Nephritis Flashcards
what are the three layers of the GBM?
LRI-LD-LRE
What is fractional clearance?
for macromolecules. The clearance of a given substance divided by clearance of inulin. If it equals 1, freely filtered. If it equals 0, impermeable
How do you determine clearance?
=urine conc times volume divided by plasma conc. Gives you the GFR when substance measured is creatinine or inulin
SGP
sialoglycoprotein, charge selectivity. on foot processes and endothelial surface
HS-PGs
heparan sulfate proteoglycan, charge and size selectivity. kind of inside lamina rara e/i
collagen and laminins provide what type of selectivity?
size
removal of sgp’s does what to foot processes?
detachment from GBM
what attaches foot processes to GBM?
alpha and beta integrins
selective proteinuria vs nonselective
selective is just albumin and is seen in minimal change dz. nonselective is albumin and globulins, seen in other nephrtiides
five characteristics of nephrotic syndrome
proteinuria>3g/day. serum albumin300mg/dl. lipiduria, edema
six characteristics of nephritic state
hematuria (rbc/wbc casts), proteinuria, azotemia, oliguria, HYPERTENSION, edema
characteristics of complexes with antigen excess
soluble, high diffusion, subepithelial deposit, complement not fixed
characteristics of complexes with antibody excess
insoluble, low diffusion, subendothelial/mesangial deposit, fixed complement
what are the three scenarios for immune complex deposition. What happens next?
1)complex formed in circulation then deposited (lupus). 2)Intrinsic component of capillary (goodpastures, Heymann). 3) foreign antigen implants and is then complexed (poststrep. glom). Then complement is activated and PMN/monocytes destroy GBM
what diseases activate the alternate pathway?
IgA nephritis, post-strep, lupus, MPGN 2
