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Final Notes > FN: Nephrotic Syndrome > Flashcards

FN: Nephrotic Syndrome Flashcards

1
Q

Triad

A

Proteinuria
Hypoalbuminaemia
Oedema
Hyperlipidaemia

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2
Q

Triad

A

Proteinuria
Hypoalbuminaemia
Oedema
Hyperlipidaemia

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3
Q

Proteinuria levels

A

PCR >300mg/mM or >3g/24hrs

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4
Q

Hypoalbuminaemia

A
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5
Q

Oedema

A

Periorbital
Genital
aScites
PEripheral - often intravascularly depleted with reduced JVP )cf. CFF)

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6
Q

Complications

A

Infection: reduced Ig, reduced complement activity
VTE: up to 40%
Hyperlipidaemia: raised cholesterol adn TG

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7
Q

Investigations

A

As for GN check lipids
Biopsy:
1. Biopsy all adults
2. Steroids 1st with children: mostly minimal change disease

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8
Q

Secondary to

A

Systemic disease
1. DM: glomerulosclerosis
SLE: membranous
Amyloidosis

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9
Q

Types

A

Minimal change glomerulonephritis
Membranous Nephropathy
FSGS
Membranoproliferative/Mesangiocapillary

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10
Q

Minimal change glomerulonephritis epi

A

Commonest in children

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11
Q

Minimal change glomerulonephritis assoc

A

URTI

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12
Q

Minimal change glomerulonephritis biopsy

A

normal light micro, fusion of podocytes on EM

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13
Q

Minimal change glomerulonephritis Rx

A

Steroids

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14
Q

Minimal change glomerulonephritis prognosis

A

1% ESRF

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15
Q

Membranous Nephropathy epi

A

20-30% of adult nephrotic syndrome

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16
Q

Membranous Nephropathy associations

A

Ca: lung, colon, breast
AI: SLE, thyroid disease
Infections: HBV
Drugs: Penicillamine, gold

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17
Q

Membranous Nephropathy biopsy shows

A

subepithelial immune complex depositis

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18
Q

Membranous Nephropathy Rx

A

immunosuppresion if renal failure declines

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19
Q

Membranous Nephropathy prognosis

A

40% spontaneous remission

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20
Q

FSGS ep

A

Commoner in Afro-caribeens

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21
Q

FSGS causes

A

Idiopathic or secondary : VUR, Bergers, SCD, HIV

22
Q

FSGS biopsy

A

focal scarring, IgM deposition

23
Q

FSGS Rx

A

Steroids or cyclophosphamide/ciclosporin

24
Q

FSGS prognosis

A

30-50% ESRF (may recur in transplants

25
Q 
Membranoproliferative/Mesangiocapillary GN
epi
May fall into which category
Assoc
Prognosis
A

Rare
AMy be nephrotic (60%) or nephritis(30%)
Association with HBV, endocarditis
Prognosis is 50% ESRF

26
Q

Management general of nephrotic syndrome

A 
Monitor U+E, fluid balance and weight
Treat the underlying causes
Symptomatic/Complications RX:
1. Oedema: salt and fluid restrict + frusemide
2. Proteinuria: ACEi/ARA reduced proteinuria
3. Stains
4. WTE prophylaxis: tinzaparin
5. Rx HTN
27
Q

Proteinuria levels

A

PCR >300mg/mM or >3g/24hrs

28
Q

Hypoalbuminaemia

29
Q

Oedema

A

Periorbital
Genital
aScites
PEripheral - often intravascularly depleted with reduced JVP )cf. CFF)

30
Q

Complications

A

Infection: reduced Ig, reduced complement activity
VTE: up to 40%
Hyperlipidaemia: raised cholesterol adn TG

31
Q

Investigations

A

As for GN check lipids
Biopsy:
1. Biopsy all adults
2. Steroids 1st with children: mostly minimal change disease

32
Q

Secondary to

A

Systemic disease
1. DM: glomerulosclerosis
SLE: membranous
Amyloidosis

33
Q

Types

A

Minimal change glomerulonephritis
Membranous Nephropathy
FSGS
Membranoproliferative/Mesangiocapillary

34
Q

Minimal change glomerulonephritis epi

A

Commonest in children

35
Q

Minimal change glomerulonephritis assoc

36
Q

Minimal change glomerulonephritis biopsy

A

normal light micro, fusion of podocytes on EM

37
Q

Minimal change glomerulonephritis Rx

38
Q

Minimal change glomerulonephritis prognosis

39
Q

Membranous Nephropathy epi

A

20-30% of adult nephrotic syndrome

40
Q

Membranous Nephropathy associations

A

Ca: lung, colon, breast
AI: SLE, thyroid disease
Infections: HBV
Drugs: Penicillamine, gold

41
Q

Membranous Nephropathy biopsy shows

A

subepithelial immune complex depositis

42
Q

Membranous Nephropathy Rx

A

immunosuppresion if renal failure declines

43
Q

Membranous Nephropathy prognosis

A

40% spontaneous remission

44
Q

FSGS ep

A

Commoner in Afro-caribeens

45
Q

FSGS causes

A

Idiopathic or secondary : VUR, Bergers, SCD, HIV

46
Q

FSGS biopsy

A

focal scarring, IgM deposition

47
Q

FSGS Rx

A

Steroids or cyclophosphamide/ciclosporin

48
Q

FSGS prognosis

A

30-50% ESRF (may recur in transplants

49
Q 
Membranoproliferative/Mesangiocapillary GN
epi
May fall into which category
Assoc
Prognosis
A

Rare
AMy be nephrotic (60%) or nephritis(30%)
Association with HBV, endocarditis
Prognosis is 50% ESRF

50
Q

Management general of nephrotic syndrome

A 
Monitor U+E, fluid balance and weight
Treat the underlying causes
Symptomatic/Complications RX:
1. Oedema: salt and fluid restrict + frusemide
2. Proteinuria: ACEi/ARA reduced proteinuria
3. Stains
4. WTE prophylaxis: tinzaparin
5. Rx HTN

Final Notes (196 decks)

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