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Nephrotic Syndrome: High-Yield Insights for FMGE | DIBS by Nextillo

Get high-yield insights on Nephrotic Syndrome for NEET PG with DIBS by Nextillo. Simplified concepts, key features, and essential clinical points in one place!

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Nephrotic Syndrome: High-Yield Insights for FMGE | DIBS by Nextillo

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  1. NEXTILLO_ #DIBS BY NEXTILLO NEPHROTIC SYNDROME DAILY INFORMATION BULLETIN SERVICE NEXTILLO.COM

  2. #DIBSBYNEXTILLO DAILY INFORMATION BULLETIN SERVICE NEPHROTIC SYNDROME Nephrotic syndrome is a clinical condition characterized by a combination of signs and symptoms that result from glomerular injury, leading to increased permeability of the glomerular capillary wall. NEXTILLO.COM

  3. CHARACTERISTIC FEATURES Proteinuria Hypoalbuminemia Edema Hyperlipidemia Lipiduria NEXTILLO.COM

  4. PROTEINURIA It is the hallmark of nephrotic syndrome and refers to the excretion of more than 3.5 grams of protein per day in the urine. Hypoalbuminemia Loss of albumin in the urine leads to low serum albumin levels, it results in decreased plasma oncotic pressure, contributing to edema. Edema Decreased oncotic pressure from hypoalbuminemia causes fluid to shift from the intravascular compartment to the interstitial space, leading to edema. Hyperlipidemia The liver compensates for hypoalbuminemia by increasing the synthesis of lipoproteins, which results in hyperlipidemia (elevated cholesterol and triglycerides). Lipiduria Lipiduria occurs as a result of lipid being filtered through the glomerulus, which then appears in the urine as fatty casts or oval fat bodies. NEXTILLO.COM

  5. CAUSES OF NEPHROTIC SYNDROME Nephrotic syndrome can result from both primary (idiopathic) and secondary causes. Primary Causes: Minimal Change Disease (MCD) Focal Segmental Glomerulosclerosis (FSGS) Membranous Nephropathy Membranoproliferative Glomerulonephritis (MPGN) Secondary Causes: Diabetes Mellitus Systemic Lupus Erythematosus (SLE) Amyloidosis Infections Drugs NEXTILLO.COM

  6. CLINICAL PRESENTATION Edema: it is the most common presenting complaint, initially starting in the face and periorbital area, progressing to the legs and abdomen. Fatigue: due to the loss of protein and the resulting anemia and general ill health. Signs of Hyperlipidemia: Xanthelasma (fatty deposits around the eyes) and tendinous xanthomas (fatty deposits on tendons) may appear. Urinary Symptoms: Frothy or foamy urine due to proteinuria. NEXTILLO.COM

  7. VISUAL REPRESENTATION NEXTILLO.COM

  8. DIAGNOSIS Urine Analysis: Proteinuria: >3.5g/day is diagnostic. Urine microscopy: Presence of fatty casts or oval fat bodies may be noted. Blood Tests: Hypoalbuminemia: Low serum albumin levels (<2.5 g/dL). Hyperlipidemia: Elevated serum cholesterol and triglycerides. Creatinine and BUN: To assess kidney function. Kidney Biopsy: Performed to confirm the underlying cause (particularly for adult nephrotic syndrome). NEXTILLO.COM

  9. MANAGEMENT Treating the Underlying Cause: 1.Treat any identified secondary causes (e.g., diabetes, lupus, infection). 2.For primary nephrotic syndrome, treatment may include immunosuppressive drugs like corticosteroids or cyclophosphamide. Symptomatic Treatment: 1.Diuretics: To manage edema (e.g., furosemide). 2. ACE inhibitors/ARBs: To reduce proteinuria and manage blood pressure. Managing Hyperlipidemia: 1.Statins may be used to control lipid levels. Anticoagulation: 1.Given the increased risk of thromboembolism due to hypercoagulability in nephrotic syndrome. NEXTILLO.COM

  10. PROGNOSIS Minimal Change Disease often has an excellent prognosis in children, with a high rate of remission with corticosteroid therapy. Focal Segmental Glomerulosclerosis and Membranous Nephropathy can be more resistant to treatment and may lead to chronic kidney disease or end-stage renal failure if not treated effectively. NEXTILLO.COM

  11. MCQ QUESTION: A 12-year-old child presents with nephrotic syndrome. Despite appropriate treatment, the child continues to relapse with frequent episodes of proteinuria and edema. Which of the following is the most appropriate next step in management? A) Renal biopsy B) Corticosteroid therapy C) Cyclophosphamide therapy D) Immunosuppressive therapy with calcineurin inhibitors Answer: A) Renal biopsy NEXTILLO.COM

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