Nephritic Syndrome

Question 1

Commonly seen in children after URI?

Answer 1

PSGN–presents 2-3 weeks after infection

Question 2

S/S of PSGN?

Answer 2

Hematuria (cola-colored urine), oliguria, HTN, periorbital edema

Question 3

Prognosis of PSGN?

Answer 3

Children self-limited, adults may progress to RPGN

Question 4

Histo seen in PSGN?

Answer 4

LM shows enlarged hypercellular glom with neutrophils and “lumpy bumpy” appearance; EM shows subepithelial deposits (humps); IF is granular

Question 5

Histo seen in RPGN?

Answer 5

Crescent moon shape in Bowman’s space composed of fibrin and macrophages (NOT collagen)

Question 6

Prognosis of RPGN?

Answer 6

Renal failure in weeks-months

Question 7

IF patterns in RPGN?

Answer 7

Linear, granular, or negative (pauci-immune)

Question 8

Most common cause of RPGN?

Answer 8

PSGN

Question 9

Due to anti-BM Abs to glom and alveoli?

Answer 9

Goodpasture’s

Question 10

IF in Goodpasture’s?

Answer 10

Linear

Question 11

Causes of granular IF in RPGN?

Answer 11

PSGN or diffuse proliferative

Question 12

Most common type of renal dz in SLE?

Answer 12

Diffuse proliferative

Question 13

Negative IF in RPGN?

Answer 13

Wegener’s, microscopic polyangiitis, Churg-Strauss

Question 14

Most common COD in SLE?

Answer 14

Diffuse proliferative

Question 15

May present as nephrotic syndrome?

Answer 15

Diffuse proliferative

Question 16

Histo in diffuse proliferative?

Answer 16

LM shows wire looping of capillaries; EM shows subendothelial (sometimes intramembranous) IgG-based anti-DNA ICs with C3 deposition; granular IF

Question 17

Most common nephropathy worldwide?

Answer 17

Berger’s dz (IgA GN)

Question 18

What is Berger’s assoc with?

Answer 18

Henoch Schonlein and celiac dz

Question 19

S/S of Berger’s?

Answer 19

Episodic gross/microscopic hematuria with RBC casts following mucosal infections (URI, gastric enteritis)

Question 20

Histo in Berger’s?

Answer 20

Granular deposits in mesangium (on IF)

Question 21

Defect in type IV collagen?

Answer 21

Alport’s

Question 22

S/S of Alport’s?

Answer 22

Isolated hematuria, sensory hearing loss, ocular disturbances

Question 23

Histo in Alport’s?

Answer 23

Thinning and splitting of GBM (LM/EM negative)

Question 24

What is granular appearance in PSGN due to?

Answer 24

IgG, IgM, and C3 deposition along GBM and mesangium

Question 25

Most important prognostic indicator of PSGN?

Answer 25

Age

Question 26

Genetics of Alport’s?

Answer 26

X-linked

Question 27

Tends to recur?

Answer 27

Berger’s

Question 28

Starry sky IF pattern?

Answer 28

PSGN