12.3 - Nephrotic syndrome Flashcards

1
Q

why does nephrotic syndrome result in a hypercoagulable state?

A

loss of antithrombin III

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2
Q

how does nephrotic syndrome lead to fatty casts?

A

due to hyperlipidemia and hypercholesterolemia

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3
Q

minimal change disease is associated with what type of cancer?

A

hodgkin lymphoma

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4
Q

what is seen on EM in minimal change disease?

A

effacement of foot processes

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5
Q

what is the IF finding in minimal change disease?

A

normal

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6
Q

is minimal change disease responsive to steroids?

A

yes - excellent response

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7
Q

which type of nephrotic syndrome is associated with HIV, heroin, and sickle cell disease?

A

FSGS

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8
Q

what are the H&E findings in FSGS?

A

focal and segmental sclerosis

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9
Q

what is seen on EM in FSGS?

A

effacement of foot processes

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10
Q

what are the IF findings in FSGS?

A

normal

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11
Q

is FSGS responsive to steroids?

A

no

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12
Q

which type of nephrotic syndrome is associated with hep B, hep C, solid tumors, SLE, drugs?

A

membranous

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13
Q

thick glomberular BM on H&E (no tram tracks) - diagnosis?

A

membranous nephropathy

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14
Q

what are the EM findings in membranous nephropathy?

A

subepithelial deposits with “spike and dome” appearance

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15
Q

subepithelial deposits with “spike and dome” appearance on EM - diagnosis?

A

membranous nephropathy

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16
Q

is membranous nephropathy responsive to steroids?

17
Q

thick glomberular BM on H&E with tram tracks - diagnosis?

A

membranoproliferative glomerulonephritis

18
Q

what is the IF appearance of membranous nephropathy?

19
Q

what is the IF appearance of membranoproliferative glomerulonephritis?

20
Q

where are the deposits in type I membranoproliferative glomerulonephritis? what diseases is it associated with?

A
  • subendothelial

- associated with HBV, HCV

21
Q

where are the deposits in type II membranoproliferative glomerulonephritis?

A

intramembranous

22
Q

which type of membranoproliferative glomerulonephritis is associated with C3 nephritic factor? what does it do?

A
  • type II
  • autoantibody that stabilizes C3 convertase, leading to overactivation of complement, inflammation, low levels of circulating C3
23
Q

low levels of C3 and intramembranous deposits - diagnosis?

A

type II membranoproliferative glomerulonephritis

24
Q

what is the end result of the nonenzymatic glycosylation of the vascular BM seen in DM?

A

hyaline arteriolosclerosis

25
which glomerular arteriole is affected more by nonenzymatic glycosylation? what is the result?
- efferent | - high GFR and hyperfiltration injury leading to microalbuminemia
26
what is the cause of the high GFR and hyperfiltration injury leading to microalbuminemia seen in DM?
selective nonenzymatic glycosylation of the efferent arteriole
27
what drug can slow the progression of hyperfiltration induced damage in DM? why?
- ACE inhibitors | - via prevention of efferent vasoconstriction from angiotensin II
28
what is the organ most involved in systemic amyloidosis? where does the deposition occur? what is the end result?
- kidneys - mesangium - nephrotic syndrome