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Step III

Step III - Renal 3

QuestionAnswer
Best initial testing of Post streptococcal/post infectious glomerulo-itis shows ASL O, anti-DNAse, anti hyaluronidase + low C3
Best initial test
Most accurate test Post streptococcal/post infectious glomerulo-itis and what does it show bx (rarely done after serology) showing SUBEPITHELIAL IgG+C3 deposits
Tx for Post streptococcal/post infectious glomerulo-itis PCN/Antibx + diuretics for HTN
Hep C pt c/o joint pain, purpuric skin lesions + renal Cryoglobulinemia
Best initial test Cryoglobulinemia and what does it show Cryoglobulins (Igs, light chains, IgM) + low C4
Most accurate test Cryoglobulinemia bx
Best initial tx Cryoglobulinemia IFN and ribavirin for Hep C
What two organs does drug induced lupus spare Kidney and brain
Best initial test for SLE nephrx ANA and anti-dsDNA
Most accurate test SLE nephrx Bx
Renal bx fo SLE nephritis is used to do what Guide therapy based on extent of involvement
Tx for SLE nephrx sclerosis Nothing
Tx for SLE nephrx mild non-proliferative Steroids
Tx for SLE nephrx severe Mycophenolate mofetil + steroids
Hearing loss + eye problems + congenital Alport’s
Intravascular hemolysis, thrombocytopenia,  creatinine, E. coli = HUS
Intravascular hemolysis, thrombocytopenia,  creatinine, E. coli + fever + neuro shit = TTP
Tx for TTP Plasmapheresis
What should you avoid giving in HUS and TTP Platelets and antibx
HYPERproteinURIA, HYPOproteinemia, HYPERlipidemia, edema, thrombosis (protein C/S, anti-thrombin in urine) = NephrOtic syndrome
Best initial test NephrOtic syndrome UA
Other tests after UA for NephrOtic syndrome Spot urine check protein:creatinine >3.5:1 OR 24 urine w/ > 3.5g Na
Most accurate test NephrOtic syndrome Bx
MC –otic in adult w/ CA (lymphoma) Membranous
SPIKE DOME, IgG + C3 deposits GBM = Membranous
Immune complex deposition, TRAM TRACK, C3 Membranous
Hep C pt Membranoproliferative
Pt w/ no specific PE findings and nothing in labwork; you have to use History to dx these primary renal dz Minimal change, Membranous, Membranoproliferative, focal segmental, mesangial
HIV, heroin use, sickle cell pt Focal segmental
Foamy urine (protein), albumin  edema, lipids↑, hypercoagulable (coag factors↑ loss AT3 causing less anticoags), HIV/heroin/sickle cell pt FSGS
Best initial tx FSGS Steroids
No response to steroids in FSGS Cyclophosphamide
If pt presents w/ proteinuria and nothing else suspicious what is first thing you do Repeat UA
If proteinuria still present in repeat UA then dx Orthostatic proteinuria (a/w occupation)
Confirmatory test for Orthostatic proteinuria Split urine sample (AM and PM)
If split urine in PM does not show > protein c/w AM urine then what do you next Spot urine/24 urine to det protein:creatinine
Created by: DrINFJ