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?

22
Q

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

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
What happens on Berguer disease
IgA immune complex deposition in mesangium of glomeruli
26
when does IgA Nephropathy present and what are symptoms
childhood | - episodic gross or microscopic hematuria with RBC casts
27
Bergery disease usually follows what? and how?
mucosal infections | - IgA production is increased during infection
28
IgA nephropathy may slowly progress to
renal failure
29
What is alport syndrome
inherited defect in type IV collagen
30
how is Alport syndrome inherited
X-linked
31
how does Alport impact glomerular basement membrane
thinning and splitting
32
how does alport syndrome clinically present
isolated hematuria sensory hearing loss ocular disturbances