Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SPR2015_WEEK8 > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

define glomerulonephritis

signs…

A

inflamm injury of glomeruli

infiltration of leukocytes
deposition of immune proteins

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

glomerulonephritis may involve (4)

A

1) mesangium
2) podocytes
3) capillaries/endothelium
4) parietal epithelial cells

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

if you see mesangial proliferative with IgA deposits…

If you see mesangial proliferative with lupus

A

IgA nephropathy

lupus class 2

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

nephritic syndrome

signs

A

1) hematuria (dysmorphic RBCs + casts)
2) proteinuria (200 mg–> 10g)
3) elev creatinine
4) HTN with loss of kidney function holding on to Na+ and H2O

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

how does nephritic syndrome affect glomerular capillaries

A

1) damages wall

2) allows protein into urine and red cells and white cells

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

“Glomerular” RBCs due to …

A

damaged with blebs as pass thru capillary wall

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

RBC cast means…

A

protein stuck together in shape of tubule

GLOMERULONEPHRITIS

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

If ANA or anti-dsDNA positive, …

2) if blood culture positive
3) if ASO psoitive
4) if Hep C positive
5) if hep B positive
6) if ANCA positive
7) if anti-GBM positive

A

1) lupus
2) bacterial endocarditis
3) post infectious GN
4) cryoglobulinemia
5) membranoproliferative glomerulonephritis
6) pauci-immune vasculitis
7) goodpasture’s

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

if patients have low serum complement, what systemic and what renal limited disease

A

systemic

1) SLE
2) cryoglobulinemia
3) HUS

renal

1) acute post strep GN
2) MPGN

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

if patients have normal serum complement, what systemic and what renal limited

A

systemic =

1) wegener’s
2) henoch-schonlein purpura
3) goodpasture’s
4) polyarteritis nodosa

renal =

1) IgA nephropathy
2) idiopathic RPGN
3) anti-GBM disease

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

definitive diagnosis of GN requires…

A

kidney biopsy

make sure patient hold breath or kidney moves

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

syndromes assoc with aggressive disease

A

1) RPGN
2) crescentic GN
3) pulm-renal syndrome

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

RPGN
1) serum creatinine change?
GFR change?

2) assoc with ..
3) treatment

A

1) creatinine doubles
GFR falls by 50%
within few days to 3 mo

2) anti-GBM
ANCA vasculitis
lupus

3) cytotoxic drugs
plasmapharesis

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

crescentic GN
1) signs

1) assoc with…
2) treatment

A

1) rupture of capillary wall = severe= capillary loops squeezed down with crescents

2) anti-GBM
ANCA vasculitis
lupus

3) cytotoxic drugs
plasmapharesis

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

pulm renal syndrome
1) GN with ___

2) presents with ___
3) assoc with __
4) treatment

A

1) pulm capillaritis

2) nephritic syndrome
hemoptysis

3) anti-GBM
ANCA vasculitis
lupus

4) cytotoxic drugs
plasmapharesis

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

causes of GN

A

1) deposited immune complexes (lupus, MPGN)

2) antibodies for renal antigens
(goodpasture

3) ANCA vascultiis
HUS
C3 glomerulopathy

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

types of immune complex deposition

A

1) mesangial
2) subendothelial
3) subepithelial
4) intra-membranous deposition

18
Q

glomerular immune complexes may caused by

treatment?

A

antibodies to ..

1) glomerular antigens
2) extraglomerular antigens (infection, cancer, drugs)
3) idiopathic

treat with plasmapharesis to remove antibodies

19
Q

mechanism of injury with immune complex

A

1) immune complex dposit
2) activ complement –> proinflamm
3) injure nearby cells –> affects adaptive immune system

20
Q

how does immune complex injury change between subendo space vs. subepi space

A

1) subendo = activ complement –> inflamm capillary wall
2) subepi space –> flux of urine across wall sweeps complex away so less inflamm (membranous disease = antibodies to podocytes- no hematuria or renal failure)

21
Q

if you see hematuria, low grade proteinuria what find on histology

if you see hematuria, RBC casts, elev creatinine, proteinuria what find on histology

if you see hematuria, RBC casts, rapidly progressive renal faiure what find on histology

