12.4 - Nephritic syndrome

Question 1

hypercellular, inflamed glomeruli are seen on biopsy from ________________ (nephritic / nephrotic) syndrome

Answer 1

nephritic

Question 2

what mediates the damage seen in nephritic syndrome?

Answer 2

neutrophils, which are attracted by C5a

Question 3

post strep GN arises after infection of what type of organism?

Answer 3

group A beta hemolytic strep infection of the skin (impetigo) or pharynx

Question 4

what factor defines the nephritic strains of strep?

Answer 4

M protein

Question 5

what are the H&E findings in post strep GN?

Answer 5

hypercellular, inflamed glomeruli

Question 6

what are the IF findings in post strep GN?

Answer 6

granular

Question 7

what are the EM findings in post strep GN?

Answer 7

subepithelial “humps”

Question 8

what are the 3 types of RPGN?

Answer 8

• goodpasture
• PSGN
• wegener granulomatosis
• microscopic polyangiitis
• churg strauss

Question 9

what differentiates churg strauss from microscopic polyangiitis?

Answer 9

churg strauss has:

• eosinophilia
• granulomatous inflammation
• asthma

Question 10

what differentiates goodpasture syndrome from wegener / microscopic polyangiitis / churg strauss?

Answer 10

wegener / microscopic polyangiitis / churg strauss are associated with a prior infection

goodpasture is NOT assocaited with a prior infection

Question 11

what is the IF pattern of wegener / microscopic polyangiitis / churg strauss?

Answer 11

negative (pauci immune)

Question 12

what is the IF pattern of PSGN or diffuse proliferative GN?

Answer 12

granular

Question 13

what is the IF pattern of goodpasture?

Answer 13

linear

Question 14

• hematuria, hemoptysis in young adult males

- linear IF

Answer 14

goodpasture

Question 15

where is the Ag-Ab complex deposition in PSGN?

Answer 15

subendothelial

Question 16

what is the most common type of renal disease in SLE? what is its IF pattern?

Answer 16

• PSGN

- granular

Question 17

wegener granulomatosis is associated with what autoantibody?

Answer 17

c-ANCA

Question 18

microscopic polyangiitis is associated with what autoantibody?

Answer 18

p-ANCA

Question 19

churg strauss is associated with what autoantibody?

Answer 19

p-ANCA

Question 20

what are the H&E findings in RPGN?

Answer 20

crescents in bowman space (of glomeruli)

Question 21

the crescents seen in RPGN are composed of _____ and _______

Answer 21

fibrin and macrophages

Question 22

IgA nephropathy displays what type of casts?

Answer 22

RBC

Question 23

• young patient
• episodic gross or microscopic hematuria with RBC casts
• follows mucosal infection (eg gastroenteritis)

Answer 23

IgA nephropathy (berger disease)

Question 24

alport syndrome is due to an inherited defect in type ____ collagen

Answer 24

type IV

Question 25

what is the inheritance of alport syndrome?

Answer 25

X linked

Question 26

• isolated hematuria
• sensory hearing loss
• ocular disturbances
• x linked

Answer 26

alport syndrome