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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
Q

Earliest clinical manifestation of Diabetic Nephropathy

A

Microabluminuria

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18
Q

BP in Nephrotic vs Nephritic

A

Elevated in Nephritic

20
Q

If ___ are present, Fatty casts can have ___ pattern under polarized light

A

Cholesterol or cholesterol esters, Maltese cross

20
Q

A 24-hour collection of urine will have less than __

A

150 mg of protein

20
Q

Podocyte injury occurs in what 2 diseases

A

Minimal Change, Focal Segmental Glomerulosclerosis

22
Q

Tubular disease is associated with proteinuria of ___ proteins

A

LMW

23
Q

Nephrotic patients have __ excretion of SMW dextrans, and ___ excretion of LMW dextrans

A

Lower, higher

24
Q

Subepithelial space immune complex formation and complement activation, without inflammation

A

Membranous Nephropathy

25
Q

4 features of Nephrotic Syndrome

A

Edema, Proteinuria, Hypoalbuminemia, Hyperlipidemia

26
Q

Creatinine in Nephrotic vs Nephritic

A

Elevated in Nephritic, Normal or mild elevation in Nephrotic

27
Q

Granular casts almost always indicate

A

significant renal disease

29
Q

2 absolute contraindications to renal bx

A

Bleeding Diathesis, Uncontrolled HTN

30
Q

4 features of chronic GN

A

HTN, Renal Insufficiency, Proteinuria, Shrunken Smooth Kidneys on US

31
Q

Does the dipstick detect microalbuminuria

A

No, Microalbuminuria is 300 mg/day

33
Q

Nephrotic Syndrome mechanisms without glomerular inflammation include glomerular capillary wall deposition in ___, ___, and ___

A

Diabetic Nephropathy, Amyloidosis, and Light Chain Deposition disease

34
Q

Casts that can be seen in Nephrotic Syndrome

A

Hyaline, Granular, Fatty, (WBC)

35
Q

Muddy brown casts are a type of ___ almost always seen in ____

A

Granular Cast, Acute Tubular Necrosis

37
Q

A spot urine protein/creatinine ratio of less than ___ corresponds with 24 hour urine protein of 150

A

0.15

38
Q

Microalbuminuria is defined as

A

30-300 mg/day

40
Q

WBC casts are indicative of

A

Inflammation

40
Q

Nephrotic Syndrome mechanisms without glomerular inflammation include subepithelial immune complex formation and complement activation in

A

Membranous Nephropathy

41
Q

Macromolecules > ___ nm are completely restricted

A

4 nm

42
Q

Uncharged macromolecules < ___ nm filter freely

A

1.8

43
Q

Onion skin in spleen =

A

Lupus

45
Q

Urinary sediment in Nephrotic Syndrome

A

Inactive - without dysmorphic RBCs or RBC casts

47
Q

How are proteins reabsorbed in PT

A

Endocytosis by endothelial cells –> Hydrolyzed in lysosomes into AAs –> Re-enter circulation

48
Q

Proportion of filtered proteins that are reabsorbed

A

Almost all

50
Q

Main site of size hindrance for larger molecules

A

Lamina Densa and Slit diaphragm

51
Q

Buzzword for Membranous Nephropathy

A

Spike and Dome

52
Q

Nephrotic Syndrome mechanisms without glomerular inflammation include podocyte injury in ___ and ___

A

Minimal Change Disease and Focal Segmental Glomerulosclerosis

54
Q

Loss of more than ___ of protein per day in urine is defined as Nephrotic

A

3.5 mg

55
Q

Buzzword for Lupus Nephritis

A

Wire Loops

56
Q

Threshold for protein dipstick

A

300-500 mg/day

57
Q

2 causes of xanthelasma

A

Hyperlipidemia in nephrotic syndrome; Amyloidosis

58
Q

Upper limit of normal for spot urine protein/creatinine ratio

A

0.15

59
Q

Subepithelial deposits tend to cause a ___ picture, as seen most characteristically with

A

Nephrotic, Membranous Nephropathy

61
Q

Primary Nephrotic syndrome management includes disease modifying tx w/

A

Corticosteroids and Immunosuppression

62
Q

Major causes of Membranous Nephropathy

A

Idiopathic or due to Systemic Disorders: SLE, Hep B, Drugs (Gold, penicillamine)

63
Q

Onion-skin is buzzword for

A

HTN nephropathy; Scleroderma

Renal (31 decks)

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