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22 Cards in this Set
- Front
- Back
characteristics of Nephritic syndrome
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hematuria
HTN Renal insuff Proteinuria (above 3.5 g/day=nephrotic) immune deposits = nephritic |
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UA results for nephritic (in general)
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proteinuria
"Active Urine Sediment" -RBC cast -dysmorphic hematuria |
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three mechanisms for glomerulonephritis
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Immune complex deposits
-IgA nephropathy -acute/diffuse proliferative -lupus nephritis -rapidly progressing GN Anti-GBM (in situ imm complex) -anti GBM GN -Goodpastures ANCA -ANCA GN -Wegeners -microscopic polyangiitis -Churg strauss |
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LM results for nephritis
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hypercellular
mesangial complex focal/diffuse segmental/global crescentic BM changes |
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IM results for GNitis
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granular- type III (IgA, etc)
linear- type II (anti GBM) negative- ANCA (type IV) |
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asymptomatic hematuria
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Thin BM dz
Airports Syndrome IgA nephropathy |
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hematuria
LM normal IMFL normal EM thin BM type IV coll dist normal |
BFH-benign familial hematuria
"thin BM dz" excellent prognosis- no RF |
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hematuria
assoc w/deafness, retinal, cornea changes males type IV collagen abnormal foam cells in interstitium basket weave BM |
Alports syndrome
chronic HTN or RF |
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mesangial immune deposits
cresents can dvp IMFL "punctate" EM big, dark deposits in mesangials |
IgA nephropathy
viral infections may initiate or exacerbations |
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Henoch-Schonlein Purpura
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IgA nephropathy + vasculitis
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hypocomplementemia
neutrophils IMFL granular C3 on cell wall IMFL "starry sky" EM buffalo humps |
Acute Diffuse Proliferative GN (Post strep)
may have pos ASO (subepithelial humps) |
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LM cellular- nonspecific
IMFL "full house" staining especially C1q (classical) EM varies |
SLE GN
Ab's against nuclear Ag's |
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most aggressive lesions in SLE GN
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segmental
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activity index in SLE GN
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can treat high
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chronicity index in SLE GN
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get transplant if high
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crescent formation
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RPGN- hallmark
-ANCA & anti GBM (also possible in IgA nephropathy) -proliferation of epis lining BC -stain for fibrin -get GBM breaks |
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mechanisms for RPGN
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rapidly progressing glomerulonephritis
-anti GBM (linear IMFL) -ANCA (neg IMFL) -circulating immune complex (granular IMFL) (least common cause) |
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EM: crescentic GN w/ruptured capillary walls
fibrinoid necrosis IMFL: linear IgG |
anti GBM GN
-type II is attack on type IV collagen -if lungs involved = Goodpasture's -young men or old females (white) -anti GBM antibodies |
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anti GBM antibodies
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anti GBM GN or Goodpasture's
in situ complex formation young white male or old white female |
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EM: crescentic GN
necrosis IMFL: negative |
ANCA GN
medical emergency |
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diseases assoc'd w/ ANCA GN
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microscopic polyangiitis (no gran or asthma, yes vasc)
Wegener's (lung granulomas, vasculitis) Churg-Strauss (eos & asthma) ANCA GN (no vasculitis, gran or asthma) |
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pathogenesis of ANCA
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Ab's to neuts, degranulate, damage endothelium
P-ANCA -perinuclear -myeloperoxidase C-ANCA -cytoplasmic -PR3 (proteinase) |