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Step III
Step III - Renal 3
| Question | Answer |
|---|---|
| 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
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