Nephrotic- Minimal Change Disease Flashcards

1
Q

What is MCD?

A

Relatively benign disorder that is the most frequent cause of nephrotic syndrome in children but less common in adults.

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2
Q

What age groups are most susceptible to MCD?

A

Very old and the very young

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3
Q

What is another name for MCD?

A

Lipid Nephrosis

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4
Q

Where is the primary defect in MCD?

A

Podocytes. Effacement and detachment but NO DEPOSITS.

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5
Q

How do podocytes appear under light microscopy in MCD?

A

Normal

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6
Q

Which gender of children is most likely to have MCD?

A

Male > Female

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7
Q

What part of the renal anatomy is primarily affected in MCD?

A

Glomerulus.

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8
Q

What disease may precipitate MCD?

A
  1. Hodgkin disease
  2. Thymoma
  3. T-Cell Leukemia
  4. Use of NSAIDs of Interferon-alpha
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9
Q

What are the immunoflurescence findings in MCD?

A

Negative

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10
Q

What is the most common finding in MCD?

A

Insidious onset of edema and nephrotic syndrome.

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11
Q

What are the BP findings in MCD?

A

Normal usually

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12
Q

What are the renal function findings in MCD?

A

Normal, there is occassinal acute kidney injury

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13
Q

What is distinctive about the proteinuria in MCD?

A

Highly selective for Albumin

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14
Q

How is the diagnosis of MCD made?

A

Renal Biopsy with electronmicroscopy.

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15
Q

What usually precedes MCD?

A

Respiratory infection and routine immunization

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16
Q

What is the pathogenesis of MCD?

A

Idiopathic but there is evidence that T-Cell (TH2) cytokines cause the GBM to lose its negative charge and thus the proteinuria

17
Q

What is the treatment for MCD?

A

Corticosteroids have be shown to be effective.

18
Q

How long does treatment last in those cases of MCD sensitive to steroids?

A

~6 weeks

19
Q

In those patients where steroid therapy fails what are the most prescribed agents in MCD?

A

Cyclophosphamide, cyclosporine, tacrolimus

20
Q

What would poor response to steroids in children indicate?

A

Possible other etiologies

21
Q

What is MCD most likely to progress to?

A

FSGS