Glomerulonephropathies

Question 1

difference between focal and diffuse nephritic disease

Answer 1

diffuse affects most of the glomeruli and has more proteinuria, edema, HTN, renal insufficiency

Question 2

T/F most glomerulonephropathies do not have an immunologic basis

Answer 2

false. Deposits of immunoglobulins & complement in basement membrane or Antigens set off inflammatory rxn

Question 3

Two etiologic agents that cause glomerulonephritis

Answer 3

streptococcal and hepatitis C

Question 4

Four systemic diseases with glomerular involvement

Answer 4

SLE, bacterial endocarditis, HIV, Hep B/C

Question 5

Age group for 60% of post strep glomerulonephritis

Answer 5

2-12 yrs

Question 6

T/F antibiotic treatment for strep does not prevent glomerular disease

Answer 6

true

Question 7

Treatment for post strep glomerulonephritis

Answer 7

Na/fluid restriction, diuretics, dialysis for severe cases

Question 8

Amount of fluid restriction when used as treatment method

Answer 8

Decrease fluids to insensible losses plus 2/3 of the urine output until diuresis

Question 9

Most common cause of vasculitis in children

Answer 9

Henoch-Scholein Purpura

Question 10

Tetrand of Henoch-Scholein Purpura

Answer 10

palpable purpura, arthritis, abdominal pain, renal disease

Question 11

Characterization of renal disease in HSP

Answer 11

deposition of IgA-containing immune complexes (identical to IgA nephropathy)

Question 12

Most common lesion to cause primary GN in the developed world

Answer 12

IgA Nephropathy/Berger’s Disease

Question 13

Age group typically affected by IgA Nephropathy/Berger’s Disease?

Answer 13

15-35 yrs (80%)

Question 14

Kidney biopsy results for IgA Nephropathy/Berger’s Disease

Answer 14

IgA deposits in the mesangium and glomerular capillary walls. C3 and IgG are also deposited

Question 15

treatment of IgA Nephropathy/Berger’s disease

Answer 15

ACE/ARB for BP control. Corticosteroids or immunosuppressants for severe disease

Question 16

Define rapidly progressive glomerulonephritis

Answer 16

Acute glomerulonephritis marked by a rapid progression to end-stage renal failure

Question 17

What represents disease stage resistant to therapy in RPGN?

Answer 17

Development of fibrous crescents

Question 18

Treatment for RPGN

Answer 18

Pulse methylprednisolone, Then daily oral prednisone. Oral or IV cyclophosphamide. Sometimes plasmapheresis

Question 19

Goodpasture’s Disease

Answer 19

course of rapidly progressive renal failure with hemoptysis, pulmonary infiltrates, dyspnea and renal failure

Question 20

What is Goodpasture’s Disease asoociated with?

Answer 20

cigarette exposure

Question 21

Kidney biopsy results for Goodpasture’s

Answer 21

linear deposition of IgG along the glomerular capillaries

Question 22

T/F some patient’s with ANCA have a positive titer with no evidence of active disease

Answer 22

true

Question 23

What percent of nephrotic syndrome in adults does membranoproliferative glomerulonephritis account for?

Answer 23

10%

Question 24

treatment for MPGN

Answer 24

ACEI, high dose corticosteroids, immunosuppressives, plasmapheresis

Question 25

name two immunosuppressives

Answer 25

cyclophosphamide, azathioprine

Question 26

Interstitial nephritis accounts for what percent of intrinisic renal faillure?

Answer 26

10-15%

Question 27

pathophysiology of interstitial nephritis

Answer 27

Interstitial inflammatory response with edema and possible tubular cell damage

Question 28

Most common cause of interstitial nephritis

Answer 28

medications

Question 29

signs/symptoms of interstitial nephritis

Answer 29

fever, rash, arthalgias, blood eosinophilia, red cells in urine

Question 30

What is commonly found in the UA of a patient with interstitial nephritis related to NSAIDs?

Answer 30

proteinuria

Question 31

treatment of interstitial nephritis if renal failure persists after removing inciting agent

Answer 31

High dose Methylprednisolone or Prednisone for 1-2 weeks, then taper