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20 Cards in this Set
- Front
- Back
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Class the following systemic dz as causing either nephritis or neprotic syndrome:
- Small vessel vasculitis +HSP, Cryo +Anti-GBM dz (Goodpastures) + ANCA (MPA, WG, CSS) - Amyloidsosis - Autoimmune (Lupus GN) - Infectious GN (membranous & MPGN) - diabetes mellitus |
Nephrotic sx:
- diabetes, amyloid, infectious, autoimmune nephritis: - autoimmune, SVV |
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When lupus presents more like nephrotic syn, it has what characteristics? nephritis?
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membranous
proliferative |
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What is the most common cause of ESRD in the USA?
What underlies it? |
Diabetic nephropathy
Diabetic glomerulosclerosis |
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What is Diabetic glomerulosclerosis characterized by?
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albuminuria
progressive decline in GFR HTN |
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Early in the evolution of diabetic kidney dz, there is actually an ______ in GFR. This is associated with shrunken/enlarged glomeruli?
What is the asymptomatic proteinuria tied to, histologically speaking? |
increase.
enlarged. thickened GBM and increased mesangial matrix |
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What can be used as a reference marker to tell if the glomerular membrane is thickened or not?
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it's supposed to be ~ the size of one foot process - it it's much thicker, you have thickening.
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Later on in Diabetic nephropahy, what is the characeristic finding on LM?
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K-W nodules.
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Is hylaine sclerosis (glass material) only seen in glomerular capillaries i/diabetic nephropathy?
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no, seen in other systemic vasculature too.
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What are the two most common types of amyloidosis in the USA?
Major manifestation? |
AL (Ig light chain)
AA (amyloid A protein) Proteinuria (nephrotic syndrome) |
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On EM imaging, what does amyloid look like?
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crosshatched.
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What is one of the major causes of morbidity and mortality in SLE pts, especially blacks?
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Lupus nephritis
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Define the following classes re: lupus nephritis:
I II III IV V VI Which stages are tx'ed most aggressively with immunosuppresive / cytotoxic agents? |
I: histologically normal
II: focal or diffuse mesangioproliferative glomerulonephritis III/IV: Focal/Diffuse proliferative or necrotizing glomerulonephritis V: membranous VI: Focal or diffuse sclerosisng glomerulonephritis III and IV |
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Skin Purpura
Peripheral neuropathy abdominal pain Glomerulonephritis Aveolar capillaritis w/ pulm hemorr. --> these are all clinical manifestations of what? |
SVV
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Immune complex SVV (HSP and croglobulinemic vasculitis) tend to present with which types of nephritic dz?
ANCA and Anti-GBM SVV? |
more in the focal/diffuse Mesangioprolif. / Proliferative
More severe, more likely to be sclerosing. |
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Henoch-Schonlein (HS) purpura is a ____ dominant SVV?
- typical sx? - ways to diff from IgA nephropathy? |
IgA
- pupuric lesions, gut inovlvement, glomeruli, and associated with arthralgias and arthritis. - see above, IgA nephropathy has none of these other sx. |
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Which SVV is caused by anti-antibody antibodies?
- sx? |
Cryoglobulinemic vasculitis
- cryoglobulin immune deposits - skin and glomeruli involved |
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What are crescents?
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etiologically nonspecific response to glom capillary rupture; ususlaly caused by severe actue inflammatory injury.
- characterized by fibrin in the crescent. |
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If you have circulating anti-GBM antibodies w/ linear IF staining, what are the two dz options, and the discerning sx?
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w/ or w/o lung hemorrage
w/ = goodpastures w/o = anti-GBM GN |
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Re: the degrees of ANCA, name:
- no extraglomerular vasculitis - no granulomatous inflammation or asthma - granulomatous inflamm w/o asthma - gran. inflamm, asthma, & eosinophilia Tx? |
- Pauci-immune crescentic glomerulonephritis
- microscopic polyangiitis - wegener's granulomatosis - Churg-Strauss Syndrome the more organs involved, the more aggressive immunosuppression used. |
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What are the three options for ANCA prevelance in active, untx'ed pauci-iumme SVV?
Most likely in: WG? MPA? CSS? GN alone? |
PR3-ANCA
MPO-ANCA Nothing PR3 (75%) MPO/Pr3/neg (50%/40%/10%) Neg/MPO (55%/40/5%) PR3/MPO (70%/20/10) |
