disease
Pathophysiology
Chromosome 3
Presentation
Hemangioblastomas
Medulla, Retina, Cerebellum
Cysts
Kidney, Liver, Pancreas
Develop Bilateral Renal Carcinomas
Pheochromocytomas
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
2 mins
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