Kidney/Urinary: Nephritic Syndrome Flashcards

1
Q

What characterizes nephritic syndrome

A

glomerular inflammation and bleeding

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2
Q

what are findings for nephritic syndrome

A
  1. limited proteinuria ( less than 3.5 g/day)
  2. Oliguira and azotemia
  3. salt retention ( periorbital edema and hypertension)
  4. RBC casts and dysmorphic RBC in urine
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3
Q

what does biopsy reveal for nephritic syndrome

A

hypercellular, inflamed glomeruli

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4
Q

Immune complex deposition from nephritic syndrome activates what

A

complement

- C5a attracts neutrophils which does the damage

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5
Q

Poststreptococcal glomerulonephritis arises after

A

group A beta-hemolytic streptococcal infection of skin ( impetigo) or pharynx

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6
Q

for poststreptococcal glomerulonephritis, it occurs in what strains

A

nephritogenic strains

- nonstreptococcal organasms as well

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7
Q

when do symptoms occur for poststreptococcal glomerulonephritis ? what are the symptoms? Who usually does this occur in?

A

2-3 weeks after infection

  • hematuria ( cola-colored urine)
  • oliguria
  • hypertension
  • periorbital edema

children, may occur in adults

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8
Q

what does poststreptococcal glomerulonephritis stain on H and E

A

hypercellular, inflamed glomeruli

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9
Q

poststreptococcal glomerulonephritis looks like what on IF

A

immune complex deposition

granular IF

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10
Q

poststreptococcal glomerulonephritis looks like what on EM

A

subepithelial ‘humps’

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11
Q

what is treatment for poststreptococcal glomerulonephritis

A

supportive

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12
Q

how does poststreptococcal glomerulonephritis progress in children and adults

A
  • children rarely progress to renal failure

- some adults develop rapidly progressive glomerulonephritis (RPGN)

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13
Q

What is rapidly progressive glomerulonephritis

A

nephritic syndrome that progresses to renal failure in weeks to months

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14
Q

What is the H&E stain for rapidly progressive glomerulonephritis

A

crescents in Bowman space

- crescents fibrin and macrophages

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15
Q

for poststreptococcal glomerulonephritis what disease is present if the IF pattern if linear

A

Goodpasture syndrome

- anti-basement membrane antibody

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16
Q

what is Good pasture syndrome? clinical presentation? Who is it classically seen in?

A

antibody against collagen in glomerular and alveolar basement membranes

  • hematuria and hemoptysis
  • young, adult males
17
Q

for poststreptococcal glomerulonephritis what disease is present if the IF pattern if granular

A

PSGN (most common)

diffuse proliferative glomerulonephritis

18
Q

diffuse proliferative glomerulonephritis in rapidly progressive flomerulonephritis is due to what

A

diffuse antigen-antibody complex deposition, usually sub-endothelial

19
Q

What is the most common type of renal disease is SLE

A

diffuse proliferative glomerulonephritis

20
Q

for poststreptococcal glomerulonephritis what disease is present if the IF pattern if negative IF ( pauci-immune)

A

Wegener granulomatosis
microscopic polyangiitis
Churg-Strauss syndrome

21
Q

Wegener granulomatosis is associated with what serum levels?

A

c-ANCA

22
Q

Microscopic polyangiitis and Churg-Strauss are associated with what serum levels

A

p-ANCA

23
Q

What distinguishes Churg-Strauss from microscopic polyangiits

A

Churg-Strauss

  1. granulomatous inflammation
  2. eosinophilia
  3. asthma
24
Q

What is the most common nephropathy worldwide

A

IgA Nephropathy ( Berger Disease)

25
Q

What happens on Berguer disease

A

IgA immune complex deposition in mesangium of glomeruli

26
Q

when does IgA Nephropathy present and what are symptoms

A

childhood

- episodic gross or microscopic hematuria with RBC casts

27
Q

Bergery disease usually follows what? and how?

A

mucosal infections

- IgA production is increased during infection

28
Q

IgA nephropathy may slowly progress to

A

renal failure

29
Q

What is alport syndrome

A

inherited defect in type IV collagen

30
Q

how is Alport syndrome inherited

A

X-linked

31
Q

how does Alport impact glomerular basement membrane

A

thinning and splitting

32
Q

how does alport syndrome clinically present

A

isolated hematuria
sensory hearing loss
ocular disturbances