nephrotic syndrome

Question 1

nephrotic range proteinuria

Answer 1

> 3.5 g/24 hours

Question 2

nephrotic syndrome hallmarks

Answer 2

nephrotic range proteinuria
hypoalbuminemia
edema

Question 3

normal urinary protein excretion

Answer 3

<150 mg/day

Question 4

dipstick urinalysis is sensitive for what protein?

Answer 4

albumin

Question 5

most common cause of nephrotic syndrome in children

Answer 5

minimal change disease

Question 6

possible cause of benign proteinuria

Answer 6

post exercise

orthostatic

Question 7

nephrotic syndrome urinalysis

Answer 7

proteinuria
frothy urine
fatty casts on microscopy

Question 8

nephrotic syndrome pathophys

Answer 8

damage to podocytes on epithelial side of glomerulus compromises the filtration barrier leading to massive protein loss in urine

Question 9

causes of minimal change disease

Answer 9

drugs (NSAIDS)
allergies
Hodgkins
hematologic malignancies
Infection

Question 10

minimal change disease treatment

Answer 10

glucocorticoids

Question 11

minimal change disease biopsy findings

Answer 11

light microscopy shows no changes but EM shows flat podocytes and loss of GBM

Question 12

focal segmental glomerulosclerosis pathophys

Answer 12

an unknown circulating factor leads to sclerosis of the glomeruli of some nephrons damaging the podocytes

Question 13

primary FSGS cause

Answer 13

unknown, random

Question 14

secondary FSGS causes

Answer 14

heroin
HIV
obesity
HTN

Question 15

FSGS treatment

Answer 15

steroids (do not reverse scarring)
immunosuppression in resistant disease
ACEi/ARB, statins

Question 16

primary membranous nephropathy pathophys

Answer 16

anti-PLA2R antibodies form immune complexes that lead to Podocyte injury

Question 17

minimal change disease pathophys

Answer 17

cytokine mediated damage of podocytes

Question 18

secondary membranous nephropathy causes

Answer 18

infections
autoimmune diseases
tumors
rx

Question 19

renal biopsy showing thick basement membrane with subepithelial deposits along the basement membrane

Answer 19

membranous nephropathy

Question 20

membranous nephropathy treatment

Answer 20

steroids and cyclophosphamide

Question 21

what happens if nephrotic syndrome is not treated?

Answer 21

will likely progress to ESRD

Question 22

primary amyloidosis pathophys

Answer 22

deposition of amyloid in mesangium that takes over membrane

Question 23

primary amyloidosis treatment

Answer 23

treat underlying systemic disease

Question 24

diabetic nephropathy pathophys

Answer 24

chronic hyperglycemia leads to GBM thickening and eventually sclerosis, decreasing GFR

Question 25

____ can cause nephrotic lesions in pregnancy

Answer 25

preeclampsia (HTN, proteinuria)

Question 26

treatment of edema in nephrotic syndrome

Answer 26

loop diuretics
sodium restriction
fluid restriction

Question 27

treatment of proteinuria in nephrotic syndrome

Answer 27

RAAS inhibitor like ACEi/ARBs

Question 28

all pts with nephrotic syndrome are at increased risk of ____ because of ____

Answer 28

thromboembolism

protein loss/hypoalbuminemia

Question 29

why does nephrotic syndrome cause edema?

Answer 29

loss of proteins in blood (peeing them out) leads to increased interstitial fluid

Question 30

additional test to get if lupus nephritis is suspected

Answer 30

ANA

Question 31

membranous nephropathy is commonly seen in _____

Answer 31

caucasian adult males

Question 32

viral hepatitis can cause which type of nephrotic syndrome?

Answer 32

membranous nephroapthy

Question 33

why is DVT a possible complication of nephrotic syndrome?

Answer 33

there is a loss or protein C, S and antithrombin III and overproduction of clotting proteins