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Renal > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

What are the 5 primary characteristics of nephritic syndrome?

A
  1. Reduction in GFR as indicated by an elevated serum creatinine
  2. Active urine sediment in the form of RBCs, WBCs, and RBC casts
  3. Proteinuria (usually sub-nephrotic)
  4. Edema
  5. Hypertension
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2
Q

What glomerulonephritis is associated with ANA, Anti-DS DNA?

A

Lupus

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3
Q

What glomerulonephritis is associated with positive blood cultures?

A

Bacterial endocarditis

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4
Q

What glomerulonephritis is associated with ASO?

A

A post-infections glomerulonephritis, usually strep.

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5
Q

What glomerulonephritis is associated with Hepatitis C?

A

Cryoglobulinemia

HepC and Cryo… both start with C.

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6
Q

What glomerulonephritis is associated with Hepatitis B?

A

Membranoproliferative glomerulonephritis

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7
Q

What glomerulonephritis is associated with ANCA

A

Pauci-immune vasculitis

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8
Q

What glomerulonephritis is associated with anti-GBM antibodies?

A

Anto-GBM disease, Goodpasture’s Syndrome

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9
Q

What is the role of immune complexes in the pathophysiology of nephritic syndrome?

A

Immune complexes get lodged in the mesangium or subendothelial space and generate an inflammatory response.

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10
Q

What is the role of autoantibodies in (some) glomerulonephritis pathophysiologies?

A

Autoantibodies attach to self-cells and elicit a destructive immune response.

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11
Q

What is the level of proteinuria in glomerulonephritis?

A

Usually less than 3gm/day

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12
Q

Why is the proteinuria in glomerulonephritis less than that of nephrotic syndrome?

A

Because the inflammatory insults in GN are generally focal in nature.

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13
Q

What is the process by which reduction in GFR arises in GN?

A

An acute inflammatory process results in glomerular vasoconstriction and/or occlusion or thrombosis of SOME capillary loops.

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14
Q

Test Presentation: Child with edema and sudden extreme weight gain, recent history of GAS. Decreased C3 with normal C4. IF shows granular deposits, and EM shows “subepithelial humps.”

A

Post-infectious glomerulonephritis

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15
Q

I say subepithelial humps and you say _____

A

Post-infectious glomerulonephritis

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16
Q

T/F: Renal biopsy is typically performed to verify a diagnosis of post-infectious glomerulonephritis.

A

F. It’s usually self-limited and not a huge deal. We don’t go around stabbing children for such things.

17
Q

Test Presentation: 22yo male presents with asymptomatic microhematuria. IgA deposits in the skin, an din the mesangium upon IF.

A

IgA Nephropathy

18
Q

What is the most common type of acute glomerulonephritis?

A

IgA nephropathy

19
Q

What is the treatment for IgA nephropathy?

A

Studies show that there is a potential benefit with ACEi and steroids.

20
Q

Test Presentation: A patient presents with hypertension and early nephritic syndrome. Perhaps a history of chronic HCV. Cryoglobulins, rheumatoid factor, low complement. C3 and IgG deposits.

A

MPGN

21
Q

What is the treatment for MPGN?

A

Not tons. Can do alternate day steroids, and treat the HCV. But it’s a pretty shit prognosis.

22
Q

Test presentation: Patient presents with hemoptysis, fatigue. Anti-GBM antibodies are found. Linear deposits on IF

A

Anti-GBM or Goodpasture’s syndrome.

Goodpasture’s MUST involve the lungs as well.

23
Q

What is the treatment for anti-GMB?

A

EARLY steroids, immunosuppresents, and plasma exchange.

24
Q

T/F: A patient will benefit from IMMEDIATE kidney transplant in the case of anti-GBM

A

F. If the antibodies are still circulating, it’s likely the problem will manifest in the new kidney.

25
Q

Test Presentation: Patient presents with GI problems, a strange rash, pulmonary problems, and GN. No immune complexes on IF, but there is detectable ANCA.

A

Pauci-immune Renal Vasculitis.

26
Q

Treatment for pauci-immune renal vasculitis

A

Immunosuppression

27
Q

Test Presentation: Patient with detectible ANA presents with hematuria, proteinuria, and various other problems.

A

Lupus nephritis

28
Q

Treatment for lupus nephritis

A

High-dose corticosteroids with mycophenolate mofetil or cyclophosphamide

29
Q

Test presentation: Patent presents with palpable purpura, arthralgia, and generalized weakness. Proteinuria and hematuria are detected with a low level of C4 and possible RF activity.

A

Cryoglobulinemia

30
Q

What disease is associated with cryoglobulinemia?

A

HepC

31
Q

Treatment for cryoglobulinemia

A

Antivirals for HepC, B-cell depleting therapy for lymphoproliferative disease or rapidly progressing/resistant. Plasmapheresis.

32
Q

Test presentation: Child presents with skin lesions, arthritis, GI colic and bleeding, and GN. Crescent formation with mesangial and capillary wall deposits of IgA.

A

Henoch-Schonlein Purpura. (HSP)

Renal (14 decks)

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