Kidney/Urinary: Nephritic Syndrome Flashcards
What characterizes nephritic syndrome
glomerular inflammation and bleeding
what are findings for nephritic syndrome
- limited proteinuria ( less than 3.5 g/day)
- Oliguira and azotemia
- salt retention ( periorbital edema and hypertension)
- RBC casts and dysmorphic RBC in urine
what does biopsy reveal for nephritic syndrome
hypercellular, inflamed glomeruli
Immune complex deposition from nephritic syndrome activates what
complement
- C5a attracts neutrophils which does the damage
Poststreptococcal glomerulonephritis arises after
group A beta-hemolytic streptococcal infection of skin ( impetigo) or pharynx
for poststreptococcal glomerulonephritis, it occurs in what strains
nephritogenic strains
- nonstreptococcal organasms as well
when do symptoms occur for poststreptococcal glomerulonephritis ? what are the symptoms? Who usually does this occur in?
2-3 weeks after infection
- hematuria ( cola-colored urine)
- oliguria
- hypertension
- periorbital edema
children, may occur in adults
what does poststreptococcal glomerulonephritis stain on H and E
hypercellular, inflamed glomeruli
poststreptococcal glomerulonephritis looks like what on IF
immune complex deposition
granular IF
poststreptococcal glomerulonephritis looks like what on EM
subepithelial ‘humps’
what is treatment for poststreptococcal glomerulonephritis
supportive
how does poststreptococcal glomerulonephritis progress in children and adults
- children rarely progress to renal failure
- some adults develop rapidly progressive glomerulonephritis (RPGN)
What is rapidly progressive glomerulonephritis
nephritic syndrome that progresses to renal failure in weeks to months
What is the H&E stain for rapidly progressive glomerulonephritis
crescents in Bowman space
- crescents fibrin and macrophages
for poststreptococcal glomerulonephritis what disease is present if the IF pattern if linear
Goodpasture syndrome
- anti-basement membrane antibody
what is Good pasture syndrome? clinical presentation? Who is it classically seen in?
antibody against collagen in glomerular and alveolar basement membranes
- hematuria and hemoptysis
- young, adult males
for poststreptococcal glomerulonephritis what disease is present if the IF pattern if granular
PSGN (most common)
diffuse proliferative glomerulonephritis
diffuse proliferative glomerulonephritis in rapidly progressive flomerulonephritis is due to what
diffuse antigen-antibody complex deposition, usually sub-endothelial
What is the most common type of renal disease is SLE
diffuse proliferative glomerulonephritis
for poststreptococcal glomerulonephritis what disease is present if the IF pattern if negative IF ( pauci-immune)
Wegener granulomatosis
microscopic polyangiitis
Churg-Strauss syndrome
Wegener granulomatosis is associated with what serum levels?
c-ANCA
Microscopic polyangiitis and Churg-Strauss are associated with what serum levels
p-ANCA
What distinguishes Churg-Strauss from microscopic polyangiits
Churg-Strauss
- granulomatous inflammation
- eosinophilia
- asthma
What is the most common nephropathy worldwide
IgA Nephropathy ( Berger Disease)
What happens on Berguer disease
IgA immune complex deposition in mesangium of glomeruli
when does IgA Nephropathy present and what are symptoms
childhood
- episodic gross or microscopic hematuria with RBC casts
Bergery disease usually follows what? and how?
mucosal infections
- IgA production is increased during infection
IgA nephropathy may slowly progress to
renal failure
What is alport syndrome
inherited defect in type IV collagen
how is Alport syndrome inherited
X-linked
how does Alport impact glomerular basement membrane
thinning and splitting
how does alport syndrome clinically present
isolated hematuria
sensory hearing loss
ocular disturbances
