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Step III

Step III - Renal 2

QuestionAnswer
LOWER respiratory + renal presentation Goodpastures
Cough, hemoptysis, SOB, lung findings + renal Goodpastures
What is the best initial test for goodpastures Anti-basement ABS
Most accurate test for goodpastures Kidney bx w/ linear deposits
Tx for goodpastures Plasmapheresis
Asthma, cough, EOSINOPHILIA + renal Churg Strauss
What is the best initial tx for Churg Strauss CBC showing EOSinophilia
Most accurate test for Churg Strauss Bx
What is the best initial tx for Churg Strauss Steroids
If initial tx for Churg Strauss does not work then tx Cyclophosphamide
UPPER respiratory + LOWER respiratory + renal presentation Wegener’s
SINUSITIS/OTITIS + hemoptysis, abnL CXR+ renal Wegener’s
Crescentic, rapidly progressive/proliferative glomerulonephritis aka Goodpastures
Hypersensitivity II in lungs PRIOR to kidney injury. IgG+C3 and LINEAR gbm Goodpastures
What is seen on CXR in Goodpastures B/L perihilar patchy infiltrates
Best initial test Wegener’s c-ANCA + anti-proteinase-3
Most accurate test Wegener’s kidney bx
Best initial tx Wegener’s cyclophosphamide and steroids
Name the two systemic vasculitis dz PAN and Wegener’s
Which systemic vasculitis involves every organ but spares the lung PAN
Multiple sensory and motor neuropathy + pain. Fever, weight loss, fatigue, uveitis, GI pain, myalgia, purpuric skin, stroke PAN
Best initial test PAN ESR OR inflammx markers
Most accurate test PAN Bx sural n or kidney
Test that can be used to dx PAN sparing bx Angiography showing beading
Best initial tx PAN Cyclophosphamide + steroids
What dz is a/w PAN Hep B/C
URI, LRI, Rhinitis, Hemoptysis Wegener’s
Asian pt w/ recent viral respiratory infection presents w/ painless recurrent hematuria and nL complement levels. Nothing remarkable on PE IgA/Berger’s Dz
Upper respiratory/GI + renal= IgA/Berger’s
Best initial test IgA/Berger’s nothing
Most accurate test IgA/Berger’s renal bx
Best initial tx IgA/Berger’s nothing effective; steroids / ACEI / fish oil
Child/adolescent c/o raised purpuric nontender pupuric skin lesions @ buttocks, ab pain, +/- bleeding, joint pain + renal HSP
Best initial test HSP Presentation of S/S
Most accurate test HSP and what does it show Bx of kidney though rarely done; IgA deposits (don’t confuse with IgA/Berger’s)
Best initial tx HSP Nothing resolves on own
Dark tea colored/cola colored urine, periorbital pain, HTN. h/o past infection = Post streptococcal/post infectious glomerulo-it is
10-14 days after ANY infection; IgG + C3 w/ granular, LUMPY, C3, Mild proteinuria, +/- ASO titer Post streptococcal/post infectious glomerulo-it is
Created by: DrINFJ