[usmlear] neg charge on GBM bec of...?

[lange] sialylglycoproteins

[erum] haparan salfete

[usmlear] rt

[usmlear] it is lost in what cond?

[erum] nephrotic stnd lypoid

[lange] nephrotic synd

[usmlear] minimal change dis

[lange] yes

[usmlear] sialylg.?

[erum] lypoid is minimal

[usmlear] ok

[lange] yes...they are resp for neg charge

[marko] 1st abnormality in renal failure?

[usmlear] type of epi. in GBM?

[usmlear] reduction in GFR..marko?

[marko] no

[erum] epi?

[usmlear] visceral epithelium

[erum] ok

[an_bo_al] proteinuria?

[marko] its inability to concentrate urine

[usmlear] which has podocytes & slit pores

[an_bo_al] ok

[marko] pass dilute urine

[erum] unable to conc urine is first for rena failure

[usmlear] ok marko

[erum] gbm is basement membrane

[usmlear] type of GN in SLE?

[erum] it has endo on one side and epi on other

[usmlear] rt erum

[lange] mesangial

[erum] 5 types

[lange] focal

[lange] diffuse

[usmlear] type IV diffuse proli. in SLE

[lange] type vis?

[erum] type 4

[erum] in sle

[usmlear] in Berger's?

[erum] diffuse proliferative

[lange] iga

[usmlear] type of GN?

[usmlear] rt

[erum] bergers is

[erum] iga

[an_bo_al] rt

[lange] coz of oliguric states?

[erum] em in asle shows

[erum] dehydration

[lange] wire loop leisons....erum

[erum] hemorhage

[erum] subendothelial deposits lange

[erum] inc salt intake

[usmlear] urinalysis..what test we do ?

[erum] look for protien glucose etc?

[erum] dipstick

[usmlear] rt erum

[lange] casts

[erum] rbc cast

[lange] cells

[usmlear] pH

[usmlear] bilirubin

[lange] sp gravity

[erum] cells

[usmlear] urobili.

[erum] ph

[erum] bilirubin

[usmlear] blood,nitrite

[usmlear] yes

[lange] ok.......name oliguric stse cozes?

[erum] crystals

[lange] state*

[an_bo_al] density too

[usmlear] ammonium smell in alk. urine..?

[lange] proteus infec

[usmlear] rt

[erum] lange did y look at my answer lange

[erum] proteus mirabilis

[usmlear] p. mirabilis..stones

[lange] yes erum

[lange] what else

[lange] they come under pre renal azo

[lange] ?

[erum] hypovolemia

[erum] diarhea

[erum] dehydration ccf

[lange] same...pre renal

[usmlear] d/t dec in CO

[marko] complete obstruction?

[usmlear] HF,hypovolemia

[lange] ok..marko

[erum] burns

[lange] also in ATN

[lange] and ac GN

[usmlear] ok

[erum] thats renal

[erum] not prerenal

[erum] atn gn is renal

[erum] not prerenal

[lange] yes..erum coz are pre renal renal and post renal

[lange] pre renal u gave

[lange] post renal marko

[erum] ok

[lange] n renal me

[marko] what erum has been writing are causes of atn only

[erum] got it

[usmlear] MCC of pre-renal azo?

[an_bo_al] marko or usmlear could any of y two change color of the letter pls?

[lange] atn

[marko] hypovolemia

[usmlear] ok

[erum] hypovolemia

[erum] ccf

[lange] isch

[usmlear] rt lange

[erum] an_bo_al now y n usmlear r same color

[erum]

[an_bo_al] i already change it

[erum] ok

[an_bo_al]

[usmlear] thx an

[lange] coz of nephro toxic atn?

[usmlear] I didn't notice it

[marko] radiocontrast dye

[usmlear] it affects multiple parts of nephron

[an_bo_al] nsaids

[usmlear] thick ascending limb is most sensi.

[usmlear] for ischemia

[marko] ethylene glycol

[lange] mcc coz of death in ATN?

[an_bo_al] what's answer for mcc of prerenal?

[usmlear] how will u diff if pt is going into renal failure or has pre-renal azo?

[erum] guys today ive done the first lect of renal

[usmlear] ischemic ATN an

[erum] that didnt include atn

[usmlear] its ok erum

[an_bo_al] txs

[usmlear] we can continue it tomo.

[usmlear] endo later

[lange] ok

[erum] no i mean first lect of renal

[usmlear] oh..yes atn is in later audios

[usmlear] ok

[erum] rt

[lange] usmlear what is ans to your q?

[erum] but all of y have done it then go on.....

[usmlear] what types of GN present as a NEPHRITIC syndrome?

[usmlear] BUN/creatinine ratio

[usmlear] lange

[an_bo_al] bun\creat level?

[usmlear] rt an

[an_bo_al] ok

[lange] ok yes

[lange] bun/cr high in pre renal right

[usmlear] yes>15/1

[lange] nephritic.......igA

[erum] post strep,crescentic,good pasture,mem prol,iga

[usmlear] in RF 10/1

[an_bo_al] poststrep

[usmlear] even its level high

[usmlear] but the ratio will be <15/1

[usmlear] rt an

[usmlear] & erum

[erum] tx

[erum] rx for post strep?

