Nephrotic/Nephritic Syndromes
Nephrotic/Nephritic Syndromes
Mixed Bag
Hyponatremia
Mixed Bag
100
This level of proteinuria defines nephrotic syndrome.
>3.5 g/day
100
Hematuria, hypertension, and AKI with less than 3.5 g/day proteinuria
Nephritic syndrome
100
Another name for Black tarry stool
Melena
100
What serum sodium level defines hyponatremia?
Less than 135 mEq/
100
What cardiac imaging modality do we use to evaluate patients with staph aureus bacteremia and no determined source?
TTE and/or TEE
200
Most common nephrotic syndrome in children; associated with recent infection and podocyte effacement
Minimal change disease
Histology:
Effacement or fusion of foot podocytes
Normal appearing glomeruli
Negative immunofluorescence
200
Occurs 2–4 weeks after strep infection with low C3 and “lumpy bumpy” deposits
Post-streptococcal glomerulonephritis
200
A patient was CAD, HTN, HLD, diabetes, GERD, and hypothyroidism has a K is 3.7. How much potassium would you give them?
30 mEq
200
What acronym stands for the syndrome of inappropriate antidiuretic hormone secretion, a major cause of euvolemic hyponatremia?
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
200
What does VIBES stand for (the management aspect for each letter) when managing liver disease?
V - Volume
I - Infection
B - Bleeding
E - Encephalopathy
S - Screening
300
Nephrotic disease associated with HIV and sickle cell disease; shows segmental sclerosis.
Focal segmental glomerulosclerosis (FSGS)
Hyalinosis or segmental sclerosis
300
Hematuria shortly after URI or GI infection with normal complement levels
IgA nephropathy
300
Elevated BUN/Cr ratio and tarry stools suggests this etiology.
Upper GI bleed
300
What is the risk in rapid/overcorrection of hyponatremia.
Central pontine myelinolysis
300
What key blood protein drops in liver failure, leading to fluid leaking out into tissues?
Albumin
400
Associated with anti-PLA2R antibodies and “spike and dome” appearance.
Membranous nephropathy
400
“Tram-track” GBM appearance
Membranoproliferative glomerulonephritis (MPGN)
400
What PFT pattern shows a reduce FEV1/FVC ration with a normal or reduced FVC?
Obstructive
400
What endocrine organ's underactivity (insufficiency of its primary hormone) can impair free water clearance and cause low sodium?
What is the adrenal cortex (Addison's disease / cortisol deficiency
400
What is a rare, inherited genetic condition can cause COPD even in non-smokers due to a lack of protective lung protein.
Alpha-1 antitrypsin deficiency
500
Amyloidosis
apple green birefringence under polarized light
500
Hematuria, hearing loss, and eye abnormalities due to type IV collagen defect
Alport syndrome
500
This lesion is a dilated submucosal artery that can cause brisk bleeding with minimal mucosal defect
Dieulafoy lesion
500
How does DDAVP work in hyponatremia?
Synthetic analogue of ADH
Used to control, rather than directly raise, sodium levels.
V2 Receptor Binding: It binds to V₂ vasopressin receptors on the basolateral membrane of principal cells in the renal collecting ducts.
Water Reabsorption: This binding triggers the insertion of aquaporin-2 water channels into the apical membrane, causing the kidney to reabsorb free water back into the bloodstream.
Dilution and Control: By holding onto free water, DDAVP stabilizes the patient's urine osmolality, allowing doctors to precisely dictate the rate of serum sodium correction.
By "clamping" urine output, it allows clinicians to safely raise sodium with hypertonic saline while lowering the risk of dangerous, unintended overcorrection
500
This intervention can reduce progression to type 2 diabetes by 58% at 3 years and 34-43% at 10-20 years.
Lifestyle modification
Weight loss target of 7% of body weight if overweight
Moderate physical activity of at least 150 min/week
Dietary modification with reduced calorie and fat and increased fiber intake