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28 Cards in this Set
- Front
- Back
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nephrotic-range proteinuria
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>3.5 g/24 hr
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Nephrotic syndrome criteria (3)
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proteinuria >3.5g/24h, hypoalb <3 g/dL, hyperlipidemia
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What causes hypercoagulable state in nephrotic syndrome?
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Urinary loss of anticoagulant proteins (protein C, protein S, antithrombin III)
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Renal vein thrombosis may occur with any cause of nephrotic syndrome but is most common with this condition
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membranous glomerulonephritis
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this condition presents with sudden-onset worsening of renal insufficiency, worsening proteinuria, hematuria, or flank pain
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Renal vein thrombosis
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primary nephrotic syndromes
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MCD, FSGS, MGN
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Pathologic hallmark of this condition is normal-appearing glomeruli on microscopy and generalized loss of foot processes of podocytes on electron microscopy
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minimal change disease
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type of nephrotic sydnrome in human immunodeficiency virus (HIV)–associated nephropathy (HIVAN)
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collapsing FSGS
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The most common cause of nephrotic syndrome in adults
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membranous GN
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antibodies associated with membranous GN
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anti-phospholipase A2 (PLA2) antibodies
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secondary causes of nephrotic syndrome
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DM, amyloidosis
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Clinical scenarios in which to consider renal biopsy in diabetics
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proteinuria with <10years of DM; no retinopathy; significant hematuria or RBC casts on UA; evidence of other systemic disease
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most common type of amyloidosis
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AL amyloid (primary amyloidosis) with deposits of light-chain immunoglobulin
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conditions associated with secondary (AA amyloid)
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chronic inflammatory or infectious states
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nephrotic syndrome associated with NSAIDS, lymphoma, bee stings
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min change disease
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nephrotic syndrome associated with hyperfiltration (morbid obesity), HIV or heroin nephropathy
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FSGS
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nephrotic syndrome associated with adenocarcinoma, hepatitis B, SLE, drug reactions to NSAIDs
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membranous glomerulonephritis
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nephrotic syndrome associated with hepatitis C, chronic hepatitis B, lipodystrophy
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membranoproliferative GN
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evaluation of nephrotic syndrome - serologics, diagnostics?
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ANA, complement levels, HBSAg, anti-hep C antibody, SPEP, UPEP; kidney biopsy
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treatment of nephrotic syndrome
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treat underlying disorder; control BP, use ACE or ARB; control cardiovascular RF, control DM
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nephritic syndrome + hypocomplementemia suggets which disorders? (4)
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lupus nephritis, PIGN, membranoproliferative GN or cryoglobulinemic GN
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nephritic syndrome + purpuric rash, arthralgias, abdominal pain
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HSP
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renal deposits in HSP
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Immunoglobulin A (IgA) deposition seen in renal mesangial cells (looks exactly like IgA nephropathy)
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hypertension, oliguria, and elevated antistreptolysin O (ASO) antibody titers 7 to 14 days after throat or skin infection with group A Streptococcus
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post-streptococcal GN
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Most common cause of glomerulonephritis in adults
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IgA nephropathy
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classically presents with gross hematuria following upper respiratory infection (majority of patients)
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IgA nephropathy
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most common cause of MPGN
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hepatitis C infection (type I MPGN)
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treatment for Goodpasture syndrome
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Plasmapheresis (to remove anti-GBM antibodies) + corticosteroids + cyclophosphamide; ?dialysis
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