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Medicine

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Endocrine

Question
11 out of 33
 

Earliest feature of diabetic nephropathy



A Enlarge kidney size
B Raise GFR

C Raise serum K
D Microalbuminuria

Ans. B

Raise GFR

Fig, 272-1, Progression of chronic renal injury in diabetes (Ref: Hari - 18th ed. Pg -1749)

1). GFR is the 1st manifestation of diabetic nephropathy. (PNQ)

2). Then is the stage of Microalbuminuria. It is the most reliable marker of diabetic nephropathy.

3). Macro albuminuria

4). CRF (diabetes is the commonest cause of CRF).

Microalbuminuria

1). Microalbuminuria is one of the earliest marker of diabetic nephropathy.

2). Microalbuminuria is associated with long term cardiovascular morbidity.

3). Strict glycemic control may prevent or revert microalbuminuria.

4). Protein restriction is helpful in diabetic nephropathy – (Ref. Hari - 18th ed. Pg- 2985)

Pathology:

1). Capillary BM thickening (AIPG 09)

2). Diffuse glomerulosclerosis (Most common). In this there is increase in mesangial

3). matrix. It is PAS positive

4). Nodular glomerulosclerosis. (It is the most characteristic feature).

5). It is accompanied by accumulation of hyalin material.

6). If it is within capillary loop (Fibrin cap) or it is attached to Bowman capsule (Capsular drop)

7). DM are prone to radio contrast induced nephropathy

8). Armani Ebstein Reaction: Collection of glycogen clumps within the renal tubules found in diabetic nephropathy

9). Dietary advice - Protein intake = 0.8 gm/kg/day in micro Albuminuria, < 0.8 gm/ kg /day = in macro albuminuria

Endocrine Flashcard List

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