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Glomerular Diseases - Nephritic and Nephrotic Syndromes

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
and Nephrotic Syndromes ... Nephritic syndrome—due ... RBC casts in urine ... but in severe cases ... Proteinuria #Nephrology #Diagnosis
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
- Diagnostic of ... glomerular disease • Leukocytes ... • White cell casts ... • “Muddy brown cast ... Microscopy #Atlas #key #diagnosis
Leukemias Overview: ALL, CML, AML, APML, CLL

Acute leukemias > 20% blasts in the peripheral blood smear
• Blasts > 10% leukocytes ... Neutrophils • Immature/Myeloblasts ... develop leukostasis syndrome ... • Tumor lysis syndrome ... Hematology #Oncology #Diagnosis
Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Nephritic vs Nephrotic Syndrome ... nephrotic/nephritic syndromes ... hematuria (RBC casts ... Nephritic #Nephrotic #Syndrome ... Algorithm #Nephrology #Diagnosis
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy - Casts ... Acellular Casts ... • Hyaline Casts ... suggestive of nephrotic sydnrome ... interpretation #diagnosis
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Between Nephrotic Syndrome ... and Nephritic Syndrome ... Red blood cell casts ... Red blood cell casts ... Table #Nephrology #Diagnosis
NINDS Diagnostic Criteria for Guillain Barre Syndrome 
Features Required for Guillain-Barré Syndrome:
 • Progressive muscle weakness
Guillain Barre Syndrome ... Guillain-Barré Syndrome ... at onset • >50 Leukocytes ... polymorphonuclear leukocytes ... Guillain #Barre #Syndrome
Algorithm for the Evaluation of Chronic Diarrhea (< 7 days)
Exclude:
1. Causes of acute diarrhea
2. Lactose intolerance
3.
Irritable bowel syndrome ... disease - Fecal leukocytes ... Malabsorption syndromes ... Irritable bowel syndrome ... algorithm #workup #diagnosis
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... breakdown of cellular casts ... heme-granular casts ... Fatty - Nephrotic syndrome ... Differential #Microscopy #Diagnosis
There are two patterns of T-wave abnormality in Wellens’ syndrome:
-Type A = Biphasic, with initial positivity
abnormality in Wellens’ syndrome ... negativity (25% of cases ... inverted (75% of cases ... ) #Diagnosis #Cardiology ... #EKG #Wellens #Syndrome