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Rebecca Shared "Renal" - 21 Picmonics

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Renal

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
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
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
Anti-glomerular Basement Membrane Antibodies
Glomerulonephritis
Goodpasture's Disease
Linear immunofluorescence
Hemoptysis
Hematuria
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1 min
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
Casts in Urine (Differential Diagnosis)
Characteristics
RBC Casts
Glomerular Disease
WBC Casts
Acute Interstitial Nephritis
Acute Pyelonephritis
Fatty Casts
Maltese Cross Sign
Nephrotic Syndrome
Granular Muddy Brown Casts
Acute Tubular Necrosis (ATN)
Waxy Casts
End Stage Renal Disease (ESRD) (Chronic Renal Failure)
Hyaline Casts
Non-Specific
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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
Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome)
Pathophysiology
Granulomatous Vasculitis
Signs and Symptoms
Sinusitis
Skin Lesions
Peripheral Neuropathy
Asthma
GI Disease
Heart Disease
Kidney Failure
Diagnosis
Eosinophilia
p-ANCA
Treatment
Corticosteroids
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4 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
Hemolytic Uremic Syndrome (HUS)
Children
Pathophysiology
Preceded by Acute Diarrheal Illness
Endothelial Damage
Classic Triad of Symptoms
Microangiopathic Hemolytic Anemia (MAHA)
Thrombocytopenia
Renal Failure
Labs
Helmet cells
LDH
Treatment
Dialysis
Supportive
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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
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
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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2 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
Nephritic Syndrome
Inflammatory
Hematuria
RBC casts
Increased Nitrogen in blood
Oliguria
Hypertension
Proteinuria < 3.5 grams per day
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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
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
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
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3 mins
Thrombotic Thrombocytopenic Purpura (TTP)
Inhibition or deficiency of ADAMTS 13
vWF Multimers are Not Degraded
Microthrombi (and Emboli)
Symptoms
FAT RN Pentad
Fever
Anemia
Thrombocytopenia
Renal Dysfunction
Neurologic Abnormalities (Altered Mental status)
Treatment
Plasmapheresis
Corticosteroids
Splenectomy
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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

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