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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
Innate and Adaptive Immune Systems
Classification of Glomerular Dz:

increase in cellular components of the glomerulus regardless of origin (immune and non-immune cells)
Proliferative
Classification of Glomerular Dz:

-increase in the thickness of the
glomerular capillary wall, often caused by immune complex deposition
Membranous
Classification of Glomerular Dz:

-increase in the non-cellular
components of the glomerulus (ex. collagen)
Sclerotic
Classification of Glomerular Dz:

-kidneys are directly affected
Primary
Classification of Glomerular Dz:

-kidneys are damaged as a result of a systemic disease, toxin or medication
Secondary
Characterized by heavy proteinuria (more than 3.5 gm/day in adults). Mechanism of glomerular injury is non-inflammatory
Nephrotic Syndrome
initiating event is a derangement in the glomerular membrane that causes increased permeability and thus protein loss
Nephrotic Syndrome
-Inflammatory process associated with hematuria and low-to-variable
proteinuria.
Nephritic Syndrome
-Caused by an inflammatory response that decreases permeability of the GCW (glomerular capillary wall)
Nephritic syndrome
Mutations in the gene encoding ______ (slit diaphragm protein between podocyte foot processes) give rise to nephrotic syndrome
Nephrin
_____ can be found in the mesangium, subendothelium, basement membrane or subepithelium
Immune Complexes
What determines the mediators of tissue injury that are activated in the glomerulus?
The SITE of immune complex deposition...

Shitty card... I know...
Antibodies bind to antigen already present in the kidney
In situ Immune Complex Deposition

Ag can be:

** endogenous- renal-self Ag in kidney**

**endogenous non-renal**

**exogenous**
Name two diseases where pre-formed IC's will be transported into the kidney via circulation
SLE

Post- Group A Strep.
What is the target of injury in Nephrotic syndrome? Is it inflammatory or non-inflammatory?
Podocytes

Nephrotic = Non-Inflammatory
Subendothelial Immune complexes result in ______ in Nephrotic Syndrome
Complement Activation --> MAC
Which complement pathway is initiated by IgG complexes?
Classical Pathway
Do C3a and C5a recruit PMNs, Macrophages and Monocytes in Nephrotic Syndrome
NO..

NO INFLAMMATION
Subepithelial Immune complexes are inflammatory/non-inflammatory
Non-inflammatory
Immune complex deposition in the
mesangium and subendothelium
Nephritic Syndrome
In this syndrome, Immune cells (T cells, neutrophils and macrophages) cause tissue damage
Nephritic Syndrome --> MAC causes damage
What serum proteins accumulate in tissues during an inflammatory
response?
Growth Factors

Albumin

Chemokines
How do immune complexes cause
glomerular injury?
Activated phagocytes:

Produce ROS, enzymes,
proteases, chemoattractants
and mediators that result in
tissue damage
Phagocytes are activated by binding to immune complexes via __ receptors and ___
antigen with complement receptors
Fc Receptors

C3b-opsonized antigen
IgA nephropathy is a type of ____ syndrome
Nephritic
Predominant deposition of polymeric IgA1 in the mesangium

Inflammation=Nephritic
IgA Nephropathy
glycosylated dimeric IgA
activates complement via the ______ pathway
Mannose-Binding Lectin pathway
Microscopic hematuria in the absence of sustained proteinuria is seen in what?
IgA Nephropathy
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
You see mesangial cell proliferation by light microscopy and IgA
deposition on immunofluorescence
IgA Nephropathy
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?
Nephritic