Anastasia Shared "Path IV" - 46 Picmonics

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Path IV

Nephrotic Syndrome
Signs and Symptoms
Massive Proteinuria > 3.5g per Day
Edema
Increased risk of infection
Thromboembolism
Hyperlipidemia
Fatty casts
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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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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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Anti-glomerular Basement Membrane Antibodies
Glomerulonephritis
Goodpasture's Disease
Linear immunofluorescence
Hemoptysis
Hematuria
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Granulomatosis with Polyangiitis (Wegeners) Symptoms
Signs and Symptoms
Lung Involvement
Cough
Hemoptysis
Chronic Sinusitis
Saddle Nose
Perforation of Nasal Septum
Otitis Media
Glomerulonephritis
Hematuria
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Granulomatosis With Polyangiitis (Wegeners) Characteristics
Pathophysiology
Granulomatosis With Polyangiitis
Vasculitis
Necrotizing
C ANCA
Lungs And Upper Airway
Crescentic Glomerulonephritis
Treatment
Cyclophosphamide
Corticosteroids
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Polyarteritis Nodosa
Pathophysiology
Immune Complex-Mediated Transmural Vasculitis
Hepatitis B Association
Fibrinoid Necrosis
Signs and Symptoms
Black Stool (Melena)
Neurologic Dysfunction
Myalgia
Fever
Hypertension
Diagnosis
Vessels / Lesions in Different Stages
Renal Microaneurysms (On Arteriogram)
Spares Pulmonary Arteries (No Pulmonary Involvement)
Treatment
Corticosteroids
Cyclophosphamide
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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
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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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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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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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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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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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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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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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Amyloidosis
Primary
Multiple myeloma
Secondary
Tuberculosis (TB)
Rheumatoid Arthritis
Congo red stain
Apple green birefringence
Nephrotic
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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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Tuberous Sclerosis
Characteristics
Autosomal Dominant
Signs and Symptoms
Hamartomas in CNS and Skin
Phakoma
Intellectual Disability (Mental Retardation)
Seizures
Subependymal Giant Cell Astrocytoma
Adenoma Sebaceum
Shagreen Patch
Ash-leaf Spots
Renal Angiomyolipoma
Cardiac Rhabdomyoma
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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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