#pearls_in_nephrology

⚠️ #association_of
👉“flash” pulmonary oedema
👁sudden onset breathlessness
👁cough frothy pink sputum
👉hypertension in young patient (˂ 50 y)
👉no obvious cardiovascular risk factors
#Think #RAS fibromuscular dysplasia

#Do MR Angiograghy
#TTT: Angioplasty.

#Pearls_in_Nephrology

#IgA_nephropathy
👉commonest cause of glomerulonephritis
👉common during the 2nd; 3rd decade of life.
👉commonly occurs #within 2 days of an onset of an URTI (sore throat, pharyngitis).
👉#normal_C3
👉diagnosed by a renal biopsy
(mesangial IgA deposition).
👉There is considerable #overlap with #HSP
(arthritis, rash, abdominal pain,
nephritis)

#Presentations:
➡️Young male ;more common in males
➡️Recurrent episodes of
painless macroscopic haematuria
➡️within 24-48 hours after URTI
(sore throat, pharyngitis).
➡️may present with proteinuria, renal failure
or hypertension.
➡️ #Good_prognosis
with normal BP, renal function and absence
of proteinuria at presentation.

#Management:
🧐treatment is conservative.
🧐 #If the proteinuria is < 3 g/day
➡️ACEIs used to reduce progression of
proteinuria.
🧐 #If nephrotic range proteinuria (>3 g/day)
➡️8-12 week course of prednisolone.
🧐 #If crescenteric nephritis on biopsy
➡️IV pulse steroid + cyclophosphamide.

#Pearls_in_Nephrology

#Post_streptococcal_glomerulonephritis
👉associated with low complement (C3).
👉Main symptom in is proteinuria
(haematuria can occur).
👉typical interval 1_3 weeks
between URTI (sore throat)
and the onset of renal problems
👉#Renal_biopsy Not required.
➡️LM: wire-loop lesion
➡️EM: Humps in the subepitheilal space.

#Clinical_Pearls📝

🎯High calcium + low PTH + normal ALP
= 🧐 #Malignancy

🎯High calcium +high phosphate + normal ALP
=🧐 #Multiple Myeloma

🎯High Calcium + high Phosphate + high ALP
= 🧐 #Bone_metastasis

🎯High calcium + low phosphate + high ALP
= 🧐 #Primary_Hyperparathyroidism

🎯Low calcium + low phosphate + high ALP
=🧐 #Osteomalacia/#vitamin_D_defienancy

🎯Low calcium + high phosphate + Normal ALP
= 🧐 #Hypoparathyroidism

🎯Normal calcium +Normal Phosphate + normal ALP
= 🧐 #Osteoporosis

🎯Normal calcium + normal Phosphate + high ALP
=🧐 #Paget_disease_of_bone

@NaplexStudyGuide
Clinical Indications of Desmopressin📝

◾️ diabetes insipidus
◾️ nocturnal enuresis
◾️ hemophilia A
◾️ von Willebrand disease
◾️ high blood urea

Test For 《Rhabdomyolysis》🔻

🔵Creatine kinase➡+Ve
🔵Urine myoglobin
🔵⬆Lactate dehydrogenase
🔵⬆Serum K
🔵⬆Prothrombin time
🔵Urine ➡+Ve blood

#Indications_of_Steroids_in_TB:

📝Pericarditis +/- Myocarditis
📝Meningitis
📝Adrenalitis
📝Uveitis
📝Paradoxical response
📝Endobronchial LN compression/impending rupture

#B12 deficiency anemia

📝Causes
Vegetarian
Pernicious anemia
Ileal disease/ Chrons
Short Bowel syndrome

📝Dx
CBC➡️Macrocytic anemia
Peripheral blood film➡️Hyperpigmented neutrophils (MCQ مهمة هلبا)

#AML (M3)📝

Good prognosis
Characterised by DIC and Gum bleeding
Treated by / ATRA

#Thalassemia and SCA and Hb electrophoresis 📝

🟨Thalassemia➡️Hb F + Hb A2
🟨SCA ➡️ Hb S + Hb F

#Meylofibrosis📝

🩺presentation/ pancytopenia , old age

🩺DX
🟨PBF➡️ tear drop poikilocytes
🟨BM aspiration ➡️Dry tap
🟨BM biopsy ➡️ excessive proliferation of megakaryocytes

🟨Severity of COPD categorised by using

➡️FEV 1

🟨Factors which improve survival in COPD

Smoking cessation
LTOT
Lung volume reduction surgery

🟨CXR in patient with PE is usually

➡️Normal

مهماااااات جداً📝

🟨CURB-65 score

Patients are stratified for risk of death as follows:

0: low risk (less than 1% mortality risk)

1 or 2: intermediate risk (1-10% mortality risk)

3 or 4: high risk (more than 10% mortality risk). https://t.co/pZQ5BjtoIW

🟨The most common infective causes of COPD exacerbations are:

📝bacteria:
-Haemophilus influenzae (most common cause)
-Streptococcus pneumoniae
Moraxella catarrhalis

📝Respiratory viruses:
-account for around 30% of exacerbations
-human rhinovirus is the most important pathogen🩺

🟨Type 1 respiratory failure (T1RF): is characterised by
hypoxaemia (PaO2 < 8 kPa)
normal or low CO2.

🟨Type 2 respiratory failure (T2RF): is characterised by
hypoxaemia (PaO2 < 8 kPa) hypercapnia (PaCO2 > 6.5 kPa).