"renal" Post in this tag
thiazide diruretics
drugs,clinical use,addverse effects
(psychic→)thyazide
hydrochlorothyazide
thyazide like diuretics
(metalic laser gun→)metolazone
(Indian→)indapamide
(colorful salad→)chlorthalidone
(water baloon→)hypertension&edematous states
(sippy cup→)nephrogenic diabetes insipidus
(milk bottle→)kidney stone
(bone→)osteoporosis
(candy bar→)hyperglycemia
(butter→)hyperlipidemia
(red rash→)sulfa allergy
hyperuricemia,hypercalcemia,hypokalemic metabolic alkalosis
pharmacology
renal
HirotoShishido
indications for acute dialysis in DIC
AIUEO
Acidosis refractory to bicarbonate
Intoxcation with some drugs
Uremic symptoms(eg. cardiac friction rub,altered mental status)
Electrolyte abnormality(especially potassium)
volume Overload refractory to diuretics
renal
HirotoShishido
nephrotic syndrome+thrombmembolic events
due to renal losses of antithrombin Ⅲ,protein C,protein S
renal
HirotoShishido
IgA nephropathy
which type of hypersensitivity is this associated with?
type Ⅲ hypersensitivity
immune complex (abnormal IgA1+IgG)
abnormal IgA1=galactose deficient IgA1 (cannot recognized by body)→cannot degenerate if it's too much→accumulation
IgG=antiglycan IgG antibody
renal
HirotoShishido
pathogenesis of Goodpasture synd
+risk factors
type Ⅱ hypersensitivity reaction targetting α3chain in collagenⅣ forming glomerular and alveolar basement membrane
genetic:HLA-DR15
environmental:infection,smoking,oxidative stress,hydrocarbon-based solvents(as in dry cleaning industry)→damage α4,α5 chains in collagen Ⅳ and expose α3
renal
HirotoShishido
refractory nephrotic syndrome
secondary cause
FSGS(focal segmental glomerulosclerosis)
HIV infection, heroin abuse,sickle cell disease
renal
HirotoShishido
angiotensin Ⅱ and prostagrandins effects to renal arterioles
PDA and ACE
Prostagrandins Dilate Afferent arteriole
Angiotensin Ⅱ Constricts Efferent arteriole
renal
HirotoShishido
the most common cause of nephrotic synd in children
cause, diagnosis
minimal change disease
often 1° (idiopathic)
2° to lymphoma(cytokine mediated damage)
LM→normal glomeruli
IF→−
EM→effacement of podocyte foot process
renal
HirotoShishido
the cause of diabetic glomerulo-nephropathy
diagnosis
hyperglycemia→nonenzymatic glycation of tissue proteins→hyaline arteriosclerosis→obstruction of blood flow(in efferent arteriole)→arteriole dialation(afferent arteriole)→hyperfiltration→albumiuria→decreased filtration→renal failure
LM→mesangial expansion, GBM thickning,eosinophilic
nodular glomerulosclerosis(Kimmelstiel-Wilson lesions)
renal
HirotoShishido
renal disease which present as both nephrotic synd, nephritic synd
①diffuse proliferative glomerulonephritis(DPGN)
often due to SLE→lupus nephritis
②membrano-proliferative glomerulonephritis(MPGN)
renal
HirotoShishido
5 signs of nephrotic synd
proteinuria(>3.5g/day),
hypoalbuminemia,edema,hyperlipidedia,lipiduria
renal
HirotoShishido
3 types of MPGN
membrano-proliferative glomerulonephritis
type Ⅰ→(most common associated with hepatitis B or C) IC(immune complex) and compliment on subendothelium
type Ⅱ→only compliment in GBM
type Ⅲ→IC and compliment on subepithelium and/or subendothelium
renal
HirotoShishido
mechanism of hypertesion in the individuals w/ ADPKD
renal cysts compress blood vessels feeding neighboring healthy nephrons→↑renin angiotensin aldsterone system→hypertension
renal
HirotoShishido
ADPKD,ARPKD mutation
(autosomal dominant(recessive) polycystic kidney disease)
ADPKD→PKD1(more severe,earlier onset),PKD2(less,later)→polycystin1,2 respectively
ARPKD→PKHD1→fibrocystin
if either one of these proteins are absent, cell proliferation occurs forming cysts filled with water
renal
HirotoShishido
thyroidization of kidney
chronic pyelonephritis may show tubules containg eosinophilic casts resembling thyroid tissue
renal
HirotoShishido
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