Nephrotic and nephritic syndromes Flashcards

1
Q

Characteristics of nephrotic syndrome

A
>3.5g proteinuria
hypoalbuminemia
edema
hyperlipidema
lipiduria
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2
Q

Characteristics of nephritic syndrome

A
Decreased renal function
hypertenaion
RBC and RBC casts
Edema
Proteinuria <3.5g/day
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3
Q

Periorbital edema

A

nephrotic syndrome.

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4
Q

Maltese crosses on urinalysis

A

lipiduria characteristic of nephrotic syndrome . “Refractile bodies”

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5
Q

Associated with a hyper coagulable state because of increased coagulation factors, increased platelet aggregation, and decreased ATIII

A

nephrotic syndrome

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6
Q

Increased risk for bacterial infections

A

nephrotic syndrome-loss of immunoglobulins and complement components

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7
Q

Normal renal function with 4+ protein on urinalysis and hyaline casts

A

Minimal change disease (nephrotic syndrome)

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8
Q

Peak incidence 2-6 years old, preference for males

A

Minimal change disease, nephrotic syndrome

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9
Q

History of allergy
Hodgkins lymphoma
NSAIDs

A

Minimal Change Disease (a nephrotic syndrome)

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10
Q

Normal light microscopy
negative IF
EM showing foot process fusion

A

minimal change disease (a nephrotic syndrome

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11
Q

Podocytes strangely expressing CD 80

A

Minimal change disease (a nephrotic syndrome)

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12
Q

Common in young adults (2-40) and African Americans

A

FSGS

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13
Q

suPAR

A

FSGS

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14
Q

Nephrotic syndrome that presents with proteinuria and hypertension. Urinary sediment often has RBCs

A

FSGS

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15
Q

Nephrotic syndrome associated with heroin usage

A

FSGS

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16
Q

Nephrotic syndrome associated with HIV

A

FSGS

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17
Q

nephrotic syndrome that can be idiopathic or related to minimal change disease

A

FSGS

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18
Q

Collapsing focal and segmental glomerulosclerosis
tubular dilation microcysts
reticuloendothelial inclusions

A

HIV nephropathy related to FSGS

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19
Q

APO lipoprotein L1 is the pathological factor

A

FSGS

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20
Q

Antibodies to phospholipase A2 on the podocyte

A

Membranous nephopathy

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21
Q

Related to gold and mercury drugs

A

Membranous nephopathy

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22
Q

Solid malignancies/carcinoma (breast, lung, GI tract, renal)

A

Membranous nephopathy

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23
Q

Immune deposits in the capillary

A

Membranous nephopathy

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24
Q

The following tests:

  • CBC
  • CXR, mammogram, stool test for occult blood, -sigmoidoscopy

Should be performed if this disease is suspected

A

Membranous nephopathy

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25
Q

Chronic HBsAG carriers

responds to interferon

A

Membranous nephopathy

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26
Q

HCV

A

Type I MPGN

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27
Q

Low C3
Low c4
Cryos
elevated LFTs

A

HCV-associated MPGN type 1

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28
Q

Low C3

Low C4

A

MPGN type I

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29
Q

Low C3

Normla C4

A

MPGN type II

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30
Q

HG/Pb

A

Membranous nephropathy

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31
Q

amyloidosis

A

plasma cell myeloma

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32
Q

lymphoma

A

Minimal change disease

33
Q

Pulmonary renal syndrome (pulmonary hemorrhage)

A

Goodpasture’s

ANCA vasculitis

34
Q

14-21 days after a GAS infection

A

post-infectious glomerulonephritis

35
Q

14-21 days after staphylococcus endocarditis

A

post-infectious glomerulonephritis

36
Q

infected vascular prostheses
abscesses or empyema
ventricolatrial shunts

A

Post-infectious glomerulonephritis

37
Q

Antibody to strep antigens resulting in circulating immune complexes

A

post-infectious glomerulonephritis

38
Q

Light microscopy shows proliferative and exudative GN with infiltration of neutrophils and monocytes

