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32 Cards in this Set
- Front
- Back
Glomerular injury of immune origin is mediated by elements of the ___ and __ immune systems
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Innate and Adaptive Immune Systems
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Classification of Glomerular Dz:
increase in cellular components of the glomerulus regardless of origin (immune and non-immune cells) |
Proliferative
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Classification of Glomerular Dz:
-increase in the thickness of the glomerular capillary wall, often caused by immune complex deposition |
Membranous
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Classification of Glomerular Dz:
-increase in the non-cellular components of the glomerulus (ex. collagen) |
Sclerotic
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Classification of Glomerular Dz:
-kidneys are directly affected |
Primary
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Classification of Glomerular Dz:
-kidneys are damaged as a result of a systemic disease, toxin or medication |
Secondary
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Characterized by heavy proteinuria (more than 3.5 gm/day in adults). Mechanism of glomerular injury is non-inflammatory
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Nephrotic Syndrome
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initiating event is a derangement in the glomerular membrane that causes increased permeability and thus protein loss
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Nephrotic Syndrome
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-Inflammatory process associated with hematuria and low-to-variable
proteinuria. |
Nephritic Syndrome
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-Caused by an inflammatory response that decreases permeability of the GCW (glomerular capillary wall)
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Nephritic syndrome
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Mutations in the gene encoding ______ (slit diaphragm protein between podocyte foot processes) give rise to nephrotic syndrome
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Nephrin
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_____ can be found in the mesangium, subendothelium, basement membrane or subepithelium
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Immune Complexes
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What determines the mediators of tissue injury that are activated in the glomerulus?
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The SITE of immune complex deposition...
Shitty card... I know... |
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Antibodies bind to antigen already present in the kidney
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In situ Immune Complex Deposition
Ag can be: ** endogenous- renal-self Ag in kidney** **endogenous non-renal** **exogenous** |
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Name two diseases where pre-formed IC's will be transported into the kidney via circulation
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SLE
Post- Group A Strep. |
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What is the target of injury in Nephrotic syndrome? Is it inflammatory or non-inflammatory?
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Podocytes
Nephrotic = Non-Inflammatory |
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Subendothelial Immune complexes result in ______ in Nephrotic Syndrome
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Complement Activation --> MAC
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Which complement pathway is initiated by IgG complexes?
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Classical Pathway
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Do C3a and C5a recruit PMNs, Macrophages and Monocytes in Nephrotic Syndrome
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NO..
NO INFLAMMATION |
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Subepithelial Immune complexes are inflammatory/non-inflammatory
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Non-inflammatory
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Immune complex deposition in the
mesangium and subendothelium |
Nephritic Syndrome
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In this syndrome, Immune cells (T cells, neutrophils and macrophages) cause tissue damage
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Nephritic Syndrome --> MAC causes damage
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What serum proteins accumulate in tissues during an inflammatory
response? |
Growth Factors
Albumin Chemokines |
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How do immune complexes cause
glomerular injury? |
Activated phagocytes:
Produce ROS, enzymes, proteases, chemoattractants and mediators that result in tissue damage |
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Phagocytes are activated by binding to immune complexes via __ receptors and ___
antigen with complement receptors |
Fc Receptors
C3b-opsonized antigen |
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IgA nephropathy is a type of ____ syndrome
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Nephritic
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Predominant deposition of polymeric IgA1 in the mesangium
Inflammation=Nephritic |
IgA Nephropathy
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glycosylated dimeric IgA
activates complement via the ______ pathway |
Mannose-Binding Lectin pathway
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Microscopic hematuria in the absence of sustained proteinuria is seen in what?
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IgA Nephropathy
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pathogenesis is thought to involve abnormal
glycosylation of IgA, which induces IgA self aggregation and IgA-IgG immune complexes. Both mechanisms lead to the formation of macromolecular complexes in the mesangium |
IgA Nephropathy
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You see mesangial cell proliferation by light microscopy and IgA
deposition on immunofluorescence |
IgA Nephropathy
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Your patient presents with hematuria andminimal proteinuria. A renal biopsy shows immune complexes, complement and neutrophils in the mesangium andsubendothelial space. Is it nephritic or nephrotic syndrome?
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Nephritic
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