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18 Cards in this Set
- Front
- Back
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What is a slit diaphragm and what are some of their functions?
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Slit diaphragms are found between foot projections and blood filters through them. Some of their functions are:
- maintain cell polarity - filtration surface area - Filtration barrier to protein movement |
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What are some key differentiating features of nephrotic and nephritic syndrome?
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Nephrotic: proteinuria >3g/day, hypoalbuminuria, non-proliferating pathology,
Nephritic: active urine sediment (hematuria, RBC casts, dysmorphic RBC), azotemia -proliferative pathology |
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What are the key features of nephrotic syndrome?
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Proteinuria: >3g/day in adult
Edema Hypoalbuminemia Hyperlipidemia+lipiduria Thromboembolism Infection |
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What would a urinalysis of someone with nephritic syndrome look like? Nephrotic?
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Nephritic: hematuria, RBC casts, dysmorphc RBC, proteinuria (b/w 1.5-<3g/day)
Nephrotic: lipiduria (Maltese cross-fats, fatty casts, oval fat bodies), gross proteinuria (>3 g/day) |
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Why is there albuminuria in nephrotic syndrome?
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2 theories:
1) Glomerular basement membrane loses its negative charge that normally repels negatively charged albumin in the blood 2) Glomerular basement membrane is very porous to proteins & they cannot all be absorbed in the nephron |
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Why is there proteinuria in nephrotic syndrome, causing loss of albumin and immunoglobulins?
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Enlarged pores and increase in # of pores in the glomerular BM.
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Why can there be hyperlipidemia in nephrotic syndrome?
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In nephrotic syndrome the liver increases its production of albumin and lipoprotein & there is less lipoprotein lipase activity for degradation.
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Why is there increased risk of thromboembolism with nephrotic syndrome?
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Loss of anti-coagulants: plasminogen & anti-thrombin. Also increased platelet activation.
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What are some primary & secondary causes of nephrotic syndrome?
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Primary:
Minimal change disease Membranous glomerularnephropathy Focal segmental glomerulosclerosis Membranoproliferative GN IgA nephropathy Secondary: Drugs (NSAIDs, gold) Infections (Hep B,c HIV, siphilis, malaria) Autoimmune (SLE, RA, sarcoid, cryoglobulins) Malignancy (multiple myeloma, solid tumor) Other: heidtary, diabetes |
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True or false. Fusion of epithelial foot processes is seen for nephrotic syndrome.
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True. Non-proliferative lesion.
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For nephrotic and nephrotic syndroms, how would you treat:
HTN Hyperlipidema Edema Proteinuria" |
HTN: ACEi or ARB (because also help with proteinuria)
Hyperlipidemia: statin Edema: salt restriction, diuretic Proteinuria: ACEi or ARB |
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What are some complications of nephrotic syndrome?
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--Protein malnutrition
--Infection (from decreased immunoglobulins & skin breakdown from edema) --Pancreatitis (hyperlipidemia) --PE, DVT, renal vein thrombosis (increased coagulability) --hyponatremia and increased artheroschlerosis |
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What are specific therapies for nephrotic syndrome?
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Primary causes: steroids +/- cyclophosamide
Secondary causes: treat underlying disorder/remove agent |
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What are the main primary & secondary causes of nephritic syndrome?
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(same as nephrotic, but different order)
Primary: IgA, MPGN, FSGS Secondary: drugs [uncommon], infections [post-strep], autoimmune [SLE], malignancy [less common] |
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What is the pathological cause for nephritic syndrome?
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Proliferative lesion, causing increase # of cells in the glomerulus.
Decreased renal function causes the salt & water retention, leading to HTN and edema |
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What are characteristics of nephritic syndrome?
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Active urine sediment (Hematuria, RBC casts)
HTN Edema (not typical) Proteinuria (but not in the range of nephrotic) Azotemia " |
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What are sepcific therapies for nephrotic syndrome?
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"Primary: immunosuppression
Secondary: remove agent/ tx underlying cause" |
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What are sepcific therapies for nephrotic syndrome?
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"Primary: immunosuppression
Secondary: remove agent/ tx underlying cause" |
