308 - Glomerular Diseases (nephritic) Flashcards
Glomerular disease are usually accompanied by ___ and ___
hematuria
proteinuria
In most cases hematuria will not be macroscopic, beside in the case of ___ and ___
IgA nephropathy
sickle cell anemia
When microscopic anemia is found, we should rule out: (5). Also remember- kidney cysts and vascular kidney injury
BPH IS nephritis papillary necrosis hypercalciuria nephrolithiasis
When dysmorphic RBC or RBC ____ are found, there is a high chance for ____
casts
glomerulonephritis
Common symptoms of proteinuria include: ___ and ____
edema
foamy urine
Transient proteinuria is usually < ___ g/24hr. It is more common in situations such as: (5)
1 Fever physical activity obesity OSA CHF
Glomerular proteinuria in the adult is non selective, while in ___ in children the proteinuria is selective- mostly for ____
MCD
albumin
Pyuria is more common in ___ disease, such as: ___ or ____
inflammatory glomerular
post acute strep
MPGN
Acute nephritic syndrome is define by proteinuria of ___g/24hr, ____, ___, ___, ____, ____ (5).
1-2 hematuria (with RBC casts) pyuria HTN edema decreased GFR
Extreme acute nephritic syndrome may lead to ___ (RPGN) within days. The histopathological expression is called ____
Rapidly progressive glomerulonephritis
Crescentic glomerulonephritis
Pulmonary renal syndrome is the combination of ___ and ___
RPGN
pulmonary bleeding
Pulmonary renal syndrome may be caused by: (4)
Goodpasture’s syndrome
ANCA associated small vessel vasculitis
SLE
cryoglobulinemia
Nephrotic syndrome is defined by massive proteinuria > ___ gr/24hr, ___,___,___,___,____ (5)
3 HTN hypercholesterolemia hypoalbuminemia edema microscopic anemia
Basement membrane syndrome may be caused by a genetic mutation (___), or autoimmune process harming the GBM (___).
Alport’s syndrome
Goodpasture’s syndrome
Basement membrane syndrome manifestations include: (4)
microscopic hematuria
proteinuria
HTN
decreased renal function
Glomerular vascular syndrome may lead to ____ or ___
hematuria
proteinuria
Glomerular vascular syndrome may be caused by: (5)
vasculitis thrombotic microangiopathy atherosclerosis cholesterol thrombi HTN
Common causes for infectious disease associated syndrome include: (5)
SBE malaria schistosomiasis HIV HBV/HCV
Name 6 clinical glomerular syndromes: (6)
acute nephritic syndrome pulmonary renal syndrome nephrotic syndrome basement membrane syndrome glomerular vascular syndrome infectious disease associated syndrome
When classifying acute vs chronic state we can notice that in the acute state it is more common to see ___ and uremic symptoms (___,___,___,___)
lethargy nausea vomiting fluid edema drowsiness
In chronic cases the patients may be ____
asymptomatic
In acute nephritic syndrome there is an extensive damage to the ___, leading to a decrease in ___ therefor ___ and ___
glomeruli
GFR
fluid retention
electrolytes
PSGN appears after cutaneous infection (___)- 2-6 weeks after, or throat infection (____) 1-3 weeks after
impetigo
pharyngitis
PSGN more common in ___ countries, in the ages of ___ and in ___ countries in ___ population with comorbidities. Generally it is more common in ___
developing 2-14 developed elder men
The pathology of PSGN includes ___ of the ___ and ___ cells
hypocellularity
mesangial
endothelial
In PSGN we can find glomerular infiltration of ___, subendothelial granular sediments of ___ and ___ (C3-9, IgM, IgG)
PMN
immunoglobulins
complements
Systemic symptoms of PSGN include in 50%- (4)
headache
malaise
anorexia
flan pain (due to capsule swelling)
In PSGN patients lab work, 90% of patients will have a depressed ___ test and low levels of ___ together with normal levels of ___
CH50
C3
C4
Testimony of strep infection in PSGN can be: ____ (10-70%), ___ (30%), ___ (70%), ___ (40%). Sometimes RF will be positive together with p-ANCA
Positive culture
ASO
anti DNAase
anti hyaluronidase
Treatment for PSGN includes supportive care- controlling ___ and ___, sometimes to the point of dialysis. Treat also with ___ both the patients and relatives.
HTN
edema
Abx
SBE (___)
subacute endocarditis
SBE patients mechanism is ___ sediments from circulation with ___ activation
immune complexes
complement
