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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 ... Nephritic #Nephrotic #Syndromes
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
Atlas of Urine Microscopy ... • Red cell casts ... • White cell casts ... #Atlas #key #diagnosis ... #nephrology #casts
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of nephrotic sydnrome ... colored compounds (e.g ... #nephrology #interpretation ... #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 ... #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 ... #ECG #EKG #Wellens ... #Syndrome #TypeA
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 ... #Diagnosis
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
disease - Alport syndrome ... pain hematuria syndrome ... hematuria: - RBC casts ... • Nutcracker syndrome ... #nephrology #renal
Causes of Erythema Nodosum - Mnemonic

NO cause found in 60% of cases
Drugs (antibiotics e.g., sulfonamides, amoxicillin)
Oral
found in 60% of cases ... Drugs (antibiotics e.g ... Sarcoidosis or Lofgren's syndrome ... Nodosum #Mnemonic #Causes ... #Differential #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 ... #Diagnosis #Nephrology
Classification of Jaundice
Unconjugated hyperbilirubinemia (predominantly indirect bilirubin)
 • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
Crigler-Najjar syndrome ... Hereditary Cholestatic Syndromes ... Dubin-Johnson syndrome ... , Rotor syndrome ... cholestasis, and some cases