Nephritic Syndrome

Question 1

Poststreptococcal glomerulonephritis

pathology

Answer 1

S. pyogenes (GAS) infection causes SUBEPITHELIAL IgG immune complex deposits

Question 2

Poststreptococcal glomerulonephritis findings: 
population
signs (2)
symptom (1)
laboratory titers (2)
other lab finding
EM findings

Answer 2

• More common in children
• HTN, edema
• Brown urine
• High ASO and Anti-DNAse B titers
• *Low C3
• *EM: “subepithelial humps/lumpy bumpy”

Question 3

Poststreptococcal glomerulonephritis treatment

Answer 3

Self limited. Treat the HTN and edema (diuretics)

Question 4

Granulomatosis with polyangitis

pathology

Answer 4

Granulomatous vasculitis affecting:
upper airway
lower airway
kidneys

Question 5

Granulomatosis with polyangitis findings
urine (2)
lungs (1)
upper airway (3)
ANCA?

Answer 5

Proteinuria
Microscopic hematuria
Pulmonary nodules/infiltrates
Saddle nose, sinus disease, palate granulomas/ulcers
**c-ANCA +

Question 6

Granulomatosis with polyangitis treatment (2)

Answer 6

1. Glucocorticoids

2. Cyclophosphamide

Question 7

Goodpasture syndrome pathology

Answer 7

IgG antibodies against the glomerular basement membrane

Question 8

Goodpasture syndrome findings
urine (2)
respiratory (3)
IF findings (1)

Answer 8

Proteinuria and hematuria
Cough/hemoptysis
Pulmonary infiltrates
**IF: linear deposits

Question 9

Goodpasture syndrome treatment

Answer 9

1. Plasmapheresis (removes antibodies)

2. Glucocorticoids

Question 10

IgA Nephropathy (Berger Disease) pathology

Answer 10

IgA immune complexes in the mesangium; mesangial proliferation

Question 11

IgA Nephropathy findings
sequela of what?
population
lab/serum findings that differs from PSGN
EM/IF findings (1)

Answer 11

Often a sequela of URI/tonsilitis
May bee seen in children with HSP
**Normal C3
**EM/IF: mesangial deposits

Question 12

IgA Nephropathy Treatment (3)

Answer 12

1. ACE-i
2. Glucocorticoid
3. Cyclophosphamide

Question 13

Alport Syndrome (hereditary nephritis) pathology

Answer 13

X-linked defect in Type IV collagen synthesis –> defective basement membranes

Question 14

Alport Syndrome findings (3)

Answer 14

Cataracts
Nephritis
High-frequency hearing loss
“cant see, cant pee, cant hear a buzzing bee”

Question 15

Alport Syndrome treatment (2)

Answer 15

1. ACE-i

2. Renal transplant

Question 16

Pauci-immune rapidly progresive glomerulonephritis (RPGN) pathology

Answer 16

Crescent-shaped fibrin deposits in glomeruli

Scarce immune complex deposits

Question 17

Pauci-immune rapidly progresive glomerulonephritis findings:
urine (2)
anca

Answer 17

1. Microscopic hematuria
2. Proteinuria
3. p-ANCA+

Question 18

Pauci-immune rapidly progresive glomerulonephritis treatment

Answer 18

1. Rapid progression to ESRD (weeks to months)
2. Glucocorticoid
3. Cyclophosphamide

Question 19

Eosinophilic granulomatosis with polyangitis pathology

Answer 19

Small vessel vasculitis

Question 20

Eosinophilic granulomatosis with polyangitis findings
body symptoms (4)
lab findings (2)

Answer 20

Asthma, sinusitis, skin nodules/purpura, peripheral neuropathy
**p-ANCA+ and increased IgE

Question 21

Eosinophilic granulomatosis with polyangitis treatment

Answer 21

Glucocorticoids

Question 22

Microscopic polyangitis:
similar to what?
How does it differ (3)

Answer 22

Similar to granulomatosis with polyangitis

**Differs by: no granulomas, no nasopharyngeal involvement, and p-ANCA+