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Spr2015_Week9 > Goljan renal > Flashcards

Goljan renal Flashcards

1
Q

Lupus

A 
antibody = anti-dsDNA
antigen = DNA

deposit in glomerular capillaries

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2
Q

If immune complex too big,

A

then stuck underneath endothelial cell nucleus and can’t get thru basement membrane to podocyte

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3
Q

post strep GN

bacterial antigen + antibody

A

small antibodies can go thru basement membrane and deposit on epithelial side = subepithelial deposit

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4
Q

how to visualize immune complex

A

electron microscopy

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5
Q

Goodpasture’s on EM

A

linear pattern due to anti-GBM antibodies

type 2

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6
Q

granular pattern on EM means…

A

immune complex disease type 3

1) lupus
2) post-strep GN

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7
Q

only glomerulonephritis truly diagnose with immunofluorescence

A

IgA glomerulonephritis

no IgG

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8
Q

2 types of glomerulonephritis

A

1) nephritic

2) nephrotic

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9
Q

definition of nephritic glomerulonephritis

A

1) red cell casts

2) inflamm of glomerulus = spill

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10
Q

definition of nephrotic syndrome

A

1) fatty casts
2) > 3.5 g/24 hr urine
3) edema

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11
Q

too many glomeruli > 100

A

proliferative glomerulonephritis

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12
Q

patient had scarlet fever 2 weeks ago

now with hematuria, RBC casts, mild-mod proteinuria, HTN, periorbital edema

A

post-strep glomerulonephritis

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13
Q

35 y/o woman with + ANA with rim pattern = anti-dsDNA

type of GN

A

diffuse proliferative GN

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14
Q

lupus on EM

A

endocapillary wire loops
diffuse prolif GN
subendotheial immune deposits

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15
Q

prolif parietal epith cells not in glomerulus with crescent around

A

crescentic GN

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16
Q

worst GN

A

crescentic GN go into ARF within 3 months without dialysis

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17
Q

most common crescentic GN disease

A

goodpasture’s
still nephritic

polyarteritis nodosa
Wegener’s

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18
Q

maltese crosses

pathopneumonic for

A

cholesterol in urine

nephrotic syndrome

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19
Q

children with nephrotic at risk for

risky organisms as child vs. adult

A

peritonitis

child = strep pneumoniae
adult = e coli
20
Q

8 y/o boy with URI 1 week ago
now weight gain
diffuse pitting edema/anasarca
normotensive

normal light microscopy
normal immunofluorescence

on EM, podocyte fusion

A

lipoid necrosis due to cholesterol in urine

minimal change disease

21
Q

when albumin goes down, liver ..

A

makes more cholesterol

cholesterol can’t get into urine –> fatty casts into urine = maltese c

22
Q

lost negative charge in basement membrane so albumin gets through

A

minimal change

23
Q

how to treat minimal change

A

corticosteroids

24
Q

most common nephrotic syndrome in kids

A

minimal change

25
Q 
HIV+ patient 
with pitting edema 
UA shows > 3.5 g/day
fatty casts in urine 
HTN

most common GN in aids patient, IVDA

A

focal segmental glomerulosclerosis

26
Q

2nd worst GN you can get

A

FSGS

27
Q

adult with pitting edema
fatty casts in urine
UA > 3.5 g protein per day

not proliferative
GBM thickened

most common GN in adults

A

diffuse membranous glomeruonephritis

28
Q

diffuse membranous glomeruonephritis
on EM

on silver stain

A

on EM, subepithelial deposits

on silver stain, epimembranous spikes = immune complexes

29
Q

most common causes of diffuse membranous nephropathy

A

1) idiopathic
2) NSAIDS
3) hep B
4) captopril
5) malaria, syphilis
6) carcinoma

30
Q

type 1 and type 2 MPGN

immune complex because end in -itis

type 1 found in what patients

A

HCV

31
Q

membranous glomerulopathy in ___
type 1 MPGN in ____

HCV found in
HBV found in

A

HBV
HCV

MPGN and cryoglobulinemia
polyarteritis nodosa and membranous glomerulopathy

32
Q

type 1 MPGN has a

A

subendothelial deposit

nephrotic syndrome

33
Q

type 2 MPGN

A

autoantibody against C3 nephritic factor

causes C3 convertase overactive breaking complement down

34
Q

lowest complement levels in any glomerulonephritis found in

A

type 2 MPGN

35
Q

type 2 MPGN also known as

A

dense deposit disease

36
Q

tram tracking means

A

mesangial cell extended btwn basement membrane and endothelial cell

MPGN

37
Q

big balls on electron microscopy

A

diabetic glomerulosclerosis

38
Q

diabetic glomerulosclerosis

1st vessel hyalinized = efferent arteriole

A

hyaline arteriolosclerosis = small vessel disease in diabetes and HTN

type 4 collagen in mesangium = big balls

excess red

39
Q

if lumen narrow in efferent arteriole

A

incr GFR, incr creatinine clearance

efferent arteriole hyalinized and obstructing

hyperfiltration damage

40
Q

when glucose attach to amino acid and protein

A

non enzymatic glycosylation of GBM

41
Q

diabetic patient with glomerulosclerosis

A

makes GBM permeable to protein

microalbuminuria

42
Q

treatment for diabetic glomerulosclerosis and microalbuminuria

A

ACE inhibitor

afferent arteriole controlled by PGE2
efferent arteriole controlled by angiotensin II

if decr angiotensin II, vasodilates efferent arteriole
decr GFR

but still glycemic control because ACEI won’t stop non enzymatic glycosylation

43
Q

kimmelsteil wilson disease

A

nodular glomerulosclerosis

diabetic glomerulosclerosis

44
Q

amyloid deposits

when stain under polarized light

A

apple green birefringence

45
Q

associations

children 
IVDA, aids
adults
HCV
autoantibody against C3, lowest complemetn

diabetes
apple green

A 
lipoid necrosis 
FSGS
membranous glomerulopathy
type 1
type 2

diabetic glomerulosclerosis
amyloids

46
Q

IgA glomerulonephritis

anti-IgA

A

bergers disease

henoch-schonlein purpura

47
Q 
palpable purpura
polyarthritis 
slight GI bleed 
hematuria 
RBC casts

mesangial IgA deposits

kids = episode hematuria relapsing
adults = episodic microscopic hematuria
A

henoch-schonlein purpura

Spr2015_Week9 (10 decks)

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