FN: Nephrotic Syndrome Flashcards

1
Q

Triad

A

Proteinuria
Hypoalbuminaemia
Oedema
Hyperlipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Triad

A

Proteinuria
Hypoalbuminaemia
Oedema
Hyperlipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Proteinuria levels

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypoalbuminaemia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Oedema

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Complications

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Investigations

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Secondary to

A

Systemic disease
1. DM: glomerulosclerosis
SLE: membranous
Amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Types

A

Minimal change glomerulonephritis
Membranous Nephropathy
FSGS
Membranoproliferative/Mesangiocapillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Minimal change glomerulonephritis epi

A

Commonest in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Minimal change glomerulonephritis assoc

A

URTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Minimal change glomerulonephritis biopsy

A

normal light micro, fusion of podocytes on EM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Minimal change glomerulonephritis Rx

A

Steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Minimal change glomerulonephritis prognosis

A

1% ESRF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Membranous Nephropathy epi

A

20-30% of adult nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Membranous Nephropathy associations

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Membranous Nephropathy biopsy shows

A

subepithelial immune complex depositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Membranous Nephropathy Rx

A

immunosuppresion if renal failure declines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Membranous Nephropathy prognosis

A

40% spontaneous remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

FSGS ep

A

Commoner in Afro-caribeens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

A
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

A

URTI

36
Q

Minimal change glomerulonephritis biopsy

A

normal light micro, fusion of podocytes on EM

37
Q

Minimal change glomerulonephritis Rx

A

Steroids

38
Q

Minimal change glomerulonephritis prognosis

A

1% ESRF

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