Diseases Of The Glomerulus Flashcards
1
Q
It is defined as reduced urine output below 400mL/day.
A
Oliguria
2
Q
A
Focal Segmental Glomerulosclerosis
3
Q
- Syndrome associated with severe glomerular injury but does not denote a specific etiology form of glomerulonephritis.
- Rapid progressive and loss of renal function
- Nephritic Syndrome
- Presence of crescents of the glomeruli
A
Rapidly Progressive Glomerulonephritis
4
Q
Denotes the accumulation of material that is homogeneous and eosinophilic by light microscopy.
A
Hyalinosis
5
Q
A
Normal Glomerulus: Minimal Change Disease
6
Q
- Results from low serum albumin producing a decrease in plasma oncotic pressure, which allows transudation of fluid from capillary beds into the extracellular space.
- Characteristically soft and pitting and is most marked in the periorbital region and dependent portions of the
A
Edema
7
Q
A
Foot Process Effacement
-Minimal Change Disease
8
Q
Reflected by stereotypic morphologic changes in the podocytes, which include effacement of foot processes, vacuolization, and retraction and detachment of cells from the GBM, and functionally by proteinuria.
A
Epithelial Cell Injury (podocyte injury)
9
Q
- Defined as the presence of a diminished GFR (less than 60 mL/minute/1.73 m2 for at least 3 months)
- Persistent albuminuria.
- Present with clinically silent decline in renal excretory function in milder forms
- Signs of uremia.
A
Chronic Kidney Disease
10
Q
- Most common cause of nephrotic syndrome in children (85-90% cases in childrens under 6 years)
- Account for up to 20% of adults with primary nephrotic syndrome.
- LIGHT MICROSCOPY: no abnormalities.
- IMMUNOFLUORESCENCE: negative, negative complement deposition.
- ELECTRON MICROSCOPY: Characterized by foot process
- effacement.
A
Minimal Change
11
Q
Presence of an excessive number of red blood cells in the urine.
It can be:
- Microscopic (visible only with the aid of a microscope)
- Macroscopic (urine that is tea-colored or cola-colored, pink, or even red).
Can result from injury to the kidney or to another site in the urinary tract.
A
Hematuria
12
Q
A
FSGS
13
Q
- Glomerular inflammation resulting in a reduction in GFR.
- Hematuria
- RBC cast
- Azotemia ( increased Cr, serum BUN)
- Oliguria
- Mild to moderate hypertension.
- Proteinuria (<3.5g/day) and edema are common
A
Nephritic Syndrome
14
Q
A
IgA Nephropathy
15
Q
- Elevation of blood urea nitrogen (BUN) and creatinine levels and is
- Related largely to a decreased glomerular filtration rate (GFR)
A
Azotemia
16
Q
A
Crescentic IgA Neprophathy
17
Q
A
IgA Nephropathy
- Silver Stain
18
Q
When it only can be made the minicmal change diagnosis?
A
when effacement is associated with normal glomeruli by light microscopy
19
Q
- Caused by a derangement in glomerular barrier resulting in increased permeability to plasma proteins.
- Proteinuria, >3.5 g/day; >40mg/h per m2 in children.
- Hypoalbuminemia <3.5g/dl.
- Generalized edema
- Hypercholesterolemia
- Lipiduria
A
Neprotic Syndrome
20
Q
What tha fuck are pointing the arrows?
A
Filtration Slits
21
Q
Damage to any one of the three layers, increasing the permeability of the glomerular filtration barrier wil cause: ________
A
Proteinuria
22
Q
- Accounts for less than 15% cases of nephrotic syndrome in children.
- And up to 25% cases in adults.
- Some forms results from mutations in podocyte proteins.
- Prone to rapid recurrence.
- Gene Mutations: NPHS1 and NPHS2
- Focal and segmental lesions may involve only a minority of the glomeruli.
- On electron microscopy both sclerotic and nonsclerotic areas show diffuse effacement of foot processes
A
Focal Segmental Glomerulosclerosis
23
Q
Deposition of extracellular collagenous matrix
- Result in obliteration of some or all of the capillary lumens in affected
glomeruli.
