Nephritic Syndrome

Question 1

Bare bones characteristics of nephritic syndrome?

Answer 1

hematuria, hypertension, renal insufficientcy

Question 2

Diseases that can present as nephritic syndrome?

Answer 2

membranoproliferative glomerulonephritis, IgA nephropathy, Anti-glomerular Basement Membrane Disease, Alport syndrome

Question 3

Membranoproliferative glomerulonephritis tends to have immune complex deposition where?

Answer 3

subendothelial

Question 4

IgA nephropathy has immune complex deposition where?

Answer 4

Mesangial location

Question 5

Glomerular endothelial cell injury can often lead to what?

Answer 5

capillary luminal thrombus

Question 6

Membranoproliferative glomerulonephritis looks like what under light microscope

Answer 6

thickened BM, increased cellularity, abundant mesangial matrix,

Question 7

Which type of MP glomerulonephritis is most common?

Answer 7

Type I

Question 8

Can MP glomerulonephritis be secondary or primary?

Answer 8

Yes

Question 9

Primary in kids and secondary in adults

Answer 9

This is generally true of most diseases that can be primary or secondary

Question 10

MP Glomerulonephritis poccurs most frequently in what age groups

Answer 10

7-30

Question 11

Injury phase of type 1 MPGN features?

Answer 11

influx of leukocytes

Question 12

Proliferative phase of MPGN type 1 leads to?

Answer 12

capillary cell wall damage

Question 13

What frequntly precedes type I MPGN?

Answer 13

upper respiratory tract infections

Question 14

MPGN is an immune complex disease that slowly progresses to end-stage kidney disease

Answer 14

True

Question 15

What is type II MPGN usually referred to as?

Answer 15

Dense deposit disease

Question 16

Also frequently follows an upper respiratory tract infection

Answer 16

true

Question 17

What is the mechanism behnd dense deposit disease?

Answer 17

Inappropriate activation of the complement pathway due to congenital mutations in the complement regulating proteins.

Question 18

Immunoflourescence appearance?

Answer 18

deposits of c3, , BUT NO IgG, C1q, or C4

Question 19

WHat is the biggest differentiator of type II from type I?

Answer 19

Presence of dense deposits in the basement membrane visualized by electron micrscopy. Dense Dark Material

Question 20

What are the major clinical differentiators between Type 1 and type 2?

Answer 20

Type II can feature dense deposits in the Bruch membrane of the eye called drusen. It may also feature loss of subcutaneous fat in the upper half of the body.

Question 21

IgA nephropathy?

Answer 21

deposition of polymeric IgA1 in the mesangial matrix

Question 22

Can be primary or secondary…what increases your chances?

Answer 22

Celiac disease and chronic liver disease

Question 23

Common in who?

Answer 23

Children and young males, genetic predisposition is east asians. This is a common cause of nephritic disease

Question 24

IgA nephropathy usually triggered by what?

Answer 24

GI infection or upper respiratory tract infection

Question 25

what shows up on electron immunoflourescence for pts with IgA nephropathy?

Answer 25

IgA deposits in the mesangium

Question 26

IgA nephropathy is differentiated from other forms of glomerulonephritis by what type of study?

Answer 26

Immunoflourescence

Question 27

Dense deposit disease i sdifferentiated by what type of study?

Answer 27

Electron microscopy

Question 28

Anti-GBM disease?

Answer 28

autoantibodies against a non-collagenous domain of collagen type IV

Question 29

Anti-GBM most common in young white males

Answer 29

true

Question 30

What differentiates Anti-GBM from goodpastures

Answer 30

renal involvement only = Anti-GBM

Renal and pulmonaary = goodpastures

Question 31

rapidly progressing glomerulonephritis is bad

Answer 31

true