Case Studies in Nephritic Patients

Question 1

Meaning of a cast

Answer 1

Formed in renal tubules

RBC - neprhitic patients

Question 2

Nephritic syndrome sx

Answer 2

HTN, hematuria (with dysmorphic RBCs), variable degree of proteinuria

Question 3

Pulm renal sx

Answer 3

Goodpasture syndrome

Small vessel vasculitis - GPA, MPA, SLE, HSP

Question 4

CANCA and PANCA

Answer 4

C - binding Ag throughout the cytoplasm…directed against proteinase 3

P - clustered around perinuclear region…directed at MPO

ELISA

Question 5

Tx of RPGN type 3

Answer 5

This is MPA or GPA

CS and cyclophos or rituximab

Azathiprine or methotrexate after induction

Maybe plasma exchange in pts with pulmonary hemorrhage

Question 6

HSP clinical

Answer 6

Skin - palpable purpura
Large joint arthralgia
Abdominal pain
Reanl disease - usually IgAN