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Flashcards in Quiz 1 Deck (19)
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1
Q

Signs and Symptoms of PSGN

A
  • Prior group A strep infx
  • Pharyngitis or rash(impetigo)
  • Latent period 1-3 weeks post pharyngitis
  • 3-6 weeks after skin infx
  • fever,confusion
  • HTN, periorbital edema
  • hematuria
  • HA N/V Malaise
2
Q

Signs and Symptoms of Acute Interstitial Nephritis (AIN)

A
  • acute onset of decrease in renal function days-2weeks post admin of meds or infx
  • fever, rash
  • hematuria
  • oliguria
  • N/V and malaise
  • Decreased urine concentration
  • Decreased GFR
3
Q

Signs and Symptoms of Acute Tubular Necrosis (ATN)

A
  • uremic pruritis
  • pericardial friction rub
  • asterixis
  • HTN
  • Edema
  • Oliguria depening on extent of tubular damage
4
Q

Signs and Symptoms of Pre-renal renal failure

A
  • Dehydration
  • Thirst
  • Diziness
  • Mental Status change
  • Poor skin turgor
  • Collapsed neck veins
  • dry mucous membranes
  • hypotensive
  • orthostatic bp changes
  • tachycardia
5
Q

Signs and Symptoms of Intrinsic Renal Failure

A
  • salient hx of URI
  • Diarrhea
  • Ab/Iv drug
  • back pain
  • gross hematuria
  • fever(PN)
  • Maculopapular Rash (interstitial nephritis
  • Dehydration
  • Shock
6
Q

Signs and Symptoms of Post-Renal Renal Failure

A
  • Renal Pain and tenderness
  • Lower abdominal pain
  • Post surgery urine leak
  • Over-hydration
  • Edema
  • Ileus with abdominal distention
  • Enlarged prostate on DRE
  • Distended bladder
7
Q

Lab Results for AIN

A
  • UA: Hematuria, proteinuria, high WBC, WBC casts,NO bacteria, eosinophilia
  • CBC: eosinophilia, impaired renal function, increased creatinine
  • FENa >1% tubular damage
8
Q

Lab Results for PSGN

A

-UA:cola colored urine
-oliguria, RBC,
-RBC casts,
-proteinuria <3.5
Serology:
-streptozyme test 5 antib
-decreased C3/CH50
-C4 and C2 may be normal

9
Q

Lab Results for Acute Tubular Necrosis

A

-UA: mild proteinuria, hematuria, RTE and RTE casts with tubular fragments, other casts
Labs: elevated BUN/Creatining. Decreased GFR

10
Q

Lab results for Pre-Renal Renal Failure

A
-oliguria
SG>1.20
Urine Sodium: <20mEq/L
HIGH BUN/creatinine >20:1(azotemia)
No changes in urine sediment
11
Q

Lab results for Intrinsic Renal Failure

A
UA:
-SG<1.010 if tubular cause
-SG>1.020 if glomerular cause
-Osmolality <300
-Urine Sodium >3o=tubular <20=glomerular
-Granular casts(ATN,GN, AIN)
-WBC casts(PN)
RBC casts(PSGN)
eosinophiluria(AIN)
-High BUN and CREATININE
-Low BUN/creatinine ratio
-high cystatin C early on
12
Q

Lab Results for Post Renal Renal Failure

A
SG>1010 early<1010 late
Urine Na: <20 early, >40 late
-high BUN creatinine
-BUN/Cr 10-20
Ua: crystals or hematuria
13
Q

Treatment for PSGN

A
  • Antibitotic for infx
  • Edema o HTN(loop diur)
    • botanical diuretics include dandelion leaf, nettles, watermelon, castor oil for edema
  • limit protein/sodium
  • bed rest
  • curcuma/echanacea
  • quercitin/bromelain
  • vit c to bowel tolerance
  • Vit E 800 IU
  • Constitutional Hydrotherapy
14
Q

Treatment for Acute Interstitial Nephritis

A
  • Normal renal fxn usu occurs with discontinuation of cauasitive agent
  • lowprotein, low K, low Na diet
  • Anti-inflammatories/antiox
  • Renafood
  • natural treatment for offending agent
  • prednisone
  • dialysis if severe
15
Q

Treatment for Acute Tubular Necrosis

A
  • Correct ischemic cause or remove toxic exposure
  • Manage ARF
  • Chelation once sx managed
  • NAC to prevent radiation nephropathy (600-1200 mg bid)
  • Cisplatin: induced nephropathy- lipoic acid, NAC, ginko, capsaicin, selenium, quercetin
  • Protectivies: silybum marianu, ginko, cordyceps, urtica seed, CoQ10, Selenium, Vit C
16
Q

Treatment for Pre-Renal Renal Failure

A

Treat underlying cause

  • rapid fluid replacement
  • vasopressor drugs (dopamine) to elevate BP and increase renal blood flow
  • Discontinue antihypertinsives/diuretic
17
Q

Treatment Intrinsic Renal Failure

A

1) Depending on cause: Eradication of infection; Removal of antigen, toxins, drugs
2) Suppression of autoimmune mechanisms (immunomodulators)
3) Pharma: Low dose dopamine (transient improvement)
4) Monitor BUN/Creatinine
5) Supportive dialysis if needed

18
Q

Post-Renal Renal Failure

A

rapidly treat the obstruction with catheterization or stent

19
Q

6 main functions of the kidneys

A
  1. Blood pressure regulation
  2. Excretion of waste
  3. Maintence of blood pH
  4. Produce EPO
  5. Vitamin D synthesis (last 2 steps of conversion)
  6. Gluconeogenesis