[erum] and em finding?

[usmlear] hey guys..I maybe suddenly disconnect..here thunder storms..

[an_bo_al] ok

[usmlear] em..granular IF

[erum] ok

[erum] em?

[lange] are they called T_storms...usmlear?

[usmlear]

[an_bo_al] humps

[usmlear] EM with subepi. deposits in post-strep

[erum] rt subepithelial humps

[lange] ok

[usmlear] thx

[usmlear] type of AB ?

[usmlear] preent in post-strep?

[erum] igg

[lange] IGG IGM

[marko] cola colored urine

[usmlear] anti-DNAase titers

[usmlear] rt..bec Hb converted into hematin

[erum] sle

[erum] antobodies?

[lange] ana

[lange] anti ds DNA

[lange] anti sm

[usmlear] anti-dsDNA

[usmlear] anti-sm is characteristic of SLE

[erum] sle a/b deposits in nephron?

[usmlear] but +only in 30-40 % cases

[lange] anti DNA..deposit in nephron

[usmlear] subendo deposit in SLE

[erum] subendothelial dna antidna antibody complex

[erum] rt

[usmlear] rt

[an_bo_al] subendothelium

[erum] rt

[lange] coz of RPGN?

[usmlear] foam cells in glomeruli..what is this?

[usmlear] RPGN..goodpasture's

[usmlear] SLE

[usmlear] infect endo

[an_bo_al] post infx

[usmlear] yes

[erum] gp ,

[lange] IGa

[lange] also in wegners..

[erum] iga ,wegners ,poly art nodosa

[lange] ok

[usmlear] wedgner's...anti-neutrophil cyto.

[lange] foam cells in alports synd

[erum] nephritc synd in aids?

[usmlear] rt lange

[lange] usmlear

[lange] ok

[usmlear] why nerve deafness here?

[usmlear] in alport's

[usmlear] maybe bec of alpha5-chain type IV collagen...demyelination?

[usmlear] ?

[an_bo_al] ?

[usmlear] my q..nr deafness in alport's..why?

[lange] not sure

[usmlear] i gave the ans though

[usmlear] type IV collagen dis

[usmlear] asso. with this

[usmlear] so nr demyelination

[lange] may be ...what others say/

[erum] could be ... but not sure

[usmlear] alport's=deafness & renal failure...rt?

[erum] nephritic synd in aids pt

[usmlear] ok

[erum] ?

[erum] sorry nephrotic synd in aids?

[usmlear] Alport's syndrome is a hereditary disease of basement membranes which is characterised by sensorineural deafness and renal failure.

[erum] ok got it

[an_bo_al] could it b because basement mebrane at Cortis is splits?

[erum]

[marko] fsgn

[lange] erum..fsgs

[usmlear] so..alport's is asso. with type IV collagen dis

[lange] in aids

[erum] rt

[erum] w/ hep b?

[usmlear] it can cause nr demyelination...cause of deafness here

[lange] ok what other renal leisons in aids?

[erum] infection?

[marko] arf by drugs used infection etc

[lange] ok

[lange] and?

[marko] mgn(hbv

[lange] ok

[marko] mpgn(hcv)

[an_bo_al] got it

[lange] :cl

[lange] great marko

[marko] thx

[usmlear] thx erum & marko

[usmlear] :cl

[erum] rt

[erum] good

[lange] types of mpgn?

[usmlear] AB in henoch-Schonlein p.?

[lange] IGA

[erum] iga

[marko] iga yes

[usmlear] rt

[an_bo_al] Alport syndrome or Alport disease Also called hereditary nephritis, familial nephritis, or Fetchner syndrome. Genetic (genes COL4A5, COL4A3, and COL4A4). It may be inherited in two ways: in an X-linked manner, in which twice as many females as males are affected, but the males tend to be more severely affected; or as an autosomal dominant characteristic, in which case equal numbers of both sexes are affected (this latter variety is also called Fetchner syndrome).

[an_bo_al] Can be passed on to successive generations. Characteristics, generally appearing in mid-childhood, include nephritis (blood and/or protein in the urine) in all cases and progressive degeneration of kidney function leading to renal failure. Kidney dialysis and/or kidney transplants are eventually required. About half of all Alport syndrome cases, males more commonly than females, have progressive sensorineural deafness from the toxic effects of unremoved body metabolic waste products on membranes in the cochlea. This deafness may appear as early as age 3 or 4.

[erum] type i and type 2 associated w/ dec c3

[an_bo_al] sorry but this is good

[usmlear] thx an

[usmlear]

[usmlear] so this is not bec of demyelination...thx again

[an_bo_al] as Goljan would say...that's how they ask it!

[usmlear] rt

[lange] ok ..so deafness is due to action of unremoved toxins

[erum] type 1 mpgn is w/ hep b

[erum] good job an_bo_al

[usmlear] yes

[an_bo_al] txs

[lange] good

ypoornima has left the chat.

