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RENAL-IM, chỉ đinh sinh thiết thận: Renal biopsy is indicated in…

- - - - tang Na + nc bth---> uống them nc
        
        tăng NA+ giảm nc + TC của giam V
        -----> nacl .9
        
        dectrose 5%
        
        tăng Na + giảm Nc + ko TC--> destroe 5%
        
        Có thê chuyên sang .45 % sau kkhi on dinh
        
        /< 1 mEq/L/h (0.5 mEq/dl/hr) without exceeding 12
        mEq/dl/24 hr
        
        5% dextrose is preferred over 0.45% saline
        
        ha nhanh gậy phù não
  - - - CLINICAL FEATURES
        
        PR keo dài +T cao <mất p<+ QRS rộng
        
        calcium IV
        
        tam thời
        
        hoàn toàn ( lơi tiêu///)
        
        INDICATIONS FOR EMERGENT TREATMENT OF HYPERKALEMIA
        ( ecg/ >6.5/ TĂNG DỘT NGỘT DO LY GIÃI
  - - - EVALUATION OF HYPONATREMIA
  - - - UCCR= (Caurine/Caserum)/(Creatinineurine /Creatinineserum)
        -->UCCR is usually <0.01 in FHH compared to >0.02 in primary hyperparathyroidis
      - weakness, GI distress, and neuropsychiatrist sx (e.g. confusion, stupor, coma) + Polyuria
- - - - tăng alosteroll
  - - - RENAL TUBULAR ACIDOSIS
- - - - PRIMARY CAUSES OF NEPHROTIC SYNDROME
        
        VCT tăng sinh màn
        
        VGB+ VGC
        
        GPB : dày màng đáy + subepithelial spikes ( gai dưới biểu mô)
        
        san thương tối thiểu
        
        Nsaid . llymphoma
        
        GPB: binh thường ( tổn thương T Cell của podocyte--> tăng tình thấm)
        
        trẻ em
        
        ko tiểu máu
        
        dtr: corticodti
        
        bệnh màng cầu thận
        
        andeocarcinoma (lung, breast)+ VGB
        
        xl: nuoc tiều 24---> C3 giảm---> ANA tăng (lupsu)--> sinh thiết
        
        IgA
        
        NTHHT
        
        viêm CT xo chai khu trú từng vùng
        
        Afican American + HIV
        
        GPB: crescent formation( hình liềm)
        
        ngưởi lớn
    - - ALPORT SYNDROME
        
        di truyền
        
        điếc + tiểu máu + protien
        ---> hinh ảnh: mao mạch ở vủng GBM nó có nhửng vủng dày xen kẽ mõng--> thoát ra
      - IgA NEPHROPATHY VS POSTINFECTIOUS GLOMERULONEPHRITIS
        
        IgA NEPHROPATHY
        
        sau 5 ngày NTHH trên+ trẻ lớn men>20-30
        
        tiểu máu
        
        :check: ứ đọng IgA ( sinh thiet)
        
        lành tính or VCTC tiến triển nhanh
        
        POSTINFECTIOUS GLOMERULONEPHRITIS
        
        sau 20-21 ngày NTHHT( vùng hàu họng)
        
        trẻ em <10 t ( or người lớn)
        
        tiểu máu
        
        :check: C3 giảm + ASO+/ani DNA B + hình ành: HUMP
        
        tiên lượng tốt
      - MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS
        
        Type 2 (dense deposit disease)
        
        stain for C3 --> lgG antibodies-->persistent complement
        activation and kidney damage
  - - - Renal vein thrombosis: abdominal pain, fever, and hematuria.
        ---->most common with membranous nephropathy
- - - - Screening:
        
        al/ cre or nc tiểu 24h
        
        que thu chỉ phát hiện> 300
        
        que thử:
        
        trace : 15-30
        
        +: 30-100
        
        ++: 100-300
        
        +++: 300-1000
        
        4+ : >1l