Nephritic and Nephrotic Syndromes Flashcards
1
Q
which of nephritic or nephrotic has hematuria?
A
nephritic
2
Q
which of nephritic or nephrotic has RBC casts?
A
nephritic
3
Q
which of nephritic or nephrotic has massive proteinuria?
A
nephrotic
4
Q
which of nephritic or nephrotic has hyperlipidemia?
A
nephrotic
5
Q
which of nephritic or nephrotic has hypoalbuminemia?
A
nephrotic
6
Q
which of nephritic or nephrotic has fatty casts or oval fat bodies in the urine?
A
nephrotic
7
Q
which of nephritic or nephrotic has lower proteinuria?
A
nephritic
8
Q
which of nephritic or nephrotic has elevated creatinine?
A
nephritic
9
Q
which of nephritic or nephrotic has hypertension?
A
nephritic
10
Q
which of nephritic or nephrotic has hypogammaglobulinemia?
A
nephrotic
11
Q
which of nephritic or nephrotic has hypercoagulable state?
A
nephrotic
12
Q
why is there a hypercoagulable state in nephrotic syndrome?
A
lose antithrombin III
13
Q
which of nephritic or nephrotic has edema?
A
nephrotic
14
Q
which of nephritic or nephrotic has tea colored urine?
A
nephritic
15
Q
is post infectious GN nephritic or nephrotic?
A
nephritic
16
Q
is proliferative lupus nephritic or nephrotic?
A
nephritis
17
Q
is membranoproliferative GN nephritic or nephrotic?
A
nephritic
18
Q
is C3 glomerulopathy nephritic or nephrotic?
A
nephritic
19
Q
is IgA nephropathy nephritic or nephrotic?
A
nephritic
20
Q
is alport syndrome nephritic or nephrotic?
A
nephritic
21
Q
is pauci immune GN nephritic or nephrotic?
A
nephritic
22
Q
is anti glomerular basement membrane disease nephritic or nephrotic?
A
nephritic
23
Q
is minimal change disease nephritic or nephrotic?
A
nephrotic
24
Q
is focal segmental glomerulosclerosis nephritic or nephrotic?
A
nephrotic
25
is membranous nephropathy nephritic or nephrotic?
nephrotic
26
is amyloidosis nephritic or nephrotic?
nephrotic
27
is diabetic kidney disease nephritic or nephrotic?
nephrotic
28
are C3/C4 up down or normal in post infectious GN?
C3 is down and C4 is sometimes down
29
what is a positive serology antibody in post infectious GN?
ASO antibody
30
what two things deposit in post infectious GN and where do they deposit?
C3 and IgG...deposit in subepithelial space of the glomeruli
31
what is the common organism that leads to post infectious GN? how long after infection does the glomerular nephropathy occur?
group A beta hemolytic strep...2-4 weeks
32
name three commone presenting features with post infectious GN?
cola colored urine
periorbital edems
hypertension
33
what is the characteristic appearance of post infectious GN on IF?
starry sky or lumpy bumpy due to subepithelial immune complex bumps
34
what population is proliferative lupus nephritis most common in
blacks
35
are C3/C4 levels up down or normal in proliferative lupus nephritis
both are down
36
name two common antibodies found in proliferative lupus nephritis
anti smith and ANA
37
what is the mechanism of issue in diffuse proliferative lupus nephritis? where do these deposit?
immune complexes
| subendothelial or intramembranous
38
which nephritic syndrome often co presents as a nephrotic syndrome?
membranoproliferative GN
39
what is type I membranoproliferative GN often associated with?
Hep B or Hep C
40
what is the characteristic appearance of membranoproliferative GN on stains?
called tram track appearance
41
where does deposit happen in membranoproliferative GN? how does it appear on IF?
immune complex deposits on subendothelium...appears granular
42
what goes wrong in C3 glomerulopathy?
mutation or antibodies that activate compliment molecules
43
will C3 be low or high in C3 glomerulopathy?
will be low bc it is getting used up
44
how does C3 glomerulopathy look on IF?
it appears light...but no antibodies...just C3 deposits
45
are C3/C4 up down or normal in IgA nephropathy?
both are normal
46
what does IgA nephropathy usually follow?
mucosal infection
47
where do IgA complexes deposit in IgA nephropathy?
the mesangium
48
describe how IgA nephropathy will look on light microscopy and IF?
light will have enlarged mesangium
| IF will show IgA complex deposits in mesangium
49
other than mucosal infections...name two things IgA nephropathy is associated with?
inflammatory bowel disease
| ankylosing spondylitis
50
are C3/C4 up down or normal in alport syndrome?