A

mesangial immune complexes

subendo immune complexes

necrotizing lesions or crescentic disease

22
Q

purpose of plasma exchange

A

1) remove patient plasma replace with healthy plasma, albumin
2) decr auto-antibodies
3) replace missing factors

23
Q

how do you treat
anti-GBM disease
anca vasculitis
cryoglobulinemia

A

plasma exchange

24
Q

IgA nephropathy
1) significance

2) pathology
3) presents with …
4) assoc with
5) treatment
6) prognosis

A

1) most common GN
2) mesangial IgA and mesangial expansion
3) hematuria +/- subnephrotic proteinuria, gross hematuria, assoc with URI
4) assoc with aberrant glycosylation of IgA (immune complex)

5) immunosuppressive (prednisone)
blood pressure, ACE inhib

6) 30% ESRD, 30% spont remission

25
Q

IgA glycosylaton in IgA neuropathy

how to form immune complex

A

1) Gal-deficient o-glycans bound to IgA

2) autoantibodies bind O-glycans –> immune complex –> stuck in mesangium

26
Q

Lupus nephritis
1) affects ___% of lupus patients

2) ___ presentation

3) caused by immune complex deposits
___ if hematuria
___ if nephritic
___ if nephrotic

4) on IF

A

1) 50%
2) variable

3) mesangium
subendothelail
subepithelial

if subendo –> high dose chemo

4) granular/patchy

27
Q

lupus nephritis class 1 and 2

1) deposits
2) presentation
3) immunosuppression?

A

1) mesangial
2) hematuria
3) no

28
Q

lupus nephritis class 3 and 4

1) deposits
2) presentation
3) immunosuppression?

A

1) subendothelial
2) hematuria, nephritic syndrome
3) yes

29
Q

lupus nephritis class 5

1) deposits
2) presentation
3) immunosuppression?

A

1) subepithelial
2) proteinuria
3) yes

30
Q

lupus nephritis class 6

1) deposits
2) presentation
3) immunosuppression?

A

1) scarring > 90% glomeruli
2) nephritic syndrome, progressive renal failure
3) no

31
Q

Anti-GBM disease

1) caused by…
2) presents as
3) often causes …

4) on IF
on EM

A

1) autoantibodies to NC1 domain of alpha 3 chain of type 4 collagen
2) renal limited or pulm-renal syndrome
3) crescentic, necrotizing GN and RPGN
4) linear staining = entire basement membrane unlike lupus = granular

EM = crescents

32
Q

anti-gbm suspect in patients with …

diagnosis by…

A

1) nephritic syndrome
RPGN
pulm renal syndrome

2) biopsy, detect anti-GBM antibody

33
Q

treatment of anti-GBM disease

if left untreated…

A

1) cytotoxic drugs (cyclophosphamide)
corticosteroids
plasma exchange

2) ESRD

34
Q

ANCA assoc vasculitis

1) type of vasculitis
2) ANCA is ____
3) on EM

4) treatment

A

1) small vessel
2) pathogeneic
3) crescents + necrotizing lesions

4) 80% die without treatment
cytotoxic drugs (cyclophos)
corticosteroids
Rituximab
Plasma exchange
35
Q

ANCA vasculitis suspect in patients with …

diagnosis by…

A

1) nephritic syndrome
RPGN
pulm renal syndrome

2) ANCA (not specific)
BIOPSY = PAUCI IMMUNE = FEW IMMUNE COMPLEX

36
Q

CLINICAL FINDINGS
1) nephritic syndrome (extra-renal involvement (airways)

C-ANCA (PR3)

A

Granulomatosis with polyangiitis

37
Q

Clinical findings
nephritic syndrome with extra-renal involvement

P-ANCA (MPO

A

microscopic polyangitis

38
Q

lung and skin vasculitis, asthma, eosinophilia

P-ANCA (MPO) > C-ANCA (PR3)

A

Churg-Strauss

39
Q

C-ANCA

A

antibodies to PR3 but can be MPO ANCA

40
Q

P-ANCA

A

> 90% antibodies to MPO

SPR2015_WEEK8 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions