308 - Glomerular Diseases (nephrotic) Flashcards
MCD= ___
minimal change disease
MCD is usually in children (___%), and sometimes in adults (__%)
70-90
10-15
MCD is usually ____ but can be ___ to Hodgkin’s lymphoma, allergy, NSAID… The pathophysiology has to do with ___ influencing the ___ barrier
primary
secondary
cytokines
glomerular
MCD common clinical presentation include: acute ___, nephrotic syndrome ( with ___ deposition), proteinuria (>__g/24hr), and ___.
edema
acellular
10 g/24hr
hypoalbuminemia
Less common clinical presentation of MCD include: (5)
HTN (more in adults) microscopic hematuria allergic symptoms renal dysfunction IS nephritis
Children with MCD usually have selective ___, mostly ___.
proteinuria
albumin
Diagnosed MCD will require ___ if the patient does not respond to ____
biopsy
steroids
Treatment for MCD includes- 1st line ____, 2nd ____
prednisone
cyclophosphamide/chlorambucil
In MCD primary responders are patients who undergo full remission (___ mg/24hr) after a course of prednisone.
0.2
In MCD steroid dependent patients are those with ___ during the ___ period from prednisone
relapses
tapering
Frequent relapsers MCD patients are those who have had at least ___ relapses in __ months
2
6
Steroid resistant MCD patients are those who do not respond to steroid treatment. Some of those are diagnosed with ___ in follow up biopsies
FSGS (Focal segmental glomerulosclerosis)
90-95% of children with MCD go through ___ remission after ___ weeks of steroid treatment
full
8
80-85% of ADULTS with MCD go through ___ remission after ___ weeks of steroid treatment
full
20-24
FSGS is defined by ____ scarring that does not involve the entire ___, mostly in the ____ junction.
segmental
glomeruli
corticomedullary
When performing FSGS biopsy which is not deep enough, it may not include all of the pathological findings, leading to a false diagnosis of ___
MCD
FSGS may be secondary to ___, ___, ___, ___ (4)
HIV
HBV
SCD
reflux nephropathy
The clinical presentation of FSGS may include: (3)
proteinuria
hematuria
HTN
Treating FSGS include ____ inhibitors, and when patients are not in the nephrotic range- also ___
RAAS
steroids
In secondary FSGS treatment is firstly directed for the ___ disease + ____. ____ should not be used
primary
proteinuria
steroids
Negative prognostic signs in FSGS involve: (3)
nephrotic range proteinuria (>3.5 g/24 hours)
Afro-American
RF
MGN=___
membranous glomerulonephritis
What is the most common cause for nephrotic syndrome in the adult?
MGN- 30%
MGN is more common in ___
men