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CPR2 Exam 2 > Kidney/Urinary: nephrotic > Flashcards

Kidney/Urinary: nephrotic Flashcards

1
Q

What is the protein content of nephrotic syndrome

A

proteinuria greater than 3.5 g/day

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2
Q

what does proteinuria cause in nephrotic syndrome

A
  1. hypoalbuminemia
  2. hypogammaglobulinemia
  3. hypercoagulable state
  4. hyperlipidemia and hypercholesterolemia
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3
Q

hypoalbuminemia causes

A

pitting edema

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4
Q

hypogammaglobulinemia causes

A

increased risk of infection

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5
Q

hypercoagulable state is caused by

A

loss of antithrombin III

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6
Q

hyperlipidemia and hypercholesterolemia may cause

A

fatty casts in urine

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7
Q

What is a common cause of nephrotic syndrome in children

A

minimal change disease (MCD)

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8
Q

What is the cause of minimal change disease

A

idiopathic

may be associated with Hodgkin Lymphoma

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9
Q

What is the H&E stain for minimal change disease

A

normal glomeruli

- lipids may be seen in proximal tubule cells

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10
Q

What does minimal change disease look like in EM

A

effacement of foot processes

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11
Q

what is the selective proteinuria in minimal change disease

A

loss of albumin

no loss of immunoglobin

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12
Q

what can used to treat minimal change disease? Why can this be used

A

steroids

- mediated by cytokines from T cells

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13
Q

Focal segmental glomerulosclerosis (FSGS) is the most common cause of nephrotic syndrome in what cultlures

A

Hispanics

African Americans

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14
Q

what causes Focal Segmental Glomerulosclerosis (FSGS)

A

idiopathic

may be associated with HIV, heroin use, sickle cell disease

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15
Q

H&E stain for Focal Segmental Glomerulosclerosis (FSGS)

A

focal and segmental sclerosis

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16
Q

Focal Segmental Glomerulosclerosis on EM

A

effacement of foot processes

17
Q

Focal Segmental Glomerulosclerosis in Immunofluorescence

A

no immune complex deposits

negative IF

18
Q

Focal Segmental Glomerulosclerosis can progress to what

A

chronic renal failure

19
Q

What is a common cause of nephrotic syndrome in Caucasian adults

A

membranous nephropathy

20
Q

what causes membranous nephropathy

A

idiopathic

may be associated with hepatitis B or C, solid tumors, SLE, drugs ( NSAIDS, penicillamine)

21
Q

H&E form membranous nephropathy

A

thick glomerular basement membrane

22
Q

Immunofluorescence for membranous nephropathy

A

immune complex deposition

- subepithelial deposits with ‘spike and dome’ appearance

23
Q

Membranous nephropathy responds poorly to what medication and progresses to what

A
  • steroids

- chronic renal failures

24
Q

what does Membranoproliferative glomerulonephritis look like on H&E

A

thick glomerular basement membrane

‘tram-track’ appearance

25
Q

Membranoproliferative glomerulonephritis on IF

A

granular due to immune complex deposition

26
Q

what are the 2 types of membranoproliferative glomerulonephritis

A

Type I - subendothelial

Type II - dense deposit disease - intramembranous

27
Q

Type II Membranoproliferative glomerulonephritis is associated with what?

A

C3 nephritic factor ( autoantibody that stabilizes C3 convertase)
- leading to overactivation of complement, inflammation, and low levels of circulating C3

28
Q

what medication does not work well with membranoproliferative glomerulonephritis

A

steroids

chronic renal failure

29
Q

for Lupus (SLE) what is the most common cause of death

A

renal failure

30
Q

what is the most common disorder with in kidneys for SLE

A

Diffuse proliferative glomerulonephritis

31
Q

Type I membranoproliferative glomerulonephritis is associated with what

A

HBV
HCV
( hepatitis B and C)

32
Q

how does diabetes mellitus impact the kidneys

A

high serum glucose

  • nonenzymatic glycosylation of vascular basement membrane
  • hyaline arteriolosclerosis
33
Q

what is the first change in the kidney in diabetes mellitus

A

nonenzymatic glycosylation

34
Q

what arteriole is impacted the most in diabetes mellitus? what does this lead to? which then will lead to what?

A

glomerular efferent arteriole

  • high glomerular filtration pressure
  • nephrotic syndrome
35
Q

characterize nephrotic syndrome

A

sclerosis of mesangium with formation of Kimmesteil-Wilson nodules

36
Q

what organ is commonly involved in systemic amyloidosis

A

kidney

37
Q

in systemic amyloidosis how do the kidneys get damaged

A

amyliod deposit sin mesangium, resulting in nephrotic syndrome

38
Q

what does systemic amyloidosis look like with Congo red staining

A

apple-green birefringence under polarized light

CPR2 Exam 2 (8 decks)

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