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Renal > 2: Nephrotic Syndrome > Flashcards

2: Nephrotic Syndrome Flashcards

1
Q

What is the mnemonic to remember causes of nephrotic syndrome

A

LADFMMM

Lupus nephritis 
Amyloidosis 
Diabetic neprhopathy 
Focal segmental glomerulonephritis 
Membranous glomerunonpehritis 
Minimal change disease 
Membranous neprhopathy
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2
Q

What is the triad of symptoms in nephrotic syndrome

A

Oedema
Hypoalbuminaemia
Proteinuria

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3
Q

What level of protein defines proteinuria

A

<3.5g/24hours

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4
Q

How does proteinuria cause urine to present

A

Frothy urine

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5
Q

What defines hypoalbuminaemia

A

<30g/L

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6
Q

Why does nephrotic syndrome cause hyperlipidaemia

A

Nephrotic syndrome causes lack of protein - this leads to over production of lipids by the liver

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7
Q

Why is there low total T4 levels in nephrotic syndrome

A

Decrease in thyroid binding globulin

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8
Q

When is focal segmental glomerulonephritis the most common cause of nephrotic syndrome

A

Afro-Carribean patients

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9
Q

What is primary focal segmental glomerulonephritis

A

Idiopathic

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10
Q

What is secondary focal segmental glomerulonephritis

A

Secondary to another disease such as sickle cell or HIV

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11
Q

How does focal segmental glomerulonephritis present clinically

A

Nephrotic:

  • Oedema
  • Proteinuria
  • Hypoalbuminaemia
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12
Q

What is the most common cause of nephrotic syndrome in adults

A

Membranous nephropathy

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13
Q

What is membranous nephropathy

A

Inflammation of glomerulus

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14
Q

What causes primary membranous nephropathy

A

Idiopathic: due to anti- phospholipase A2 receptor antibodies

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15
Q

What causes secondary primary membranous nephropathy

A

Underlying disease:

  • Hep B and C
  • SLE
  • Tumours
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16
Q

How does membranous nephropathy present clinically

A

Nephrotic syndrome

17
Q

What is characteristic of membranous nephropathy on electron microscopy

A

Spike and Dome appearance

18
Q

How is primary membranous nephropathy managed

A

Corticosteroids

19
Q

What is membranoproliferative glomerulonephritis

A

Deposition of immune complexes in the glomerulus that causing inflammation altering kidney structure and function

20
Q

What is type I membranoproliferative glomerulonephritis

A

Antigen-antibody complexes which activate complement

21
Q

What pattern is present in type I membranoproliferazive glomerulonephritis

A

Tram-track

22
Q

What pattern is present in type II membranoproliferative glomerulonephritis

A

Deposition of complement (without immune complexes) in the basement membrane

23
Q

How can membroproliferative glomerulonephritis present

A

Nephrotic or nephritic

24
Q

How will complement appear in membranoproliferazive glomerulonephritis

A

Low

25
Q

What is the most common cause of nephrotic syndrome in children

A

Minimal change disease

26
Q

What are 5 causes of minimal change disease

A
  • Idiopathic
  • Medication (NSAID, Rifampicin)
  • Hodgkin Lymphoma
  • Thymoma
  • Infectious mononucleosis
27
Q

How does minimal change disease present

A

Nephrotic

28
Q

Why is it called minimal change disease

A

Unable to visualise changes on light microscopy

29
Q

How is minimal change disease managed

A

Steroids

30
Q

If resistant to steroids how is minimal change disease managed

A

Cyclophosphamide

31
Q

What are patients with nephrotic syndrome at risk of

A

VTE

32
Q

Why are patients with nephrotic syndrome at increased risk of VTE

A

Due to loss of antithrombin-3, leaving individuals in a pro-coagulant state

33
Q

How is risk of VTE in nephrotic syndrome reduced

A

LMWH

Renal (15 decks)

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