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Block 4: SD3 Week 11 > Glomerular Disease 3 > Flashcards

Glomerular Disease 3 Flashcards

1
Q

What are nephrotic syndromes that are under primary glomerular diseases.

A

Minimal Change disease
FSGS (focal segmental glomerulosclerosis)
Membranous GN
Others - IgA nephropathy, mesangial

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2
Q

What are secondary glomerular diseases that would be classified under nephrotic syndrome?

A

DM
amyloidosis
drugs - NSAIDs, Pencillamine, street heroin
Infections - malaria, syphilis, HBV, HCV
Malignancies - carcinoma, lymphoma
Miscellaneous - bee sting allergy, hereditary nephritis

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3
Q

What is the most frequent cause of nephrotic syndrome in children?

A

Minimal Change Disease

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4
Q

Another name for Minimal Change Disease?

A

lipoid nephorsis

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5
Q

What is the age for the peak incidences of minimal change disease?

A

2-6 years of age

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6
Q

What is the best treatment for minimal change disease?

A

corticosteroid therapy (dramatic response)

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7
Q

Prognosis of Minimal Change Disease?

A

excellent prognosis

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8
Q

How does the kidney appear in Light microscopy of one with minimal change disease?

A

normal

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9
Q

How do the kidneys appear upon EM of one with Minimal Change disease?

A

diffuse effacement of foot processes

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10
Q

What are the mechanisms of proteinuria in minimal change disease?

A

loss of glomerular polyanions causing defects in the charge barrier

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11
Q

What is Congenital nephrotic syndrome (Finnish type) with minimal change disease.

A

mutation in nephron gene leading to loss of proteins

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12
Q

On PAS of an individual with minimal change disease what may be observed?

A

tubular lipoid cells - lipoid nephrosis

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13
Q

Does minimal change disease resolve?

A

yes; resolves as child reaches puberty

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14
Q

What is an association of MCD in adults?

A

association with Hodgkin disease and other leukemias and lymphomas NSAID therapy

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15
Q

Describe what may be seen upon light microscopy of individual with FSGS?

A

sclerosis involving a portion of the few glomerulus involvement of juxtamedullary glomeruli

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16
Q

What can be seen upon EM of a person with FSGS?

A

diffuse effacement of foot processes
may also be focal detachment of epithelial cells

17
Q

What is the most common cause of nephrotic syndrome in adults?

A

FSGS

18
Q

What are some secondary causes of FSGS?

A

HIV nephropathy
heroin nephropathy
sickle cell disease

19
Q

Is there a higher chance of hematuria in minimal change disease of FSGS?

A

FSGS

20
Q

Is there higher incidence of reduced GFR in FSGS or minimal change disease?

A

FSGS

21
Q

Is there a higher incidence of HTN in FSGS or minimal change disease?

A

FSGS

22
Q

Is proteinuria in FSGS selective or nonselective?

A

nonselective

23
Q

Describe response of FSGS to corticosteroid therapy?

A

poor

24
Q

Describe prognosis too FSGS and how it progresses.

A

poor prognosis

progression to chronic glomerulosclerosis with at least 50% end-stage renal disease within 10 years

25
Q

Why is IF -ve in FSGS?

A

The proportion of glomeruli are not enough to be seen

There is nonspecific deposition (“trapping”) of IgM and C3 in sclerotic segment

26
Q

Which age group does better with FSGS?

A

children

27
Q

What is the second most common cause of NS in adults?

A

membranous GN

28
Q

Describe capillary wall of one with membranous GN?

A

uniform, diffuse thickening

29
Q

On silver stain what is characteristic features of membranous GN?

A

spike and dome pattern

30
Q

Is membranous GN IF +ve or IF -ve?

A

IF +ve

31
Q

Primary cause of membranous GN?

A

idiopathic (may be autoab against the phospholipase A2 on podocytes.

32
Q

Secondary causes of membranous GN?

A

Infections (HBV, HCV, etc)

solid tumors

SLE

Drugs( penicillamine, gold, NSAIDS)

33
Q

Is a feature of membranous GN slow onset or rapid onset of nephrotic syndrome?

A

slow onset

34
Q

Is proteinuria selective or non selective in membranous GN?

A

non selective

35
Q

Does membranous GN respond well to corticosteroid therapy?

A

no

36
Q

Prognosis of membranous GN?

A

poor prognosis

37
Q

Is membranous GN associated with sclerosis of glomeruli and increased BUN and HTN?

A

yes

38
Q

There are cases of spontaneous remission of membranous GN in what groups?

A

mostly in women and in those with non-nephrotic range proteinuria

39
Q

Before you claim an idiopathic cause of membranous GN, what must you rule out?

A

secondary causes

Block 4: SD3 Week 11 (13 decks)

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