[erum] type 2 w/ dec c3 levels

[usmlear] what is the MCC of nephotic syndrome in adults?

[lange] type 1 what on em?

[lange] MGN..usmlear

[usmlear] tram tracks

[usmlear] rt lange

[lange] type 1 sub endo and mesangial

[erum] subendothelial humps tram track

[lange] ok

[usmlear] yes

[lange] type 2 dense deposit dis

[erum] type 2 dense deposits

[usmlear] intramemb deposits r C3 in type II

[lange] yes

[erum] rt

[lange] cozes of MGN?

[erum] when do y see fused podocytes

[lange] lipoid MGN and FSGS

[lange] erum

[usmlear] em..christmas balls..?

[erum] diabetic

[usmlear] rt

[erum] sclerosing

[usmlear] rt..afferent & efferent hyaline arteriosclerosis

[erum] drugs captipril,a nsaid

[usmlear] ok

[erum] syphilis malaria,cea antibody in colon ca

[erum] all for mgn

[usmlear] ok

[lange] usml;ear what is this christmas balls?

[erum] hyaline in capilary limen

[lange] seen in DM

[lange] ?

[erum] of diabetic nephropathy

[usmlear] these r focal areas of glomeruloscl. d/t protein accumulation..lange

[usmlear] rt..seen in DM

[erum] rt

[lange] ok u mean nodular glomerulosc..

[erum] rt

[lange] ok

[erum] kimmelstein wilson

[lange] ya ok

[erum] nodular

[erum] ok

[usmlear] rt erum

[erum] how does ace prevents diabetic sclerosis

[erum] progression/

[erum] ?

[usmlear] pathogen is imp. here..remeber..nonenz glycosylation?

[lange] inhibits A 2 med gfr inc

[lange] so dec proteinuria

[erum] rt

[usmlear] it inc vess permeabilty

[usmlear] ok

[erum] d/m affects effernt

[usmlear] both erum

[erum] so constricted efferent inc filtration

[usmlear] aff & eff

[usmlear] ?

[erum] inc filtration inc load on kidney ,further damage

[usmlear] ys..constric eff-->inc GFR

[usmlear] ok

[erum] ace inhibits angiotensin

[erum] ang causes constriction so dec angio dilation of efferent dec filtration

[usmlear] what is the first sign of DM nephropathy?

[erum] microalbuminimia

[usmlear] rt

[usmlear] oh..its nuria..not nimia

[usmlear] in urine

[usmlear] i mean not in blood

[an_bo_al] rt

[usmlear] ok

[erum] rt ..sorry

[usmlear] i saw q based on even these minor nomencla.

[usmlear] easy to distract

[an_bo_al] rt

[usmlear] ok

[erum] y see mesangial deposits in?

[lange] IGA

[an_bo_al] doesnt it angiot 2 work more in constricting afferent?

[erum] rt bergers

[erum] angio works on afferent

[erum] more

[erum] then efferent

[usmlear] rt

[erum] ins in that inc overall pressure

[erum] inc

[an_bo_al] agree

[erum] ok

[usmlear] ur prep is excellent erum..we almost done with first audio?

[usmlear] want to continue renal tomorrow?

[usmlear] or endo?

[an_bo_al] but im asking bec y saidf before"ang causes constriction so dec angio dilation of efferent dec filtration "

[erum] tx alot

[erum] rt an angio works more on efferent

[erum] so it inc fitration

[usmlear] ya..by inc gfr

[erum] and gfr

[an_bo_al] well i think is afferent more

[erum] y mean aferent is more affected by angio

[erum] ?

[an_bo_al] yeap

[lange] no guys it is efferent arteriole that is more affected by angiotensis

[lange] dont get confused

[erum] but only thing is hyaline arteriosclerosis is deposited

[erum] more at efferent

[usmlear] agree

[erum] so when angio cnstricts efferent is more

[erum] bcuz its already narrow

[erum] so efferent is more constricted

[usmlear] an_bo_al..can u give any ref?

[an_bo_al] looking

[usmlear] ok

[erum] pge dilates arterioles

[usmlear] ok, guys..v. good discussion

[usmlear] so whats for tomorrow?

[erum] thats why aspirin nsaid

[erum] causes ischemia

[erum] in nephron

[erum] yep it was good

[usmlear] so,endo for tomorrow?

[erum] how about the next lect of renal

[usmlear] or renal?

[usmlear] we can do it tomorrow..no prob

[usmlear] all agree?

[erum] ok so renal next lect tomorow?

[erum] let me tell y guys on ething

[erum] wont be here

[usmlear] ?

[erum] on friday night

[erum] and saturday

[usmlear] this coming fri?

[usmlear] & sat?

[erum] will join in sunday

[erum] yep tomorow

[erum] n day after

[usmlear] so, maybe we can take a break on fri./sunday

[erum] will be back on sunday

[usmlear] can finish on sunday..longer chat?

[erum] ok

[lange] ok

[usmlear] an_bo_al

[an_bo_al] ok

[usmlear] thx all

[an_bo_al] txs
[lange] ok guys bye