Lecture 7.5 Glomerular-Nephritic and other Flashcards
Nephritic syndrome:
____ and ____ casts in urine;
azotemia, ____, and HTN due to ____;
____ edema
hematuria, RBC;
oliguria, salt retention;
periorbital
nephritic syndrome general pathogenesis:
_____ process: immune complex deposition activates ____. this activates ____ which causes glomerular damage
inflammatory;
complement, PMNs
RPGN:
LM and IF show a _____ shape. consists of ____ and ____ with parietal cells and MQs
crescent;
fibrin, plasma proteins
RPGN:
linear deposits on IF is due to antibodies against _____. this is called _____ syndrome;
_____ immune deposits indicates lupus or cryoglobulinemia
GBM, goodpasture’s;
granular
RPGN:
______ stains positive with c-ANCA (PR3)
______ stains positive for p-ANCA (MPO)
these syndromes are called _____ diseases
granulomatosis with polyangitis (wegener’s);
microscopic polyangitis and churg- Strauss;
pauci-immune
_____ is an emergent treatment for goodpasture syndrome
plasmapheresis
if a patient appears to have RPGN but also have hemolytic anemia and thrombocytopenia, what does the patient probably have?
a thrombotic microangiopathy
acquired TTP is due to inhibition or deficiency of _______. what does this usually do?
ADAMTS13 (vWF metalloprotease);
cleaves vWF multimers
without ADAMTS13, long, sticky _____ multimers accumulate. these cause ____ platelet adhesion and thrombosis
vWF; increased
labs of a thrombotic microangiopathy show high ____, presence of ____, and low haptoglobulin
LDH, schistocytes
what syndrome is similar to TTP that is caused by infection
Hemolytic Uremic syndrome; e.g. shigella, e.coli
treatment of TTP / HUS
plasmapheresis
classic triad of HUS?
hemolytic anemia, thrombocytopenia, renal failure
treatment to delay progressive kidney disease in diabetics?
ACE inhibitors;
low protein diet helps too
diabetic nephrosclerosis:
_____ glycosylation of the ____ arterioles, causes ____ GFR and microalbuminuria
non-enzymatic, efferent;
increased
