Lecture 14

classification acute GN

classification acute GN

• infectious - strep

• noninfectious - primary (MPGN, berger), multisystem systemic diseases (Wegener, lupus), Guillain-Barre

structural and fxnal changes of acute GN

• focal, segmental or diffuse

• proteinuria, hematuria, urine sediment w/ RBC casts, reduction GFR → edema, HTN

history of acute GN

systemic disease, recent infection (fever, sore throat, skin infection)

symptoms acute GN

abrupt, boy w/ face edema poststrep, fever, flank pain, hematuria, oliguria, htn → headache, dyspnea on exertion

triad of wegener granulomatosis

sinusitis, pul infiltrate, nephritis

symptoms of acute GN w/ henoch-schonlein purpura

nausea, abd pain, purpura

symptom of Goodpasture (idiopathic progressive GN)

hemoptysis

symptoms of ________ are present in rapidly progressive GN

uremia (loss appetite, itching, nausea)

physical exam acute GN

edema, htn, signs of fluid overload (periorbital edema, pul rales, elevated jvp, ascites)

blood analysis of what in acute gn

BUN, creatinine, GFR, ESR, leukocytosis, ASO

acute nephritic syndrome

PHAROAH (proteinuria, hematuria, azotemia, rbc in urine, anti-strep, oliguria, htn)

nephrotic syndrome characteristics

proteinuria, hypoalbuminemia, hypoproteinemia, edema, hyperlipidemia

classification nephrotic syndrome

• primary - minimal change, focal GS

• secondary - DM, lupus, viruses

history nephrotic syndrome

DM, NSAID use

symptoms nephrotic syndrome

edema (face, anasarca), foamy urine, thrombotic event, oliguria

physical exam nephrotic syndrome

edema (eyes, legs → anasarca), hematuria, htn, anemia signs

investigations nephrotic syndrome

• urine - casts, microhematuria, proteinuria

• US shows echogenicity

result of chronic GN

CKD → ESRD

etiology chronic GN

from acute GN, IgA nephropathy, crescentic, MPGN

symptoms chronic GN

uremia → weakness, pruritus, morning nausea

edema, htn, dyspnea

physical exma chronic GN

uremia → htn, jvp, pul rales

acute pyelonephritis

ascending uti to pyelum

predisposing factors acute pyelonephritis

obstruction, postmenopausal mucosa, pregnancy, DM

symptoms acute pyelonephritis

develops over hours, triad of fever (high), costovertebral angle pain, nausea/vomiting

diff bw manifestations pyelonephritis and cystitis

pyelonephritis has systemic infection signs (fever)

pain in acute pyelonephritis

flank pain, suprapubic discomfort

symptoms cystitis

urinary frequency, hesitancy, lower abd pain, gross hematuria, malaise

urinalysis in acute pyelonephritis

nitrites, wbcs, urine culture shows bacteria