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TCD 23 - Glomerulonephritis and PKD > Nephrotic Syndrome > Flashcards

Nephrotic Syndrome Flashcards

1
Q

What are the clinical syndromes of glomerulonephritis?

A
  • Isolated haematuria/proteinuria or haematoproteinuria
  • Nephrotic syndrome
  • Acute glomerulonephritis (acute nephritic syndrome)
  • Rapidly progressive glomerulonephritis (RPGN)
  • Chronic kidney disease (ESRD)
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2
Q

What happens in nephrotic syndrome?

A

Podocytes are not working

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3
Q

What is the triad of nephrotic syndrome?

A 
o	Proteinuria (>3.5g/24hrs)
o	Oedema -> peripheral, periorbital, pulmonary 
o	Hypoalbuminaemia (<30g/L)
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4
Q

Why do you get hypercholesterolaemia in nephrotic syndrome?

A

o Liver compensates for decreased albumin and increases its production which causes increased production of lipids too

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5
Q

Why is there a hypercoagulable state in nephrotic syndrome?

A

• Antithrombin-III, protein C and S are filtered out of the blood and lost

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6
Q

What is the most common cause of nephrotic syndrome in children?

A

Minimal change glomerulonephritis

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7
Q

What is the most common cause of nephrotic syndrome in adults?

A

Membranous glomerulonephritis

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8
Q

What is minimal change disease?

A

Electron microscopy

- Effacement of podocytes

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9
Q

What is minimal change disease associated with?

A
  • NSAIDs
  • Rifampicin
  • Hodgkin’s lymphoma
  • Thymoma
  • Infectious monoucleosis
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10
Q

What is focal segmental glomerulosclerosis (FSGS)?

A

Segmental scarring in glomerulus

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11
Q

What is focal segmental glomerulosclerosis (FSGS) associated with?

A
  • HIV
  • Obesity
  • Reflux nephropathy
  • Healing of previous glomerular injury
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12
Q

What is membranous glomerulonephritis?

A
  • Thickening of GBM
  • IgG and complement deposits
    ‘Spike and dome’ appearance
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13
Q

What is the age range of membranous glomerulonephritis?

A

Bimodal

  • 20s
  • 60s
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14
Q

What is membranous glomerulonephritis associated with?

A
  • Hepatitis B
  • SLE
  • Malignancy
  • ADR (gold, penicillamine, NSAIDs)
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15
Q

What is the management of membranous glomerulonephritis?

A
  • ACEi/ARB

* Corticosteroid + cyclophosphamide

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16
Q

What is membranoproliferative glomerulonephritis?

A

Immune deposits in GBM and mesangium

17
Q

What would a renal biopsy of diabetic nephropathy show?

A

Nodules in the mesangium known as Kimmelstiel-Wilson lesions

18
Q

What is the management of nephrotic syndrome?

A 
o	Salt restriction 
o	Fluid restriction
o	Diuretics
o	ACEi/ARB
o	Anticoagulation

TCD 23 - Glomerulonephritis and PKD (6 decks)

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