Hematuria ddx infectious uti hemorrhagic cystitis

hematuria ddx
infectious: UTI, hemorrhagic cystitis
Trauma
Heme causes: SCD, TCP
Metabolic cause: hypercalcemia
Structural: tumor, obstruction, stones, vascular malformations
Glomerular; Bergers, HSP, PSG, alports
236.
Proteinuria defn
>100mg/m2/day pathologic
237.
Classification of proteinuria
Benign transient proteinuria: inc protein w/ vig exercise, fever, dehydration, CHF
Orthostatic proteinuria: inc urinary protein while upright, but not supine.
Pathologic protineuria: glomeular disease or tubular disease(interstitia nephritis, ischemic renal injuryATN)
and nephrotoxic drugs
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nephrotic syndrome
heavy proteinuria
Edema
hypercholesterolemia
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Nephritic syndrome
gross hematuria
HTN
Fluid overload from renal insufficiency
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MCC of acute glomerulonephritis? MCC of chronic GN?
Acute: PSGN
Chronic: IgA nephropathy

241.
CF PSGN
8-14 d after skin or pharynx w/ nephritogenic strian of GABHS. 28 days after impetigo.
Hematuria(gross), proteinuria, HTN, fluid overload.
Low complement
242.
Dx of PSGN
ASO titer
ADB titer
UA, serum complement, renal US, RFTs, serum albumin, serum cholesterol
243.
Tx of PSGN. Does abx help dec risk of PSGN? Rheumatic fever?
Fluid restriction, antihypertensive, dietary restrictions of protein, sodium, potassium, phosphorous.
Abx tx doesn't reduce risk of PSGN but will reduce risk of rheumatic fever
244.
IgA nephropathy
Etio:
CF:
Dx:
tx:
Etio: abnl clearance or formation of IgA Immune complexes
CF: recurrent gross hematuria assoc w/ resp infections. Transient ARF. Microscopic hematuria
Dx: renal biopsy
Tx: suportive, ACEI, steroids, immunosuppressants
245.
HSP nephritis
Defn
CF
Defn: IgA mediated vaculitis w/ nonTCP palpable purpura on buttocks+thighs, abd pain, arthritis, gross or
microscopic hematuria.
CF: Protineuria presnt possible glomerular inflammation should do renal bx. In majority renal features self
limited-recover in 3 mo.
246.
Nephrotic syndrome defn
heavy proteinuria(>50mg/kg/24hours), hypoalbuminemia, hypercholesterolemia, edema
247.
Categories of Nephrotic syndrome
PRimary NS: 90% of all childhood cases. MCC of primary is MCD
NS from other primary glomerular diseases: IgA nephropathy, MPGN, PSGN
NS that results from systemic diseases: SLE, HSP
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CF of nephrotic syndrome
Edema which follows a URI.
PRedisposed to thromboses
Inc risk of encapsulated org infections-can have SBP, PNA, sepsis
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Dx of Nephrotic syndrome

UA: shows +3/4 protein, elevated
CBC
CMP: met acidosis. BUN/Cr
C3, ANA, Antistrep ab
Renal US
250.
massive edema with nephrotic syndrome
IV infusions of 25% albumin to achieve a diuresis and maintain intravascular volume
251.
MCD tx
steroids, no added salt. Steroid resistant-cyclophosphamide, cyclosporine
252.
HUS defn
ARF in presence of MHA, TCP
Two different subtypes: Shiga toxin assoc HUS, Atypical HUS
253.
CF of HUS
diarrheal prodrome-->sudden onset of hemolytic anemia, TCP, ARF
254.
Alports syndrome
progressive hereditary nephritis
Type IV collagen defect
X linked dominant.