Nephrotic Syndrome

Question 1

Nephrotic syndrome is characterized by ___________.

Answer 1

high protein urine; hypoalbuminemia; edema; hyperlipidemia; lipiduria

Question 2

Nephrologists think that ____________ causes nephrotic syndrome.

Answer 2

destruction of podocytes or inter-podocyte proteins

Question 3

Nephrotic syndrome leads to increased risk of ____________.

Answer 3

coagulation (decreased anti-thrombin), infections (loss of Ig), and decreased vitamin D

Question 4

These treatments are all indicated for nephrotic syndrome: ______________.

Answer 4

BP control
Diuretics
Low salt diets
Cholesterol lowering drugs
ACE inhibitors 
Vitamin D supplements

Question 5

Minimal change disease has a peak incidence from age _____ to ______.

Answer 5

2; 8

Question 6

Podocytes express ________ in minimal change disease.

Answer 6

CD80

Question 7

Hereditary nephrotic syndrome presents in ___________.

Answer 7

infancy

Question 8

Hereditary nephrotic syndrome does not respond to _____; it requires _________.

Answer 8

steroids; transplantation

Question 9

Those with relapsing minimal change disease are often given ____________.

Answer 9

cytoxan

Question 10

What are some associations with focal segmental glomerulosclerosis?

Answer 10

Being African American
Age 20-40
Sickle cell
HIV
APOL1polymorphisms

Question 11

What are some treatments for focal segmental glomerulosclerosis?

Answer 11

Cyclosporine

Corticosteroids

Question 12

HIV glomerulosclerosis presents with _________.

Answer 12

tubular dilations

Question 13

Membranous nephropathy can be caused by ___________.

Answer 13

HBV
Cancer
Idiopathic
Heavy metals
SLE

Question 14

Histologically, membranous nephropathy is characterized by ____________.

Answer 14

thickened glomberular membrane with immune complex deposits, projections on silver stain, and subepithelial deposits

Question 15

What are treatments for membranous nephropathy?

Answer 15

Coricosteroids

Cytoxan

Question 16

___________ have interdigitating foot processes.

Answer 16

Podocytes

Question 17

What protein connects podocytes together (across their slit diaphragms)?

Answer 17

Nephrin

Question 18

What are the five kinds of primary renal nephrotic syndrome?

Answer 18

Focal segmental glomerulosclerosis
Membranoproliferative glomerulonephritis
Membranous nephropathy
Minimal change disease
Hereditary nephrotic syndrome

Question 19

Lipiduria presents as ___________ in the urine.

Answer 19

“Maltese crosses”

Question 20

What are the two most common kinds of nephrotic syndrome in adults? And in children?

Answer 20

Adults: membranous nephropathy (most common in fifth and sixth decades) and FSGS
Children: minimal change disease and a tie between membranous nephropathy and FSGS

Question 21

Histologically, minimal change disease will be ______________.

Answer 21

negative to immunofluorescence and light microscopy, but will show podocyte foot fusion on electron micrographs

Question 22

FSGS is usually __________.

Answer 22

idiopathic

Question 23

HIV nephropathy responds to __________ treatment.

Answer 23

HAART

Question 24

What percent of AIDS patients have HIV nephropathy?

Answer 24

5% - 10%

Question 25

What type of nephrotic syndrome is associated with HCV?

Answer 25

Membranproliferative nephropathy

Question 26

What cell secretes the glomerular basement membrane?

Answer 26

The mesangial cell

Question 27

Excretion of greater than 30 mg per day of albumin is indicative of ____________.

Answer 27

glomerular damage; less than 300 mg per day is not detectable with urine dipsticks and is called microalbuminuria

Question 28

___________ presents with subendothelial deposits.

Answer 28

Membranoproliferative glomerulonephritis

Question 29

Minimal change disease is twice as common in _________.

Answer 29

males

Question 30

Over seventy percent of idiopathic __________ is due to antibodies to phospholipases on podocytes.

Answer 30

membranous nephropathy

Question 31

Hereditary nephrotic syndrome can be treated with _________.

Answer 31

ACE inhibitors (to reduce proteinuria)