A
Sclerosis
24
Q
It is characterized by reduced urine output (<100mL urine per day), reflecting renal injury.
A
Anuria
25
**Etiology: Any cause of decreased circulating blood volumes**
* Gastrointestinal Hemorrhage
* Burns
* Diarrhea
* Diuretics.
* Volume sequestration
* Reduction in cardiac output from vasodilation.
* Severe vasoconstriction caused by NSAIDS.
Prerenal Azotemia
26
**Minimal Change**
- Stain: PAS
27
* It usually appears 1 to 4 weeks after a streptococcal infection of the pharynx or skin (impetigo) with specific (nephritogenic) strains of group A B- Hemolytic streptococci.
* Most commonly affects children from 6 to 10 years of age.
* Nephritic Syndrome
* LM: Diffuse glomerular hypercellularity and infiltration of polymorphonuclear leukocytes, monocytes or macrophages.
* IF: Depositions of igG, C3 and ocasionally IgM
* EM: subepithelial deposists "humps" can be seen along the GBM.
Post Streptococcal Glomerulonephritis
28
N**ormal glomerular tuft with surrounding Bowman's capsule and hilar arterioles.**
- Silver Stain
29
* Rapid decline in GFR
* Concurrent dysregulation of fluid and electrolyte balance
* Retention of metabolic waste (including urea and creatinine)
* Oliguria or Anuria
* It can result from glomerular, interstitial, vascular or acute tubular injury.
Acute Kidney Injury
30
Supplies only a semiquantitative measurement of urine albumin, which is expressed on a scale from 0 to +++ or ++++.
Albumin Reagent Strip
31
When prerenal and postrenal azotemia have been excluded as etiologies of renal failure, an ________________ is present.
Intrinsic Renal Disease
32
Wich type of technique is use to examinate immunoglobulins, complement system and detect prescence of fibrin?
Immunofluorescence and Immunoperoxidase Microscopy
33
* Berger's Disease
* Deposition of IgA immune complexes in the glomerular mesangium.
* Is the prototype of a mesangioproliferative glomerulonephritis.
* Frequent in Asian populations and in American Indians.
* Its most frequent in the third decade of life.
* Is associated with Henoch-Schonlein purpura.
* Linked to galactose-deficient IgA1 molecules and increased formation of anti-GD-IgA immune complexes
IgA Nephropathy
34
Membranoproliferative glomerulonephritis type I
35
* Accounts for approximately 20 to 30 percent of cases of nephrotic syndrome in Caucasian adults.
* Incidence peak during the fourth and fifth decades of life.
* Male to female ratio 2:1
* Associated with hepatitis B, autoimmune diseases, hyroiditis, malignancies, and the use of certain drugs such as nonsteroidal antiinflammatory drugs (NSAIDs).
* Immunofluoresence:Deposition of igG and C3 in walls
Membranous Nephropathy
36
Wich stains are used to identify a glomerular disease unde light microscopy?
* **Hematoxylin-eosin (HE)**
* **Periodic acidSchiff (PAS) reaction.**
Evaluation of:
* Cellularity and matrix expansion.
37
It is defined as increased volume of urine (\>3 L of urine per day).
Polyuria
38
Misshapen red cells that have been distorted by osmotic and chemical stress as red blood cells pass through the nephron. (less than 10% of cases)
Glomerular Hematuria
39
Membranous Nephropathy
40
Azotemia + Constellation of clinical sings and symptoms + biochemical abnormalities = \_\_\_\_\_\_\_\_\_\_\_\_
* Characterized by: Nausea, vomiting, fatigue, anorexia , weight los, muscle cramps, pruritus, mental status changes, visual disturbances, increased thirst.
Uremia
41
* Urinary tract obstruction (\<5% of cases of acute renal failure)
* Can be caused by congenital abnormalities such as:
* Vesicoureteral reflux
* Blockage of the ureters by kidney stones
* Pregnancy
* Compression of the ureters by cancer, prostatic hyperplasia
* Blockage of the urethra by kidney or bladder stones
Post Renal Azotemia
