ACUTE PSGN

Question 1

What is the cause of Wolfgang Amadeus Mozart’s early death at the age of 35?

Answer 1

ACUTE PSGN

Question 2

What are the 5 nephritogenic M type associated with nephritis after pyoderma?

Answer 2

2, 49, 55, 57, 60

Question 3

What is the nephritogenic M type associated with nephritis after pharyngitis or pyoderma?

Answer 3

49

Question 4

What are the 2 types of PSGN?

Answer 4

1. EPIDEMIC
2. SPORADIC

Question 5

What type of PSGN is associated with skin infections?

Answer 5

Epidemic PSGN

Question 6

What type of PSGN is associated with pharyngitides?

Answer 6

SPORADIC PSGN

Question 7

What is the acute histologic change in acute PSGN?

Answer 7

DIFFUSE GLOBAL HYPERCELLULARITY

Question 8

What are the 2 causes of hypercellularity in acute PSGN?

Answer 8

1. INFLUX OF NEUTROPHILS
2. ENDOCAPILLARY PROLIFERATION (mesangial and endothelial cells)

Question 9

What is the pathologic designation for the acute stage of acute PSGN?

Answer 9

ACUTE DIFFUSE PROLIFERATIVE GN

Question 10

Where iks the location of deposits in acute PSGN?

Answer 10

SUBEPITHELIAL

Question 11

What is the pattern in IF during the acute diffuse proliferative phase of acute phase of acute PSGN?

Answer 11

diffuse global coarsely granular capillary wall and mesangial staining, which usually is very intense for C3

Question 12

What are the 3 patterns of immune staining in acute PSGN?

Answer 12

1. GARLAND (closely apposed; have non-nephrotic range proteinuria)
2. STARRY SKY (scattered; less severe disease)
3. MESANGIAL (predominantly C3 staining; corresponds to the resolving phase)

Question 13

What pattern of immune staining corresponds to the resolving phase of acute PSGN?

Answer 13

MESANGIAL PATTERN

Question 14

What pattern of immune staining in acute PSGN that is associated with non-nephrotic range proteinuria?

Answer 14

GARLAND PATTERN

Question 15

What pattern of immune staining in acute PSGN that is associated with less severe disease?

Answer 15

STARRY SKY PATTERN

Question 16

What is the hallmark ultrastructural feature of PSGN?

Answer 16

SUBEPITHELIAL HUMPLIKE DENSE DEPOSITS

Question 17

What are the 3 M protein types that elicit antibodies that react with myocardial and skeletal muscle proteins?

Answer 17

5,6,19

Question 18

What are the 2 M protein types that cross react with kidney cortex?

Answer 18

6, 12

Question 19

What is the M protein type that cross react with VIMENTIN?

Answer 19

1

Question 20

What is the cytoskeletal protein of glomerular mesangial cells

Answer 20

VIMENTIN

Question 21

What is the latent period in postpharyngitic cases in acute PSGN?

Answer 21

AVERAGE: 10 days
RANGE: 7-21 days

Question 22

What is the latent period for skin infection in acute PSGN?

Answer 22

14–21 days

Question 23

Short latency period <1 week or synpharyngitic syndrome is associated with?

Answer 23

IgA NEPHROPATHY

Question 24

Anuria in acute PSGN indicates the development of?

Answer 24

CRESCENTIC GN

Question 25

What are the differential diagnosis for acute PSGN?

Answer 25

1. IgA nephropathy and IgA vasculitis 2. MPGN and C3 glomerulopathy
2. Acute crescentic glomerulonephritis—RPGN:
   • immune complex–mediated
   • anti-GBM–mediated
   • pauciimmune

Question 26

What are the 2 causes of acute nephritis in the setting of peraistent fever?

Answer 26

1. OCCULT ABSCESSES
2. INFECTIVE ENDOCARDITIS

Question 27

What is the most common test used to detect recent streptococcal infection?

Answer 27

ASO titer (>200)

Question 28

What is the test that combines several antistreptococcal antibody assays and may be a useful screening test?

Answer 28

streptozyme test

Question 29

What is the treatment for acute PSGN?

Answer 29

SUPPORTIVE

Question 30

What are the medications/modalities used in the management of acute PSGN?

Answer 30

1. Diuretics
2. Anti-HPN
3. Dialysis
4. Penicillin

Question 31

What drug is used to control the spread of outbreaks in epidemic PSGN?

Answer 31

PENICILLIN