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15 Cards in this Set
- Front
- Back
Nephrotic syndrome:
Most common causes?(3) 5 major symptoms? Why does the glom get affected by inflammation? |
Acute post-strep GN
Anti-GBM nephritis Lupus nephritis, vasculitis hematuria, proteinuria, edema, oliguria, reduced renal fxn capillary network, enormous blood volume, high pressure, directs MHC I, II molecules |
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Most common form of primary GN worldwide:
defined by presence of _____ and to a lesser extent ____ in the glom. main cause of _______ in pts who require renal replacement. Glom deposits are what subtype of IgA (produced by what)? Strong link between occurrence and progression of IgA nephropathy and certain what? |
IgA nephropathy
presence of IgA, lesser extent C3 ESRD produced by plasma cells, IgA1- certain HLA antigens |
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Some IgA nephropathy pts have elevated serum levels of IgA in complex with _________.
________ is seen in over 35% of transplant recipients. IgA nephropathy: decreased clearance of IgA1 by _________. IgA-mediated vasculitis, purpuric rash on legs/butt, abd pain, renal lesions: |
fibronectin (physiological glue)
IgA nephropathy RES (reticuloendothelial system) Henoch-Schonlein purpura (secondary IgA condition) |
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What does the unique feature of IgA1 (presence of multiple O-glycosylation) have to do with GN?
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IgA1 are less glycosylated in patients with IgA nephropathy
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Anti-GBM GN:
strong association with _______. Anti-GBM Ag's (type ____) are directed to _______ collagen. Anti-GBM + pulmonary hemorrhage: |
HLA-DR2
IgG - Type IV Goodpasture's |
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What cells are routinely found in the tissue infiltrates of Anti-GBM?
Blood levels of ______, a marker for T-cell activation, are increased. what alters permeability at the GBM, causing proteinuria, secreted by the T-cells? |
Activated T-cells (Th1-CD4+)
sIL2-R (CD25) (aka soluble interleukin 2 receptor) lymphokines (cytokines produced from lymphocytes not macrophage derived) |
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Pro-inflammatory cytokines made produced by macrophages:
How do macrophages link innate and specific immunity? |
TNF-a, IL-1, IL-6, IL-12
act as APC's for B-cells, T-cells |
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When does a post-infectious GN usually appear?
What gets deposited in tissues? Hypersensitivity type? What forms in situ? Hypersensitivity type? Post-infectious GN - activates what pathway? |
7-10 days post infection
circulating Ag-Ab complexes - Type III in situ - immune complexes with bacterial ag's - Type II alternative complement |
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Acute proliferative GN occurs 1 to 2 weeks after strep but how long after skin infection?
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3-6 weeks after skin infection
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Post-infectious GN:
renal biopsies show deposits of ____, ____, sometimes ____. What are two "candidate" nephritogenic antigens? What do you use to treat? Lab results show what at 95%? |
renal biopsies - C3, IgG, sometimes IgM
endostreptosin, strep exotoxin B PCN, erythromycin positive streptozyme |
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Lupus nephritis:
What type of hypersensitivity? Intense local complement activation --> ___ C3,4 in circulation. Tx for lupus nephritis? |
Mixed Type II,III
low C3,C4 prednisolone |
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non-immune mediated GN, causes bystander damage to glom endothelial cells:
Biopsies from Wegener's show _____ immune deposits. What causes Wegener's? C-ANCA characterized by staining cytoplasm for __________. |
Wegener's granulomatosis
little to no immune deposits presence of C-ANCA (anti-neutrophil cytoplasmis auto-Ab's_ proteinase 3 (PR3) |
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P-ANCA characterized by staining cytoplasm for _______.
ANCA-neutrophil interaction close to capillary triggers _________. T/F: ANCA titers correlate with disease activity. |
myeloperoxidase (MPO)
endothelial damage True |
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Cryoglobulinemia:
essential cryoglobulinemia characterized by large ____________ on the vessel walls. Causes? (4) What Ab is predominantly present? |
deposits of Ag-Ab complexes
viral/bacterial infections Non-Hodgkin's lymphoma SLE Hep C IgG |
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Any GN characterized by crescents in Bowman's capsule:
presence of crescents in gloms is a marker for ________. Types: Anti-GBM? Immune complex mediated? Non-immune mediated? |
RPGN
severe injury Anti-GBM - Goodpasture's Immune complex - IgA, post-strep, SLE Non-immune - Wegener's |