Nephrology-Notes Flashcards
What are some examples of nephrotic syndromes?
membranous nephropathy minimal change disease focal segmental glomerulosclerosis membranoproliferative glomerulonephritis diabetic nephropathy amyloidosis
What are some examples of nephritic syndromes?
diffuse proliferative glomerulonephritis post strep glomerulonephritis RPGN IgA nephropathy Alport syndrome thin BM disease
What are the features of membranous nephropathy?
nephrotic
granular immune complex deposition
diffuse capillary thickening
spike and dome (subepithelial immune complex deposits)
What are important features of minimal change disease?
nephrotic
good steroid response
cytokine damages podocytes
What are the features of focal segmental glomerulosclerosis?
segmental sclerosis and hyalinosis
nephrotic
Membranoproliferative glomerulonephritis?
immune complex deposition subendothelial humps increased GBM and mesangial matrix tram tracks decreased complements due to HBV, HCV, cryoglobulinemia
Diabetic nephropathy?
nephrotic
massive mesangial proliferation
gbm thickening
kimmelstein-wilson nodules
Diffuse proliferative glomerulonephritis?
nephritic
anti-dsDNA deposits in mesangium and subepithelium
wire loop appearance, dense BM
lupus
Post strep glomerulonephritis?
nephritic subepithelial humps coarsy granular deposits of C3 hypercellular glomeruli granular pattern of immune complex deposition \+ASO decreased C3
RPGN?
nephritic
crescent formation in glomerulus
fibrin in the crescents
Goodpasture’s?
RPGN Type I
linear immune complexes
HSP?
purpura on back of arms and legs
abdominal pain
RPGNII
Wegener’s?
necrotizing granulomatous vasculitis
involves the nasopharynx, lungs, kidney
c-ANCA (PR3ANCA)
Microscopic polyangitiis?
no nasopharynx involving
just lung and kidney
p-ANCA
IgA Nephropathy?
aka Berger’s
dark dense deposits IgA in mesangium
associated with URIs
Alport syndrome?
type 4 collagen defect
BM splits
nephritis, deafness, cataracts
can’t see, pee, hear high C
Thin BM disease?
benign familial hematuria
Painless hematuria? that is gross, visible
cancer of the kidney or bladder
When do you see low complement levels?
postinfectious GN
lupus nephritis
MPGN
mixed cryoglobulinemia (associated with Hep C)
Symptoms associated with nephrotic syndrome?
massive proteinuria>3.5g/d
hypoalbuminemia (
Symptoms associated with nephritic syndromes?
not a lot of proteinuria
What is the usual cause of nephrotic syndromes in children and adults?
children-primary kidney lesion
adults-systemic disease, diabetes, lupus etc.
What is the workup for nephrotic syndrome?
UA with micro
24 hour protein
HbA1c, ANA/ds-DNA, C3/C4, Hep panel
renal biopsy
Wilm’s tumor, nephroblastoma?
neoplastic embryonal renal cells
What are some associated factors with wilm’s tumor?
WAGR: wilm's aniridia GU abnormalities Retardation
Beckwith-Wiedemann
macrosomia, macroglossia
omphalocele, umbilical hernia
neonatal hypoglycemia
hemihyperplasia (R side larger than left)
Wilm’s tumor, hepatoblastoma, adrenal cortical carcinoma
What is the surveillance for beckwith wiedemann syndrome?
serum AFP
abdominal u/s
renal u/s
What is the workup for Wilm’s tumor?
abdominal u/s
CT scan
CXR (for mets)
treat with surgery, chemo, radiation
Features of neuroblastoma?
2nd most common solid tumor
infant tumor
What are the symptoms of a neuroblastoma in the neck?
horner’s syndrome
What are the symptoms of a neuroblastoma in the thorax?
respiratory distress
abnormal CXR
What are the symptoms of a neuroblastoma in the abdomen?
mass
abdominal pain
HTN due to compression of the kidneys
infant with RUQ mass and pallor without jaundice
Symptoms of VIPoma?
watery diarrhea
What is the workup for a neuroblastoma?
abdominal us cbc urine/serum VMA/HVA CXR CT histo: malignancy of neural crest cells small round blue cells, uniform with hyperchromatic nuclei and scant cytoplasm (small cell rosettes)
treat with surgery, chemo, radiation
