[nephrotic] Flashcards
1
Q
A
Proteinuria (>3.5g/day)
Hypoalbuminaemia (<25g/L)
Oedema
2
Q
A
> 250mg/mmol
3
Q
A
albumin: creatinine ratio
* ** add in meaning
4
Q
A
hyperlipidaemia
5
Q
A
reduced oncotic pressure of blood, increased hepatic triglyceride and cholesterol synthesis to compensate
6
Q
A
total cholesterol >10mmol/L
7
Q
A
Membranous
Minimal change
Mesangiocapillary
Focal segmental glomerulosclerosis
8
Q
A
DM
Amyloidosis
SLE (5)
Hep B/C
9
Q
A
membranous disease
Hep C can also –> MCGN
10
Q
A
NSAIDs
11
Q
A
NSAIDs
Penicillamine
anti-TNF
12
Q
A
podocytes
13
Q
A
maintain the filtration barrier
i.e. prevents large weight molecules from passing through
14
Q
A
foot processes
15
Q
A
pitting
16
Q
A
low tissue resistance (also legs - relative low resistance due to gravity)
17
Q
A
no - mild or normal
18
Q
A
no - mild raise or normal.
19
Q
A
CCF (oedema, proteinuria) Liver failure (hypoalbuminaemia)
20
Q
A
children
21
Q
A
can be normal - hence the name
22
Q
A
foot effacement
23
Q
A
ACEi/ARB in all patients to reduce proteinuria
24
Q
A
Steroids
most relapse
25
[nephrotic]: Minimal change: when would cyclophosphamide be indicated
If patient undergoes frequent relapse
26
[nephrotic]: Membranous: common in which age group
adults
27
[nephrotic]: Membranous: what would be seen on biopsy
diffusely thickened GBM
28
[nephrotic]: Membranous: What is see on IF of biopsy
IgG
| C3
29
[nephrotic]: Membranous: 1st line Tx?
ACEi/ARB
30
[nephrotic]: Membranous: which antibody is found in 80% of those with idiopathic membranous GN
anti-phospolipase A2 receptor
31
[nephrotic]: Membranous: 1st remission Tx
Steroids
32
[nephrotic]: FSGS: what is seen on biopsy
some glomeruli have scarring
33
[nephrotic]: FSGS: what is seen on IF?
IgM
| C3
34
[nephrotic]: FSGS: what IVDU drug is it associated with
Heroin
35
[nephrotic]: FSGS: What virus can cause the collapsing tubule subtype
HIV
36
[nephrotic]: FSGS: HIV causes which subtype
collapsing tubule
37
[nephrotic]: FSGS: 1st Tx - ?
Steroids
38
[nephrotic]: FSGS: What would indicate cyclophosphamide use?
steroid resistant
39
[nephrotic]: vesico-ureteric reflux results in ... GN
FSGS
40
[nephrotic]: sickle cell anaemia can result in which GN?
FSGS
41
[nephrotic]: what is the most common cause of nephrotic syndrome in children
minimal change
42
[nephrotic]: is biopsy indicated in children
no
43
[nephrotic]: when is biopsy indicated in children (2)
no response to steroids
| features suggest a different cause (e.g. haematuria --> nephritic)
44
[nephrotic]: which adults should undergo biopsy
all
45
[nephrotic]: what happens to the level of serum IgA
reduced - lost in urine
46
[nephrotic]: what is the result of reduced serum IgA
increased susceptibility to infection
47
[nephrotic]: why is the patient in a hypercoaguable state?
loss of anti-coagulants in urine (anti-thrombin/protein s)
| increase production of clotting factors from liver
48
[nephrotic]: Loss of which 2 particular proteins leads to a hyper coaguable state
Protein s
| Anti-thrombin
49
[nephrotic]: general Tx: what 4 components are there to treating nephrotic syndrome
reduce oedema
Reduce proteinuria
reduce complications
Treat cause
50
[nephrotic]: general Tx: of oedema?
Loop diuretics: furosemide
51
[nephrotic]: general Tx: why might IV loop diuretics be needed
Gut oedema preventing absorption
52
[nephrotic]: general Tx: what fluid intake advice may you give in tandem with loop diuretics
limit fluid intake
53
[nephrotic]: general Tx: what is used to reduce proteinuria
ACEi/ARB
54
[nephrotic]: general Tx: how do ACEi lower proteinuria
independent of antihypertensive effect
| increase nephrin levels (protein in filtration barrier) and realigns proteins in barrier
55
[nephrotic]: general Tx: why do you start a statin
reduce hypercholesterolaemia
56
[nephrotic]: general Tx: what is the indication for anticoagulation
proteinuria >3.5g/day
57
[nephrotic]: general Tx: what is the only way to induce full and long term remission
treat underlying cause
