Nephrotic Syndrome

Question 1

Three types of cellular changes with glomerular disease

Answer 1

proliferative, sclerotic, membranous

Question 2

Three different ways that diseases of the glomerulus present

Answer 2

focal nephritic, diffuse nephritic, nephrotic

Question 3

Primary component of glomerulus that’s increased in sclerotic disease

Answer 3

collagen

Question 4

Primary component of glomerulus that’s increased in proliferative disease

Answer 4

cellular

Question 5

Pathophysiology of nephrotic syndrome sequelae

Answer 5

glomerular damage–>protenuria (>3.5g/day)—>hypoproteinemia (albumin < 3g/100ml)—> edema, hyperlipidemia and thrombotic disease

Question 6

Epidemiology of minimal change disease in kids

Answer 6

90% of nephrotic cases in children <10yrs. 50% of cases in older children

Question 7

What happens glomerulus in minimal change disease?

Answer 7

fusion of podocytes

Question 8

Treatment for minimal change disease

Answer 8

steroids

Question 9

Define focal and segmental glomerulosclerosis

Answer 9

presence in some of the glomeruli of segmental areas of mesangial collapse and sclerosis

Question 10

What patient popns is focal and segmental glomerulosclerosis associated with?

Answer 10

HIV and massive obesity

Question 11

What is membranous glomerulopathy?

Answer 11

basement membrane thickening with little or no cellular proliferation or infiltration.

Question 12

T/F membranous glomerulopathy can precede the diagnosis of cancer

Answer 12

true

Question 13

What metabolic disorder might severe hypoproteinemia lead to?

Answer 13

metabolic alkalosis

Question 14

How do ACE inhibitors work?

Answer 14

ACE inhibitors relax the efferent arteriole decreasing glomerular pressure. SE is decreased GFR

Question 15

Most common cause of end stage renal disease

Answer 15

diabetes

Question 16

How long after diagnosis does microalbuminuria typically develop in diabetics?

Answer 16

10-15 yrs

Question 17

Pathognomic lesion in diabetic nephropathy

Answer 17

nodular glomerulosclerosis

Question 18

What medications lower the rate of progression to clinical proteinuria/ESRD?

Answer 18

ACI and ARBs

Question 19

Poorest prognostic features of Type III and IV SLE nephropathy

Answer 19

elevated Cr, hematocrit <26%, black race

Question 20

Do type I and II SLE nephropathy require tx?

Answer 20

NO. Not until transformation into more active lesion

Question 21

Myeloma kidney is the presence of light chain Bence-Jones protein. How does it show up on dipstick?

Answer 21

dipstick negative proteinuria or low grade proteinuria. albumin:globulin ratio will be high

Question 22

Electrolyte disturbance associated with multiple myeloma

Answer 22

hypercalcemia and hyperuricemia

Question 23

Classic renal manifestation of TB

Answer 23

STERILE PYURIA