both are normal
51
what is alport syndrome a problem with?
type IV collagen
52
in alport syndrome...what does the issue with type IV collagen lead to?
thinning and splitting of the basement membrane
53
what is the inheritance of alport syndrome?
x linked dominant
54
what is the descriptive term for alport syndrome on EM?
basket weave appearance from the thinning and splitting of the basement membrane
55
what are two other problems you can have with alport syndrome?
eye issues and deafness
56
how do pauci immune GN appear on LM or EM?
crescent shaped glomeruli
57
in pauci immune GN, what cells make up the crescent in the glomeruli?
macrophages and fibrin
58
what are the two most common types of pauci immune GNs?
microscopic polyangitis
| granulomatosis with polyangitis (wegeners)
59
what is the antibody associated with pauci immune GNs?
ANCA
60
is microscopic polyangitis P or C ANCA?
P ANCA
61
is granulomatosis with polyangitis P or C ANCA?
C ANCA
62
what is the result of IF testing in pauci immune GNs?
negative for anything because all mediated my neutrophils so do not appear on the IF
63
does GPA or MPA have oropharynx involvement?
GPA
64
which nephritic disease has a linear pattern on IF?
antiglomerular basement membrane disease
65
what pattern will antiglomerular basement membrane disease cause in glomerulus?
crescent shape
66
if antiglomerular basement membrane disease presents with pulmonary hemorrhage...you have what disease?
goodpastures
67
how do we treat antiglomerular basement membrane disease?
immediate plasmapheresis
68
what is the characteristic change seen in minimal change disease?
effacement of the foot processes on epithelium of Glomerulus
69
what can we treat minimal change disease with?
corticosteroids
70
what population commonly gets minimal change disease?
kids...most common nephrotic syndrome of kids
71
name two common associations with minimal change disease
NSAIDs and lymphomas
72
what two populations get focal segmental glomerulosclerosis a lot?
african americans and hispanics
73
what are imaging findings in focal segmental glomerulosclerosis ?
segmental sclerosis and hyalinosis in the glomeruli
74
what can happen to the epithelium focal segmental glomerulosclerosis?
effacement of foot processes
75
name five common associations with focal segmental glomerulosclerosis
```
HIV
Sickle cell disease
cyanotic heart disease
obesity
heroin
```
76
membranous nephropathy has what appearance on IF?
granular due to complexes
77
what is the antibody that drives primary membranous nephropathy?
anti M type PLA2
78
what is the characteristic description of membranous nephropathy on EM?
spike and dome
79
name four common causes of secondary membranous nephropathy
NSAIDs
Hep B
Hep C
SLE
80
in membranous nephropathy where do the immune complexes deposit?
subepithelial around the GBM
81
the AL form of amyloidosis is associated with what?
plasma cell disorders
82
the AA form of amyloidosis is associated with what?
chronic infections
83
name the two staining buzz words for amyloidosis
apple green birefringence
| congo red stain
84
where does amyloid deposit in the kidney?
mesangium
85
what are the two changes to the kidney seen histologically in diabetic kidney disease?
mesangial expansion
| GBM thickening
86
name the characteristic stain finding of diabetic nephropathy
kimmelstein wilson nodules
87
what cell is in the kimmelstein wilson nodules? what disease are these common with?
eosinophils
| diabetic nephropathy
88
membranoproliferative GN is often associated with what two things?
hepatitis B and cryoglobulins
89
what is the gene associated with FSGS?
APOL-1
90
which nephrotic syndrome is a paraneoplastic syndrome?
membranous glomerulopathy
91
which four nephritic and nephrotic syndromes present pulmonary and renal?
ANCA
Lupus
Cryoglobulins (membranoproliferative GN)
Goodpastures
92
which four nephritic and nephrotic syndromes present with a rash?
ANCA
Lupus
Cryoglobulins
IgA vasculitis
93
name the test that we use to determine the daily protein excretion
how do the numbers correlate?
spot urine protein creatinine ratio
1 = 1 g
94
if we cannot do the protein creatinine ratio...what do we use?
24 hour urine collection
95
what are three risks with nephrotic syndromes?
thrombosis
infections
accelerated atherosclerosis
96
do children get hematuria from glomerular causes of urinary problems more often? what about adults?
glomerular for kids
| urinary for adults
97
what is the other name for the C-ANCA antibody?
PR3-ANCA
98
what is the other name for the P-ANCA antibody?
MPO-ANCA
99
PR3-ANCA stands for what?
anti-proteinase 3
100
MPO-ANCA stands for what?
anti myeloperoxidase
