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29 Cards in this Set
- Front
- Back
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These 5 things are included in the normal glomerular capillary
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mesangial matrix, mesangial cell, podocyte (foot processes), endothelium, GBM
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What stx serves to control proteinuria?
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Slit diaphragms b/t podocytes
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What are the 2 reasons for glomerular injury? Explain
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Imumunologic - IC's or immune cells
Non-immunologic - permeability, hyperperfusion, genetic |
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Name some of the cellular and noncellular mediators of glomerular injury?
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PMN's, monocytes, macs, lymphocytes, plts, intrinsic GC's
IC's, complement, cytokines, GF's, superoxides, coagulants, vasoactive substance, and enzymes |
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This is seen in Acute GN
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IC's injuring the membrane and allowing the passage of blood & protein
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These four things indicate "glomerular" hematuria?
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microscopic (>5rbc/ul urine), macroscopic (>2500rbc/ul urine), dysmorphic rbc's in urine, & rbc casts
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What is a normal level of protein?
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< 100-150 mg/day
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Define microalbuminuria
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up to 300mg/day
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What is the nephrotic range for proteinuria?
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> 3.5 g/day
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What is the difference b/t selective and nonselective proteinuria?
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Selective proteinuria leaks albumin only. Non-selective leaks all proteins.
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These 2 things are the main causes of proteinuria
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GC injury
Tubular abnormalities |
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What are some other things that may cause GC injury?
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loss of GBM anionic charges, hemodynamic changes, NSAIDS, diabetes, and Alport's syndrome
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Wha is the quartet seen in Nephritic Syndrome?
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Hematuria, casts, proteinuria, and HTN
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What is the cause of edema seen in NS?
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Na+ retention
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Name the syndromes that show:
Muddy brown urine Yellow foamy urine |
Nephrotic, Nephritic
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This is the most useful too for dx ARF
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renal biopsy!
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What are contradindications to biopsy?
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uncontrolled HTN, hemorrhagic diathesis, ectopic or horseshoe kidney, hydronephrosis, polycystic kidney, acute pyelonephritis, aneurysms, uncooperative pt.
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What are the complications of biopsy?
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gross hematuria, perirenal hematoma,
A-V fistula, infections, death |
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What are the 3 portions of kidney Bx?
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LM, IF, and EM
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Describe the LM stain
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H&E, PAS, trichome, and methanamine Ag stains, formalin fixation
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Describe IF
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Fresh frozen sections, FITC labeled Ab's to IgG,M, & A, kappa, lamba light chains, C3, C1q, fibrinogen, & albumin
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Describe the EM stain?
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glutaraldehyde fixation. Exam of ultra-thin sections contrasted w/ Pb citrate and uranyl citrate
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What is the difference b/t intra and extracapillary hypercellularity?
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Too many cells are w/in the glomerular capillary tuft.
Too many cells are in the Bowman's capsule epi and the podocytes. |
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What types of cells are found w/in a crescent?
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Glomerular epi cells, inflammatory cells, myofibroblasts/fibroblasts
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Define Mesangial Hypercellularity
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>3 cells per mesangial area (macs + mesangial cells)
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What is the difference b/t a segmental vs a global glomerular sclerosis?
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A part of the glomerular capillary lumen is obliterated.
The entire glomerus tuft is obliterated by inc. glomerular ECM |
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How may IF patterns appear?
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Linear (anti-GBM disease), Granular (most IC GN)
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If the fluorescence if peripheral what type of disease may be present? Mesangial? Combined?
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membranous; IgA nephropathy; think Lupus, nephritis, and MPGN
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What disease under EM shows lamellation of the GBM? Fibrils?
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Alports's syndrome; amyloid.
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