Wk 4 Kidney_Pathology - Pathological Conditions Effecting...

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Pathological Conditions Effecting the Urinary System
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Glomerulonephritis (GMN) Aka Nephritic syndrome May be acute or chronic Caused by Group A Beta-hemolytic Strep Throat strep - 5-10% develop GMN Skin strep - up to 25% develop GMN May be autoimmune
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Glomerulonephritis (GMN) Causes diffuse inflammation of glomeruli Reduces glomerular filtration Results in azotemia Results in oligouria Autoimmune form attacks basement membrane of the nephron and lung
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Glomerulonephritis (GMN) Signs and symptoms Abrupt hematuria RBC casts Proteinuria Hypertension Edema May be asymptomatic
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Glomerulonephritis (GMN) Patient Complaint History of strep infection Malaise Headache Anorexia Fever
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Glomerulonephritis (GMN) Diagnostic testing Routine urinalysis Proteinuria, hematuria, cylinduria, pyuria (neutrophils and eosinophils) Antistreptolysin-O (ASO) titre in blood Immunoflourescence IgG
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Glomerulonephritis (GMN) Treatment is to slow the progress Chiropractic is a given Fish oils with omega-3 fatty acids Prednisone (killer anti-inflammatory)
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Chronic Form of GMN Various causes Shows hematuria, cylinduria, proteinuria May be asymptomatic for years Leads to uremia (diminished filtration) Demonstrates diffuse sclerosis of nephron BUN and serum creatinine levels rise No therapy available
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Nephrotic Syndrome Collection of symptoms which occur because the tiny blood vessels (glomeruli) in kidney become leaky Not a disease itself, condition that results from other kidney disorders ie. Diabetes mellitus and Lupus
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Nephrotic Syndrome Results from long term increase in glomerular permeability The holes get bigger and the (-) charge is lost Occurs at any age (children more common) May result from GMN
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Nephrotic Syndrome Signs and symptoms Frothy urine Anorexia Malaise Puffy eyelids Abdominal pain ascites Muscle wasting Chest pain Pericardial effusion Dyspnea Pleural effusion Joint swelling (knees) Scrotal swelling Moving edema Edema may mask muscle wasting
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Nephrotic Syndrome Proteinuria leading to nutritional deficiency Brittle hair and nails (subungual edema) Stunted growth Demineralization of bone Glucosuria Potassium depletion (tetany) Opportunistic infection
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Nephrotic Syndrome Lipiduria Casts Fatty Hyaline (protein) Cellular-granular-waxy Cholesterol crystals Oval fat bodies
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Nephrotic Syndrome Differential list Underlying systemic disease (malaise and anorexia) Diabetes (glucose) Multiple myeloma (MM) (protein) Systemic lupus (joint swelling)
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Nephrotic Syndrome Prognosis in children Good may spontaneously resolve is responsive to corticosteroids
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Nephrotic Syndrome Prognosis in adults: Tendency to lead to chronic renal failure
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Wk 4 Kidney_Pathology - Pathological Conditions Effecting...

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