A

post-infectious glomerulonephritis

39
Q

IF shows granular deposits of IgG and C3 in sub endothelial, mesangial and subepithelieal locations

A

post-infectious glomerulonephritis

40
Q

EM shows “sub epithelial humps”

A

post-infectious glomerulonephritis

41
Q

elevated ASO titer

A

post-infectious glomerulonephritis

42
Q

IgA immune deposits in mesangium

A

IgA nephropathy

43
Q

Light microscopy: increase in mesangial cell number and matrix

A

IgA nephropathy

44
Q

EM: mesangial immune deposits

A

IgA nephropathy

45
Q

asymptomatic hematuria/microhematuria
nonnephrotic hematuria
nml renal function

A

IgA nephropathy

46
Q

Occurs immediately with the onset of viral illness

A

IgA nephropathy

47
Q

Skin biopsy shows IgA

A

Henoch-Schonlein purpura

48
Q

pupura on arms and legs

A

Henoch-Schonlein purpura, systemic IgA nephropathy

49
Q

Histological pattern of proliferation (lobular) and thickening of the GBM

50
Q

Hep C
Cryos
RF low complement

51
Q

Iron deficient anemia

A

Goodpasture’s or ANCA associated vasculitis

52
Q

ANCA

A

pauci0immune small vessel vasculitis

53
Q

IF demonstrates “full house” C3, IgG, IgM, IgA, and C1qCryoglobulinemic glomerulonephritis

A

Lupus nephritis

54
Q

Palpable purpura, arthralgias, generalized weakness

A

cryoglobulinemia

55
Q
Skin lesions (palpable purpura), arthritis, GI involvement (colic and bleeding), GN
Kid
56
Q

focal proliferative necrotizing glomerulonephritis, often with crescents

57
Q

SLE is associated most commonly with which type of Glomerulonephopathy?

A

membranous

58
Q

Triad of nephritis, deafness, ocular lesions

A

Alport’s Disease

59
Q

Basket weave pattern on electron microscopy

A

Alport’s disease

60
Q

tubuloreticular body in endothelium

A

SLE nephritis

61
Q

Hyaline arteriolar disease

62
Q

-Medial and intimal thickening

– Hyaline deposition

A

HTN in renal disease

63
Q

fibrinoid necrosis and hyperplastic arteriolitis

A

malignant hypertension manifested in the kidney

64
Q
  • Pericarditis,pleuritis
  • Nausea,vomiting, ulcers
  • Neurologic: itching, seizures, lethargy, coma • Depressed immune response (infections)
  • Platelet dysfunction (bleeding disorders)
  • Amenorrhea
65
Q

Eosins on a UA

A

AIN (a type of renal/intrinsic AKI)

66
Q

BUN/Cr>20

A

pre renal azotemia

67
Q

specific gravity > 1.010

A

pre renal azotemia

68
Q

specific gravity =1.010 but the kidney is injured

69
Q

FENa <1

A

pre renal azotemia (or rhabdomyolysis or radiocontrast-not prerenal)

70
Q

FENa >2%

A

Either intrinsic renal AKI or port renal AKI

71
Q

isosomotic urine in AKI

A

Intrinsic renal

72
Q

High Uosm in AKI (>500)

A

pre renal azotemia

73
Q

Pigmented, coarsely granular casts on UA

74
Q

Renal tubular epithelial cells (RTEs) on a UA

75
Q

AKI: cardiac dysfunction, edema, rales, S3 gallop

A

pre renal azotemia

76
Q

Evidence of fever or rash after ampicillin

77
Q

AKI: intravascular volume depletion (decreased weight, flat neck veins, postural changes in BP/pulse

A

Pre renal azotemia

78
Q

anuria or swings in urine flow rate

A

post renal obstruction

79
Q

“Starry sky appearance”

A

post-infectiousl glomerulonephritis