Nephrotic Syndrome

Question 1

Brights Dz

Answer 1

Acute glomerulonephritis

Question 2

Nephrotic

Answer 2

Protein in urine but NO blood

Question 3

Nephritic syndrome

Answer 3

Protein and blood and others

Inflammatory process.

Question 4

What defines proteinuria?

Answer 4

> 3.5g / 24 hrs.

Question 5

Nephrotic etiologies

Answer 5

Systemic dz (diabetes, HIV)
NSAIDS
Minimal change dz (children)

Question 6

Minimal change dz

Answer 6

Accounts for 90% of nephrotic cases in children under age of 10.
Also occurs in older children (50%)
and adults.

Question 7

Focal and Segmental Glomerulosclerosis (FSTS)

Answer 7

Characterized by the presence in some of the glomeruli.
Segmental areas of mesangial collapse and sclerosis
Usually idiopathic, or HIV related
More common in black population

Question 8

Membranous Glomerulopathy

Answer 8

Characterized by basement membrane thickening with little or no cellular proliferation or infiltration. Electron dense deposits across the basement membrane
Generally idiopathic

Question 9

S/S nephrotic syndrome

Answer 9

Adema
HTN
acute renal failure
Protein malnutrition
Thromboelbolism
Infection
Vitamin D deficiency, hypocalcemia
Increased risk for atherosclerosis

Question 10

Nephrotic Dx

Answer 10

Spot urine. total protein/creatinine ratio

Renal biopsy required

Question 11

Which acid base disorder can hypoproteinemia lead to?

Answer 11

Persistent metabolic acidosis

Question 12

Proteinuria Tx

Answer 12

ACE, ARB
Sodium restriction
Loop diuretics
Statins

Question 13

Hypercoagulability treatment?

Answer 13

If asymptomatic, no treatment.

With thrombosis … heparin followed by warfarin for remainder of disease process

Question 14

Diabetic nephropathy

Answer 14

Most common cause of ESRD in US
Retinopathy invariably present as well
Strict glycemic control essential (ACE, ARB)

Question 15

Protein negative dipstick proteinuria =?

Answer 15

Multiple myeloma

Light chains not detected