Nephritic Syndrome

Question 1

4 Basic Features

Answer 1

Limited proteinuria (<3.5g/day)
Oliguria and azotemia
Salt retention w/ periorbital edema and HTN
RBC casts and dysmorphic RBCs in urine

Question 2

Poststreptococcal Glomerulonephritis (what it is/presentation, what strains, microscopy, treatment, prognosis based on age)

Answer 2

Nephritic syndrome a few weeks after GAS (Beta hemolytic) with M protein virulence factor infection
Hematuria (cola-colored) and other nephritic findings
Subepithelial “humps” on EM
Children usually fine, adults have 25% chance to progress to rapidly progressive glomerulonephritis

Question 3

Rapidly Progressive Glomerulonephritis Classic Histologic Finding

Answer 3

Crescents in Bowman’s space comprised of fibrin and macrophages

Question 4

Linear Anti-BM Staining in RPGN

Answer 4

Goodpasture’s syndrome which will attack BM in glomerulus and alveolus leading to hematuria and hemoptysis usually in young males

Question 5

Granular IC Deposition in RPGN (2)

Answer 5

PSGN or Diffuse Proliferative Glomerulonephritis

Question 6

Diffuse Proliferative Glomerulonephritis

Answer 6

Nephritic syndrome from SLE, most common type of renal disease in SLE

Question 7

SLE 2 Glomerular Diseases

Answer 7

Nephritic - DPGN

Nephrotic - Membranous nephropathy

Question 8

Negative IF in RPGN (pauci-immune)

Answer 8

Wegener’s granulomatosis
Microscopic polyangitis
Churg-Strauss

Question 9

How to Differentiate Wegener’s Granulomatosis from Goodpasture’s

Answer 9

Nasopharyngeal/sinus involvement and c-ANCA instead of anti-BM linear staining

Question 10

IgA Nephropathy (Berger Disease)

Answer 10

IgA deposition in mesangium usually in children following mucosal infection presenting with gross or microscopic hematuria

Question 11

Alport Syndrome (3 symptoms and etiology)

Answer 11

Isolated hematuria, sensory hearing loss, and ocular disturbance
Inherited so family history/XL