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Pediatric Nephrology Boards > Glomerular Diseases > Flashcards

Glomerular Diseases Flashcards

1
Q

Most cases of this GN are sub clinical

A

Post Infectious GN

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2
Q

LM shows:

  • exudative proliferative GN
  • diffuse glomerular hypercellularity,
  • abundant inflammatory cells
  • mesangial and endothelial cell proliferation
  • sometimes crescents
A

Post Infectious GN

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3
Q

IF shows:

  • Granular C3 (always glomerular) & IgG
  • “Starry Sky” or “Garland” pattern
A

Post Infectious GN

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4
Q

EM shows:

- Subepithelial “humps”

A

Post Infectious GN

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5
Q

Caused by nephritogenic strains of group A beta-hemolytic Streptococcus (GAS)

A

Post Infectious GN

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6
Q

Activates the alternate or lectin pathway for complements (hence normal c4)

A

Post Infectious GN

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7
Q
  • Large vessel vasculitis
  • Granulamtous
  • ANCA negative
A

Takayasu’s artertitis

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8
Q
  • Medium vessel vasculitis
  • Not granulomatous
  • Can be necrotizing (but not in glom’s)
  • ANCA negative
A

Polyarteritis nodosa or kawasaki disease

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9
Q
  • Pauci-immune
  • granulomatous
  • p-ANCA/MPO
A

Churg-Strauss Syndrome

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10
Q
  • Pauci-immune
  • granulomatous
  • c-ANCA/PR3
A

Granulomatosis with polyangiitis (Wegeners’)

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11
Q
  • Pauci-immune
  • Not granulomatous
  • p-ANCA/MPO
A

Microscopic Polyangiitis

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12
Q
  • Leukocytoclastic

- Immune complex (IgA)

A

HSP

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13
Q
  • Immune complex deposits

- Negative ANCA’s

A

SLE

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14
Q

LM can be variable but shows:

- mesangial proliferation vs. normal

A

HSP

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15
Q

IF shows:

- Granular, mesangial IgA

A

HSP

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16
Q

EM shows:

  • Mesangial electron dense deposits
  • Sometimes thinning of GBM
A

HSP

17
Q

Skin biopsy shows leukoctyoclastic small-vessel vasculitis with IgA deposits

A

HSP

18
Q

Most common vasculitis in children (most cases < 10 years old)

A

HSP

19
Q

How many of the following to diagnose lupus?

  • malar rash
  • discoid rash
  • photosensitivity
  • oral ulcers
  • nonerosive arthritis
  • serositis, pleuritis or pericarditis
  • renal disease
  • neurologic involvement
  • hematologic involvement
  • immunologic tests (anti-DS DNA, anti phospholipid, anti smith)
  • positive ANA
A

4

20
Q

What class of Lupus Nephritis:

  • normal on LM
  • few mesangial deposits on IF/EM
  • normal UA
  • no renal therapies needed
A

Class 1 (minimal mesangial)

21
Q

What class of Lupus Nephritis:

  • mesangial hypercellularity
  • mesangial deposits
  • no significant deposits or scarring
  • microscopic hematuria and/or proteinruia
  • normal renal function
  • normal bp
  • no renal therapies needed
A

Class 2 (mesangial proliferative)

22
Q

What class of Lupus Nephritis:

  • < 50% gloms show GN
  • subendothelial & mesangial deposits
  • hematuria, proteinuria
  • can have hypertension, nephrotic syndrome, or elevated sCr
  • tx depends on severity and activity vs. chronicity
A

Class 3 (focal)

23
Q

What class of Lupus Nephritis:

  • > 50% gloms show GN
  • subendothelial & mesangial deposits
  • hematuria, proteinuria
  • can have hypertension, nephrotic syndrome, or elevated sCr
  • tx depends on severity and activity vs. chronicity
A

Class 4 (diffuse)

24
Q

What class of Lupus Nephritis:

  • diffuse GBM thickening
  • subepithelial & messangial deposits
  • spikes
  • similar to membranous nephropathy
  • usually nephritic with little or no systemic SLE
  • treat with cytoxan, azathioprine or mmf
A

Class 5 (membranous)

25
Q

What class of Lupus Nephritis:

  • global sclerosis in > 90% glomeruli
  • no active disease
  • elevated sCr, slow decline in function
  • irreversible
A

Class 6 (advanced sclerosis)

26
Q
  • Prevalence is 40-150 cases per 100,000

- More common in women

A

SLE

27
Q

c-ANCA and anti PR3 antibodies

A

Granulomatosis with Polyangiitis

28
Q

p-ANCA and anti MPO antibodies

A

Microscopic Polyangiitis or Churg-Strauss syndrome

29
Q
  • Small vessel vasculitis
  • Granulomatous inflammation
  • Affects upper/lower respiratory tract and kidneys
A

GPA or Wegeners

30
Q

LM shows:

  • focal pauci immune crescentic necrotizing GN
  • renal biopsy may not show vasculitis
  • granulomas found in respiratory tract
A

GPA

31
Q

LM shows:

  • focal pauci immune crescentic necrotizing GN
  • renal biopsy may not show vasculitis
  • NO granulomas found in respiratory tract
  • NO upper respiratory tract involvment
  • Can have alveolar capillaritis, but uncommon
A

Microscopic polyangiitis

32
Q

Tubular reabsorptive threshold for glucose

A

180-200 mg/dL

33
Q

What happens when glucose enters the urine

A

osmotic diuresis

34
Q

LM shows:

  • diffuse mesangial expansion
  • nodular glomerulosclerossi (Kimmelstiel-Wilson lesions)
  • arteriolar hyalinosis of afferent and efferent arterioles
A

Diabetic Nephropathy

Pediatric Nephrology Boards (2 decks)

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