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Renal > 05.13 - Nephrotic Syndrome 1 (Nichols, Showkat) - PP + Handout > Flashcards

05.13 - Nephrotic Syndrome 1 (Nichols, Showkat) - PP + Handout Flashcards

1
Q

Other than Post-infectious GN, Subepithelial humps are seen in

A

SLE

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1
Q

What tx do you use in both Primary and Secondary Nephrotic

A

Supportive measures to control HTN

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2
Q

Granular casts can result from

A

Aggregates of plasma proteins or breakdown of cellular casts

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2
Q

Why do patients with nephrotic syndrome have subcutaneous lipid deposits (Xanthelasma)

A

Increased hepatic synthesis of cholesterol, TG’s and Lipoproteins

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2
Q

Estimated glomerular pore radius for spherical molecules

A

42 angstroms

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2
Q

Most common cause of ESRD requiring dialysis

A

Diabetic Nephropathy

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3
Q

3 diseases: Subendothelial space or Mesangial Immune Complex formation and complement activaiton with inflammation

A

Post-Infectious GN, IgA Nephropathy, Lupus Nephritis

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4
Q

Normal rate of protein excretion

A

40-80 normal; 150 upper limit of normal

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4
Q

3.5 mg/day 24 hour urine corresponds with what spot urine protein/creatinine ratio

A

3.5

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4
Q

Spike and Dome is buzzword for

A

Membranous Nephropathy

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4
Q

Buzzword for Alport Syndrome

A

Basketweave

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5
Q

Buzzword for MPGN

A

Tram Tracks

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6
Q

Most important prognostic predictor of nephrotic syndrome

A

Degree of Proteinuria

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7
Q

Nephrotic patients have __ filtration SA, and ___ change in large pores

A

Loss of filtration surface, increased number of large pores

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8
Q

Main site of charge hindrance

A

Anionic charged lamina rara interna, Fenestrate capillary endothelium

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9
Q

Subepithelial deposits tend to cause a ___ picture, wherease Subendothelial and Mesangial deposits tend to cause a ____ picture

A

Nephrotic, Nephritic

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9
Q

Buzzword for Post-Infectious GN

A

Subepithelial Humps

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11
Q

Fatty casts are indicative of

A

Lipiduria of nephrotic syndrome

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12
Q

If there is generalized edema, evaluate for

A

Proteinuria

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12
Q

Tram Tracks is buzzworf for

A

MPGN

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13
Q

Subepithelial humps is buzzword for

A

Post-Infectious GN

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14
Q

Foot process effacement is buzzword for

A

Minimal Change Disease

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15
Q

Most common cause of rapidly progressive GN

A

Autoimmune Vasculitis

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16
Q

Basketweave is buzzword for

A

Alport Syndrome

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17
Earliest clinical manifestation of Diabetic Nephropathy
Microabluminuria
18
BP in Nephrotic vs Nephritic
Elevated in Nephritic
20
If ___ are present, Fatty casts can have ___ pattern under polarized light
Cholesterol or cholesterol esters, Maltese cross
20
A 24-hour collection of urine will have less than \_\_
150 mg of protein
20
Podocyte injury occurs in what 2 diseases
Minimal Change, Focal Segmental Glomerulosclerosis
22
Tubular disease is associated with proteinuria of ___ proteins
LMW
23
Nephrotic patients have __ excretion of SMW dextrans, and ___ excretion of LMW dextrans
Lower, higher
24
Subepithelial space immune complex formation and complement activation, without inflammation
Membranous Nephropathy
25
4 features of Nephrotic Syndrome
Edema, Proteinuria, Hypoalbuminemia, Hyperlipidemia
26
Creatinine in Nephrotic vs Nephritic
Elevated in Nephritic, Normal or mild elevation in Nephrotic
27
Granular casts almost always indicate
significant renal disease
29
2 absolute contraindications to renal bx
Bleeding Diathesis, Uncontrolled HTN
30
4 features of chronic GN
HTN, Renal Insufficiency, Proteinuria, Shrunken Smooth Kidneys on US
31
Does the dipstick detect microalbuminuria
No, Microalbuminuria is 300 mg/day
33
Nephrotic Syndrome mechanisms without glomerular inflammation include glomerular capillary wall deposition in \_\_\_, \_\_\_, and \_\_\_
Diabetic Nephropathy, Amyloidosis, and Light Chain Deposition disease
34
Casts that can be seen in Nephrotic Syndrome
Hyaline, Granular, Fatty, (WBC)
35
Muddy brown casts are a type of ___ almost always seen in \_\_\_\_
Granular Cast, Acute Tubular Necrosis
37
A spot urine protein/creatinine ratio of less than ___ corresponds with 24 hour urine protein of 150
0.15
38
Microalbuminuria is defined as
30-300 mg/day
40
WBC casts are indicative of
Inflammation
40
Nephrotic Syndrome mechanisms without glomerular inflammation include subepithelial immune complex formation and complement activation in
Membranous Nephropathy
41
Macromolecules \> ___ nm are completely restricted
4 nm
42
Uncharged macromolecules \< ___ nm filter freely
1.8
43
Onion skin in spleen =
Lupus
45
Urinary sediment in Nephrotic Syndrome
Inactive - without dysmorphic RBCs or RBC casts
47
How are proteins reabsorbed in PT
Endocytosis by endothelial cells --\> Hydrolyzed in lysosomes into AAs --\> Re-enter circulation
48
Proportion of filtered proteins that are reabsorbed
Almost all
50
Main site of size hindrance for larger molecules
Lamina Densa and Slit diaphragm
51
Buzzword for Membranous Nephropathy
Spike and Dome
52
Nephrotic Syndrome mechanisms without glomerular inflammation include podocyte injury in ___ and \_\_\_
Minimal Change Disease and Focal Segmental Glomerulosclerosis
54
Loss of more than ___ of protein per day in urine is defined as Nephrotic
3.5 mg
55
Buzzword for Lupus Nephritis
Wire Loops
56
Threshold for protein dipstick
300-500 mg/day
57
2 causes of xanthelasma
Hyperlipidemia in nephrotic syndrome; Amyloidosis
58
Upper limit of normal for spot urine protein/creatinine ratio
0.15
59
Subepithelial deposits tend to cause a ___ picture, as seen most characteristically with
Nephrotic, Membranous Nephropathy
61
Primary Nephrotic syndrome management includes disease modifying tx w/
Corticosteroids and Immunosuppression
62
Major causes of Membranous Nephropathy
Idiopathic or due to Systemic Disorders: SLE, Hep B, Drugs (Gold, penicillamine)
63
Onion-skin is buzzword for
HTN nephropathy; Scleroderma

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