Nephritic and nephrotic syndromes

Question 1

Post infectious glomerulonephritis- IF, C3, other labs

Answer 1

low C3
Lumpy bumpy on IF
elevated ASO titer

Question 2

IgA- preceded by, presentation, C3, tx, assoc w/ what pediatric condition

Answer 2

MC, generally follows URI
presents w episodic gross hematuria or persistent microscopic hematuria
normal C3
tx with glucocorticoids, ACE in some pts

Question 3

Wegners granulomatosis- presentation, labs, tx

Answer 3

Hemoptysis, hematuria, sinus symptoms- this is a necrotizing vasculitis
cANCA
segmental necrotizing glomerulonephritis with few immunoglobulin deposits
Tx is high dose corticosteroids and cytotoxic agents

Question 4

Goodpastures syndrome- presentation, IF, other labs, tx

Answer 4

hemoptysis, hematuria
linear anti GBM deposits, Fe deficiency anemia, hemosiderin laden macs in sputum, pulm infiltrates on CXR
tx with plasma ex, pulsed steroids

Question 5

Alport syndrome- presentation, IF

Answer 5

hematuria, sensorineural deafness, eye disorders
EGM splitting on EM
progress to RF,

Question 6

Minimal change disease- epidemiology, labs, tx

Answer 6

MCC nephrotic syndrome in children, also caused by NSAID, hematologic malignancies.
Sudden onset of edema
normal on LM, fusion of foot processes with lipid laden renal cortices
tx steroids

Question 7

focal segmental glomerulosclerosis- causes, imaging, tx

Answer 7

associated with IV drug use, HIV, obesity, or idiopathic
normally young AA male with uncontrolled HTN
microscopic hematuria with bx shows sclerosis in capillary tufts
tx is predinisone, cytotoxic tx, and ACE/ARB

Question 8

membranous nephropathy- epidemiology, assoc, IF

Answer 8

misc common nephropathy in caucasian adults- an immune complex dz assoc with EBV, syphilis, malaria, and gold.
Spike dome appearance on IF from Ig and C3 deposits.

Question 9

diabetic nephropathy- types, labs.

Answer 9

diffuse hyalinization’s and nodular glomerulosclerosis
thickened GBM, increased mesangial matrix.
tx involves control of BS, ACE for type 1 and ARB for t2

Question 10

Lupus nephritis-UA, IF, tx

Answer 10

proteinuria or RBC’s

mesangial prolif, sub endothelial and or sub epithelial immune complex depot

Question 11

renal amyloidosis- labs

Answer 11

nodular glomerulosclerosis

EM reveals amyloidfibrils, APPLE GREEN BIREFERINGENCE W CONGO RED STAIN

Question 12

Membrenoproliferative nephropathy- accos, appearance, complement

Answer 12

type 1 associated with HCV, cryoglobulinemia, SLE, subacute bacterial endocarditis.
tram track on IF, type 1 has sub endothelial deposits and mesangial deposits. all have low C3