GN Flashcards
The most common cause of chronic kidney injury.
glomerular disease
Should always be considered in the differential diagnosis when the urinary protein excretion is elevated or the urine sediment reveals RBCs.
glomerular disease
pathognomonic for glomerular disease.
Proteinuria (>3.5 g/d) or RBC casts in the urine sediment
Whats the definitive diagnosis of glomerular disease
renal biopsy
whats the type of collagen in the glomerular basement membrane
type 4
mutations in a345
alport syndrome
antibodies to NC1 domain of a3
goodpastures
GBM is
300nm
state the two immune mechanisms by which pathogenesis of glomerular disorders takes place
t cell i.e. MCD , antigen antibody dependent pathways
name two circulating immune complezes that get trapped in the glomeruli
sle, POSTSTREPTOCOCCAL
what are the systemic complications of nephron loss (4)
hyperlipidemia, hyperphosphatermia, systemic hypertension, hyperparathryoidism
name the adaptive changes that happen in remanant nephrons due to nephron loss
glomerular hypertension, proteinuria
name the 5 places where injury to the glomerulus could occur
visceral and parietal epi, mesangial , basement membrance, endothelium
injury to the endothelium manifests as ________________, give an example
hypercellularity i.e. acute poststreptococcal glomerulonephritis
acummulation of extracellular matrix manifests as injru to the _________________example__________
mesangium, diabetic nephropathy
give an example where thinning of the basement membrane with lamellation occurs
alport syndrome
thekening of the GBM
diabetic nephropathy
proliferation with crescent formation
parietal epithelium
detachment of podocytes igive an example
focal segmental glomerulosclerosis
foot process effacement
minimal change disease
moderate edema is in nephritic or nephrotic syndrome
nephritic
hematurica, oliguria, azotemia are all characteritstics of
nephritic syndrome
moderate proteiunuria is in nephritic or nephrotic s
nephritic
hypercoagulability, lipiduria, hyperlipidemia, hypoalbuminemia are characteristics off
nephrotic syndrome
rapidly progressive renal failure with heamaturia w/ RBCs casts
RAPIDLY Progressive glomerulonephritis
what is the primary nephrotic syndrome that is the most in children 70%
minimal change disease
what is the primary nephrotic syndrome that is the most in adults 35%
focal segmental glomerulosclerosis
what is the primary nephrotic syndrome that presents as 30% in adults
membranous nephropathy
T or F, minimal change disease prognosis is bad
false, its excellent
state secondary causes of minimal change disease
NSAIDs, Hodgkins disease, viral
focal segmental glomerulosclerosis is more prevalent among
african americans and hispanics
how many cases of FSGsclerosis progress to ESRD
> 50%
mutations involving vairous slit diaphragm proteins is a hereditary form of
FSGS
rule of third applies to which nephropathy?
membranous nephropathy
gold and penicillamine can ppt which type of nephropathy?
membranous nephropathy
HBV and HCV, syphilis, schistosomiasis, and malaria can ppt which type of glomerular disease
membranous nephropathy
state the five causes of membranous nephropathy
drugs, infections, carcionma, autoimmune disorders, idiopathic
state another name for membranoproliferative glomerulonephritis
mesangiocapillary glomerulonephritis
what is often almost always seen by analysing serum of mambranoproliferativenephritis
hypocomplementemia
membranousproliferative glomeruloneprhitis is associated odten with
HCV
which disease is both nephritic and nephrotic
membranoproliferative glomerulonephtitis
whats the leading cause of ESRD in many countries
diabetic nephropathy
what happens in the early stages of diabetic neprhopathy
hyperfileration and microalbuminuria
STRUCTURAL CHANGES (Increasing glomerular basement membrane thickening and mesangial expansion), which part of diabtic neprhopathy
preclinical (5y)
Hyperfiltration, microalbuminuria, rising blood pressure, which stage of diabetic nephropathy
incipent (15y)
before overt nepphropthay what appears in the urine?
proteinuria onset (20y)
Rising Scr, Decreasing GFR
, which part of diabetic nephropathy
oveert (10y)
whats beyond overt nerphpathy
end stage renal disease (30y)
multisystem involvement with poor prognosis
amyloidosis
male: female of SLE
1:10
Low C3 & positive Ab to ASO & DNAse B
ACUTE PROLIFERATIVE GLOMERULONEPRHITIS
THE MOST common cause of glomerulonephropathy isss
IgA neprhopathy aka Berger syndrome
describe the course of bergers syndrome
starts off as begnin and then ends with ESRS
Henoch-Schonlein purpira is a cause off
Bergers syndrome
crescentic GN or might present as simple
rapidly progressive glomerulonephritis
cellular cresents in RPGN is found in more than
50% of the glomeruli
if left untreated, RPGN _________
> 90% progresses into ESRD
IgG deposit along GBM (anti-GBM disease)
Type 1 RPGN
IC deposition in the subendothelial, subepithelial, and/or mesangial compartment (virtually any IC–mediated GN, although most are idiopathic).
type 2 RPGN
absence of immune deposits “pauci- immune GN”. (ANCA vasculitis)
type 3 RPGN
Double-antibody positive disease is a unique variant of RPGN characterized by features of
type 1 and type 3 disease (i.e. anti-GBM antibodies and ANCA are both detected).
Typically presents with microscopic hematuria and mild proteinuria (<2.0 g/d)
• May have: ocular abnormalities (retinopathy and anterior lenticonus), sensorineural hearing loss and rarely, leiomyomatosus.
alport syndrome
follows angiographic procedures by days or weeks
renal atheroembolic
renal atheroemboli is reported in _____of cases
30%
on biopsy, pts with renal atheroembloli have
atherosclerotic aorta, cholesterol emboli
blood chemistry of pts with renal artheroemboli
low complements, high esinophils
secondary to E. coli (serotype 0157:H7).
HUS
