Clinical Glomerular Disease Flashcards
what lab should always be ordered w/ nephritic syndrome
complement- low complement indicates immune complex mediated diseases
4 pulmonary renal syndromes
ANCA
goodpasture
SLE
cryoglobulinemia
4 dermato renal syndromes
ANCA
SLE
IgA vasculitis
cryoglobulinemic
urine protein creatinine ratio is equal to…
x g/g is equivalent to urine protein excretion in 24 hrs
early intervention w/ AKI
ACEi to lower glomerular pressure, protect the kidneys
normal protein excretion
less than 150mg per day
normal protein-creatinine ratio
less than 2, correlates w/ daily excretion
3 kinds of proteinuria
transient, orthostatic, (less than 500 mg/day) and fixed (denotes glomerular disease)
complications of nephrotic syndrome (3)
thrombosis- loss of balance b/w anticoag and procoag, leads to DVT, CVA, etc
infections- loss of Ig
accelerated atherosclerosis- from hyperlipidemia
etiology of most membranous nephropathy
autoAb against phospholipase A2
age dependent causes of hematuria
kids/young adults: mostly glomerular causes
adults above 40- more commonly cancer and kidney stones
clues for glomerular hematuria
brown or tea colored urine
proteinuria
dysmorphic RBCs, RBC casts
extra renal manifestaions
main 2 clinical pres of IgA
episodic hematuria, asymptomatic
pathogenesis of IgA nephropathy
serum IgA has reduced glycosylation at the hinge region, target for other antibodies
define rapidly progressive GN
loss of over half of GFR w/i weeks
acute onset of azotemia, HTN, proteinuria, edema, oliguria
associated w/ crescentic GN
C ANCA vs P ANCA
C ANCA is directed at PR3 in the cytoplasm
P ANCA is directed at MPO in the perinuclear region
which disease is typically caused by overworked kidneys following loss of kidney mass
FSGS
why compare dipstick w/ PCR and ACR
negative dipstick does not necessarily mean no proteinuria- w/ positive ACR means that the ACR is lower in the 30-300 range, w/ + PCR means some other kind of protein like light chains are present
positive w/ + PCR and ACR: if over half of the protein is albumin, more likely glomerular than tubulointerstitial
two serologies for PIGN
ASO- post strep pharyngitis
anti Dnase B- cellulitis
triad of alport syndrome
GN, hearing loss, ocular abnormalities
etiology of alport syndrome
x linked abnormality of type IV collage (present in GBM)
laminated, frayed GBM on EM
4 steps for evaluating glomerular disease
- nephrotic vs nephritic
- renal limited vs systemic
- investigate: urine analysis, microscopy, complement, path
- determine primary or secondary- genetic, infectious, inflammatory, etc
