USMLE Prep

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USMLE Prep

• Samuel Heardmon
• Pages 269-272

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Polyarteritis Nodosa

• Inflammation of MEDIUM sized arteries
• No ANCA association
• Hep B, multiple aneurysms and constrictions on
  arteriogram
• Corticosteroids

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Wegeners Granulomatosis

• Vasculitis and Granulomas in Lung and Upper
  Airway and also Glomerulonephritis
• C-ANCA
• Cyclophosphamide and Corticosteroids

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Other ANCA-positive Vasculitides

• Microscopic Polyangitis
• No Granulomas. P- or C-ANCA
• 1 Pauci Immune Crescentic
• Vasculitis limited to Kidney
• Churg-Strauss Syndrome
• Granulamotous w/ Eosinophilia. Multi-organ
  effects. Seen in atopic patients.

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Kawasaki Disease

• CHILD
• 5 Letters 5 Days, lt or 5 years old
• Conjunctivitis
• Hyperthermia (Fever)
• Idiopathic Rash
• Lymphadenitis
• Dryness of lips/mouth

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Nephritic Syndrome

• HHEAP
• Hematuria
• Hypertension
• Edema
• Azotemia
• Proteinuria

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NephrItic Syndrome

• Poststreptococcal
• IgA Nephropathy (Bergers Disease)
• Goodpastures Syndrome
• Alports Syndrome
• Rapidly Progressive (Crescentic)
• Membranoproliferative Glomerulonephritis

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Nephritic Syndromes

• Acute Poststreptococcal Glomurelonephritis
• -LM- Enlarged Glomeruli, Neutrophils
• Lumpy Bumpy
• -EM- Subepithelial Humps
• -IF- Granular Pattern
• -Mostly Seen in Kids

• Rapidly Progressive (Crescentic)
  Glomerulonephritis
• -LM and IF- Crescent Moon Shape
• -Rapid Course to Renal Failure

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Nephritic Syndromes

• Goodpastures Syndrome (Type II)
• -IF- Linear Pattern anti- GBM antibodies
• -Hemoptysis, Hematuria

• Membranoproliferative Glomerulonephritis
• -EM- Subendothelial Humps, tram tracks
• -Slowly Progresses to Renal Failure

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Nephritic Syndromes

• IgA Nephropathy (Bergers Disease)
• -IF and EM mesangial deposits of IGA

• Alports Syndrome
• Split Basement Membrane
• Collagen IV mutation. Nerve deafness and Ocular
  Disorder

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NephrOtic Syndrome

• Protein LEAC
• Proteinuria
• Lipid Up
• Edema
• Albumin Down
• Cholesterol Up
• In Nephrotic, the Protein LEACs out

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Minimal Change Disease (Lipoid Nephrosis)

• LM Normal Glomeruli
• EM Foot Process Effacement
• Most common cause of Childhood Nephrotic Syndrome

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Diabetic Nephropathy

• LM- Kimmelsteil- Wilson lesions, basement
  membrane thickening

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SLE

• 5 patterns of Involvement (Type IV)
• LM- Wire loop with granular deposits in
  subendothelial basement

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Nephrotic Syndromes

• Membranous Glomerulonephritis
• LM Capillary and BM thicknening
• IF- Granular Pattern
• EM- Spike and Dome
• Adult Nephrotic Syndrome

• Focal Segmental Glomerular Sclerosis
• LM- Segmental and Hyalinosis
• Seen in AIDS patients and Heroin Addicts

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2 Causes of Nephrotic Syndrome

• Diabetes Mellitus
• Amyloidosis
• Vasculitis
• Infections
• Drugs

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CAlCUli (Kidney Stones)

• Calcium
• 1 Cause, Radiopaque, Hypercalcemia
• Ammonium magnesium phosphate (struvite)
• 2 Cause, Radiopaque, Proteus (Urease ),
  Staghorn Calculi that lead to UTIs
• Cystine
• Radiolucent, Secondary to Cystinuria
• Uric Acid
• Radiolucent, Seen with Leukemia and
  Myeloprofilerative Disorders

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Renal Cell Carcinoma

• 1 Renal Malignancy
• Originates from tubular cells
• Men Ages 50-70
• Smokers/Dialysis Patients have increased Risk
• Paraneoplastic Syndromes/ Can Invade IVC and
  spread

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Wilms Tumor

• 1 Renal Malignancy of Kids ages 2-4
• Deletion of WT1 gene on Chromosome 11
• WAGR Complex
• Wilms Tumor
• Aniridia
• Genitourinary Malfor.
• Retardation

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Transitional Cell Carcinoma

• 1 Tumor Of Urinary Tract
• Presents w/ Hematuria
• Phenacetin
• e
• e
• Smoking
• Aniline Dyes
• Cyclophosphamide

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THE END!