07:06,18,Sep,2006 | (1474/0/0) | Original

glomerulonephritis nephrotic syndrome


University education in the case of the Southern Paper
î—¥ î—¥ Division Head: Pediatrics
Instructor: Wu Xiaochuan
Audience: Clinical Medicine
Venue: Classroom, Second Xiangya Hospital of the Second
Teaching chapters: Chapter 14, Section 3,4
Course Duration: 3 hours (150 minutes)
Contents: acute glomerulonephritis, nephrotic syndrome
Session: 2006 school year
First, the purpose and requirements of teaching
Acute nephritis:
(A) the cause of acute nephritis, pathogenesis, pathology and pathophysiology
(B) of the master general cases of acute nephritis, severe cases, atypical cases, clinical manifestations, diagnosis and treatment
(C) be familiar with the differential diagnosis of acute nephritis
(D) to understand the prognosis and prevention of acute nephritis
Nephrotic syndrome:
(A) understand the nephrotic syndrome and pathogenesis of type
(B) be familiar with the pathophysiology of nephrotic syndrome and complications
(To) nephropathy and nephritis nephropathy simple identification
(D) to master the principles of nephrotic syndrome and hormone treatment
Second, the teaching points
Acute nephritis:
1. The general cases of acute nephritis, severe cases, atypical cases, the principles of diagnosis and treatment
2. Acute nephritis and acute exacerbation of chronic nephritis identify points
Nephrotic syndrome:
1. Nephropathy and nephritis, nephrotic simple identification of elements
2. Nephrotic syndrome dose hormone therapy, treatment and therapeutic efficacy standards
Third, the difficulty of teaching
(A) of the pathological changes of acute nephritis and pathological physiology
(B) the pathogenesis of nephrotic syndrome and the pathophysiological changes
Fourth, the type of course
Courses
Fifth, teaching methods
Lecture method
Sixth, teaching aids
Computer, disk, laser pen, chalk, blackboard, etc.
Seven, teaching contents and procedures
Acute glomerulonephritis, nephrotic syndrome
(A) into a new lesson: there have been bits physician said: "The children is father to the man", means that many adult diseases, starting from children, and children with renal disease kidney disease is also the source of many adults, in order to reduce the final the incidence of end stage renal disease, so prevention and treatment of children, particularly in chronic progressive renal disease prevention is of great significance. Today, we learn the two most common kidney disease: acute nephritis, nephrotic syndrome.
(B) Overview
1. Children the incidence of urinary system diseases: acute glomerulonephritis in children with urinary system diseases over the same period accounted for 53.7%; nephrotic syndrome patient urinary tract diseases over the same period accounted for 21% of children.
2. Diseases of more than
3. Control key and progress
(C) the definition of acute nephritis, etiology, pathogenesis and pathophysiology.
1. Defin
ition: acute glomerulonephritis (acute glomerulonephritis; AGN) referred to as acute nephritis, is a set of different causes, clinical manifestations of acute onset, more than a pre-infection, the urine-based, with varying degrees of protein urine, may have edema, hypertension, or renal insufficiency and other characteristics of glomerular disease.
2. Etiology: Most cases are caused by acute streptococcal infection.
3. Pathogenesis and pathophysiology
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Figure 14-1 Acute post-streptococcal glomerulonephritis pathogenesis diagram
(D) the pathological changes of acute nephritis
Exudative diffuse proliferative glomerulonephritis capillary
(E) the general case of acute nephritis, severe clinical cases
1. Prodromal infection
2. Typical cases: edema, oliguria, hematuria, hypertension
3. Severe cases: serious circulation congestion, hypertensive encephalopathy, acute renal failure
4. Atypical features: asymptomatic acute nephritis, acute nephritis extrarenal symptoms to the performance of acute nephritis with nephrotic syndrome
(Vi) changes in laboratory tests of acute nephritis
1. Urine
2. ASO
3. C3
4. ESR
(Vii) acute nephritis diagnosis and differential diagnosis
1. Diagnosis: (1) 1-3w onset of the prodromal period of infection with Streptococcus
(2) clinical edema, oliguria, hematuria,
(3) Hypertension
(4) urine has protein, RBC, tube
(5) serum C3 ↓, with or without ASO ↑
2. Differential diagnosis: IgA nephropathy, acute exacerbation of chronic nephritis, idiopathic nephrotic syndrome, rapidly progressive type of glomerulonephritis
(Viii) acute nephritis treatment, prevention and prognosis
1. Rest
2. Diet
3. Anti-infection
4. Symptomatic treatment: diuretic, antihypertensive
5. Treatment of severe cases
6. Prevention and Prognosis
(I) nephrotic syndrome: definitions, the difference between attention and nephritis
Definition: children with nephrotic syndrome (nephrotic syndrome; NS) is a group of various causes increased permeability of glomerular basement membrane, leading to a large number of plasma proteins lost from the urine of clinical syndrome. There are four major clinical features: â‘  proteinuria; â‘¡ hypoalbuminemia; â‘¢ hyperlipidemia; â‘£ edema. Above the first â‘ , â‘¡ the two conditions is essential.
1. Nephrotic syndrome in the pathogenesis and pathophysiological changes
(1) pathogenesis
(2) pathophysiology
â‘  proteinuria
â‘¡ hypoalbuminemia
â‘¢ hyperlipidemia
â‘£ edema
2. Nephrotic Syndrome Classification and identification of key points
Clinically on the basis of hematuria, hypertension, azotemia, hyperphosphatemia low presence or absence of complement with primary nephrotic syndrome and nephritis were divided into simple
NS NS nephritis simple
Pathology-based non-MCD MCD-based
Edema with clinical depression, one or more of the following simple NS
â‘  persistent proteinuria, hematuria, urinary three times in two weeks
Hypoproteinemia sediment RBC> 10   / HP
â‘¡ azotemia hyperlipidemia, insufficient circulation except
â‘¢ high blood pressure, other than hormones
â‘£ viremia persistent low complement
3. Nephrotic Syndrome complications
(1) infection
(2) low blood volume
(3) thrombosis
(4) acute renal failure
(5) renal tubular dysfunction
4. Nephrotic syndrome and hormone treatment principles
(1) Principle
(2) hormone options
5. Progress in the treatment of nephrotic syndrome and the problems to be solved
VIII References
(A) Yang Xijiang and easy with the text editor. Pediatrics. 6th ed. Beijing: People's Medical Publishing House ,2004320-332
(B) Hu Yamei, edited by Jiang Fang set. Zhu Fu Tang Practical Pediatrics. 7th Edition. Beijing: People Health Press, 2003
(C) Behrman RE, Kliegman RM andJenson HB. Nelson textbook of pediatrics. 16th ed. Science Press, HarcourtAsia, WB Saunders, 2001
glomerulonephritis nephrotic syndrome

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