Nephrology 08 Glmerular Disorders

Front 1

Nephritic syndrome

Back 1

acute/subacute inflamm process
hematuria, proteinuria and sometimes RBC casts
may burn out to nephrotic syn

Front 2

nephrotic syndrome

Back 2

heavy proteinuria and edema, also urine fat

Front 3

causes of glomerular dx #3

Back 3

1. antigen/antibody
2. antibody against basement membrane
3. idiopathic

Front 4

what is FeNa value in glomerulopathy?

Back 4

always <1%

Front 5

what are the 3 components of the glomerular wall

Back 5

1. endothelial cells
2. glomerular BM
3. slit pores betw the epithelial foot processes

Front 6

3 findings on light/electron microscopy of renal bx

Back 6

1. subepithelial deposits
2. sub endothelial deposits
3. mesangial deposits

Front 7

what glomerular diseases have subepithelial deposits on renal bx?

Back 7

membranous nephropathy
postinfectious GN

Front 8

What glomerular diseases have subendothelial deposits on renal bx?

Back 8

diffuse, proliferative, lupus nephritis, and membranoproliferative GN

Front 9

What glomerular disease(s) have mesangial deposits on renal bx?

Back 9

IgA nephropathy

Front 10

Nephritic urine sediment

Back 10

active--dysmorphic RBCs and WBCs and casts of RBC, WBC and granular material
variable proteinuria

Front 11

Nephritic syndrome causes:

Back 11

postinfectious GN, IgA nephropathy, lupus nephritis

Front 12

Nephrotic syndrome urine sediment

Back 12

usu nl, see heavy proteinuria and urine fat
also hypogammaglobulinemia--which makes them prone to infection w encapsulated orgs, also hypercoagulable
also hyperlipidemia

Front 13

glomerular dx and low complement

Back 13

lupus, PIGN, freq w membranoproliferative, cryoglobulin GN, shunt nephritis, endocarditis

Front 14

causes of RPGN

Back 14

Goodpastures
idiopathic, SLE
vasculitis(wegeners, PAn)

Front 15

3 categories of RPGN by pathology

Back 15

1. immune complex
2. pauci-immune dx
3. anti-GBM antibody dx

Front 16

urine findings RPGN
path/glomeruli

Back 16

protein, RBC casts
>50% glomeruli have crescents--if inflamm crescents will respond to tx, if fibrous irreversible

Front 17

What are the first 2 antibody tests you order in workup of RBGN?

Back 17

first order Anti_GBM and ANCa

Front 18

RPGN + anti GBM + pulmonary hemorrhage

Back 18

Goodpastures
if no pul hemorrhage think just anti -GBM GN

Front 19

RPGN + +ANCA
3 possibilities

Back 19

1. Wegeners
2. PAN
3. idiopathic ANCA + crescentic GN

Front 20

RPGN
-anti-GBM and -ANCA
think:

Back 20

IC mediated problems
lupus nephritis--ck anti DS DNA ab
post strep GN
cryoglobulinemic Gn-ck cryo levels and complement-should be low)

Front 21

RPGN tx

Back 21

corticosteroids + cyclophosphamide or azathioprine

Front 22

RPGN from Goodpastures or cryoglobulinemic GN tx:

Back 22

plasmapheresis followed by alkylating agent

Front 23

PIGN etiol

Back 23

usu nonstrep causes
freq septicemia or viruses
subepithelial deposits
AB/Ag reaction IgG C3

Front 24

PIGN labs
latency period?

Back 24

low complement which returns to nl in 6-8 wks
latency betw infection/PIGN is 1-6 wks

Front 25

PIGN tx

Back 25

abtics/underlying infection
prorgresses to severe renal failure only if infections persists

Front 26

Membranoproliferative gn or MPGN
assoc w ?infection
complement level?

Back 26

assoc w Hep C
complement low

Front 27

why is this called "double" GN?
what is complement level?

Back 27

both basement membrane chgs and cell proliferation.
BM chgs--can cause nephrotic syn
cell prolif--is the nephritic component
low complement

Front 28

when does complement level return to normal in MPGN?

Back 28

stays low indefinitely

Front 29

MPGN tx

Back 29

kids prednisone
adults ASA and oral dipyridamole
if MPGN assoc w hep c interferon