Glomerulopatías Secundarias Flashcards

1
Q

Enfermedades que causan glomerulopatías secundarias

A
  • DBT (nefropatía diabetica)
  • HTA (nefroesclerosis hipertensiva)
  • Amiloidosis
  • LES (nefropatía lúpica)
  • Vasculitis (Wegener, Churg-Strauss, PAM, Scholein-Henoch, etc)
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2
Q

Nefropatía DBT - Alteraciones MO

A
  • Aumento de espesor de MB glomerular
  • Hipertrofia glomerular
  • Expansion mesangial con glomerulo-esclerosis difusa y nodular (Kimmestiel-Welson)
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3
Q

Nefropatía DBT - Etapas (4)

A
  1. Pre-nefropatía (solo hiperfiltracion glomerular)
  2. Etapa de Microalbuminuria (30-300 mg/g)
  3. Etapa de Proteinuria evidente (lesion renal declarada, HTA, edema, retinopatía DBT)
  4. Azoemia (ERC terminal)
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4
Q

Nefropatía DBT - Tratamiento

A
  • Control de glucemia HbA1c < 7
  • Control dislipidemia (LDL < 100, TAG < 150)
  • IECA o ARA-2 para control de proteinuria y nefroproteccion
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5
Q

Nefroesclerosis Hipertensiva - Tipos

A
  1. Nefroesclerosis HTA Benigna
  2. Nefroesclerosis HTA Maligna
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6
Q

Nefroesclerosis Hipertensiva Benigna - Características MO

A
  • Hipertrofia de capa media
  • Aterosclerosis hialina
  • Glomeruloesclerosis global y focal
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7
Q

Nefroesclerosis Hipertensiva Maligna -
Características MO

A
  • Necrosis fibrinoide
  • Aterosclerosis hiperplasica
  • GN necrosante
  • IRA
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8
Q

Amiloidosis Renal - Depositos

A

Deposito de material extra-celular tincion Rojo Congo +
* AL: region variable de cadenas livianas de Ig (mieloma)
* AA: aumento de produccion hepatica de amiloide A secundario a inflamacion cronica (AR, EII, etc)

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9
Q

Amiloidosis Renal - Clínica

A

Sme Nefrotico
ERC
HTA
IC Diastolica / Restrictiva

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10
Q

Amiloidosis Renal - Dx

A

Biopsia renal que presenta deposito mesangial difuso

PAAF abdominal o biopsia rectal

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11
Q

Amiloidosis Renal - Tto

A

GCC
Transplante en < 40 años

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12
Q

Nefropatía Lúpica - Características

A

Proteinuria persistente > 500 mg/día o cilindros hematicos o leucocitarios.

Ocurre por deposito de Ic y Complemento (full-house en la biopsia):
1. Normal
2. GN mesangial
3. GN proliferativa focal
4. GN proliferativa difusa
5. GN membranosa
6. Esclerosis e ERC

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13
Q

Nefropatía Lúpica - Clínica y Tto

A
  • ER progresiva
  • HTA

Tratamiento: GCC, micofenolato

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