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URN Biweekly 1 > Nephrotic Syndrome- Bessette > Flashcards

Nephrotic Syndrome- Bessette Flashcards

1
Q

3 signs that make up nephrotic syndrome

A

hypoalbuminemia
peripheral edema
hyperlipidemia

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2
Q

foamy urine sign of

A

nephrotic syndrome

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3
Q

what to order if you see foamy urine

A

urine protein/creatinine ratio

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4
Q

what 3 things to look for on nephrotic urinalysis microscopy

A

lipid droplets
oval fat bodies
fatty casts

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5
Q
A

lipid droplets

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6
Q
A

oval fat body (foam cell)

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7
Q
A

fatty cast

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8
Q
A

maltese crosses

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9
Q

maltese crosses are pathognomonic for what

A

nephrotic syndrome

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10
Q

disruption of GBM causes what to be seen in urine

A

protein

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11
Q

what is seen with the podocytes when there is proteinuria

A

podocyte foot process effacement

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12
Q

what 2 proteins help maintain filtration slit diaphragm

A

Neph and FAT

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13
Q
A

podocyte effacement (proteinuria)

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14
Q

gold standard for diagnosing nephrotic syndrome

A

renal biopsy

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15
Q

urine protein/creatitine ratio > ? to diagnose nephrotic syndrome

A

> 3.5 gm/gm

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16
Q

Treat the underlying cause
Reduction of Proteinuria
Control of Blood Pressure
Consideration of prevention of atherosclerosis related events
Monitoring for and prevention of infection
Prevention / treatment of hypercoagulability

A

treatment for nephrotic syndrome

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17
Q

to evaluate proteinuria

A

serology

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18
Q

to treat proteinuria

A

ACEIs/ARBs
moderate protein diet

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19
Q
A

edema is a complication of nephrosis

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20
Q

primarily due to Na+ retention (water reabsorption)

A

edema

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21
Q

to treat edema

A

monitor for hypovolemia in vasculature
ACEIs/ARBs
diuretics
Na+ and fluid restriction

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22
Q

Edema
Thrombosis
Hyperlipidemia
Infection
Bone disease

A

complications of nephrosis

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23
Q

thromboembolic complications of nephrosis

A

DVT
PE
RVT

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24
Q
A

renal vein thrombosis

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25
2 things that promote platelet production and aggregation
hypoalbuminemia hypercholesterolemia
26
to treat thrombembolic complications
anticoags (not heparin b/c low anti-thrombin III already)
27
effects of hyperlipidemia and lipiduria
increased cholesterol TG's LDL and decreased HDL
28
treat hyperlipidemia
statins and ACEIs/ARBs
29
goal serum LDL for nephrotic patients
<70
30
why are nephrotic patients susceptible to infections
low levels of IgG (lost in urine)
31
primary nephrotic syndrome seen in children
minimal change disease
32
primary nephrotic syndrome seen in adults
focal and segmental glomerular sclerosis
33
primary nephrotic syndrome seen in adults >60
membranous nephropathy
34
children proteinuria edema low GFR
Minimal change disease
35
EM:
minimal change disease
36
light microscopy normal in this nephrotic syndrome
minimal change disease
37
this syndrome can be associated with hematologic malginancies
minimal change disease
38
main treatment for minimal change disease
glucocorticoids
39
focal segmental glomerular sclerosis
40
affects some of the glomeruli and parts of the glomeruli
focal segmental glomerular sclerosis
41
18-35 yr old african american seen with high proteinuria
FSGS
42
FSGS collapsing variant
43
what causes FSGS collapsing variant
HIV, COVID, SLE, drug use
44
acute onset causes ____ FSGS
primary
45
maladaptive response to hyperfiltration causes what
secondary FSGS
46
nephron loss can cause what
secondary FSGS
47
drugs and toxins can cause what
FSGS
48
viruses can cause what
secondary FSGS
49
main treatment for primary FSGS
glucocorticoids
50
have to rule out malignancies w/ this nephrotic syndrome
membranous nephropathy
51
high risk for thromboembolic disease with this nephrotic syndrome
membranous nephropathy
52
what to look at to differentiate b/t primary and secondary membranous nephropathy
serum PLA2R Ab's
53
2 main causes of secondary membranous nephropathy
Hep B carcinoma
54
to diagnose membranous nephropathy
renal biopsy
55
what would you expect to see in histologic slide of membranous nephropathy
basement membrane thickening deposits in subepithelial GBM spikes
56
thickened GBM
membranous nephropathy
57
subepithelial deposits seen in membranous nephropathy
58
spikes seen in membranous nephropathy
59
treatment for membranous nephropathy is based on what
risk of progression
60
treatment of membranous nephropathy with high risk for progression
glucocorticoids + cyclophosphamide
61
nephrotic syndrome due to extracellular deposits of beta pleated sheets
Amyloidosis
62
stain used to detect amyloidosis
congo red
63
this is indicative of amyloidosis when ____ turns apple-green birefringence under ____ light
congo red; polarized
64
Amyloidosis
65
primary amyloidosis
AL
66
secondary amyloidosis
AA
67
neoplastic proliferation of plasma cells that can cause nephrotic syndrome
multiple myeloma
68
bone pain increased total serum protein -mabs in serum or urine anemia proteinuria
multiple myeloma
69
due to Hep B and C infections (more hep C)
membranoproliferative glomerulonephrosis (MPGN)
70
can also be due to autoimmune disorders
MPGN
71
to treat MPGN
glucocorticoids
72
sickle cell disease can lead to what two nephrotic syndromes
FSGS MPGN
73
Heavy proteinuria >3.5 grams/ 24 hours Hypoalbuminemia Peripheral edema Hyperlipidemia
nephrotic syndrome
74
urine microscopy shows lipid droplets, oval fat bodies, and fatty casts
nephrotic syndrome
75
maltese crosses (nephrotic syndrome)
76
goal LDL for nephrotic syndrome
<70 mg/dl
77
FSGS collapsing variant tubuloreticular inclusions
HIV
78
30 yr old african american male w/ nephrotic syndrome
FSGS
79
Hep B mainly associated with what nephrotic syndrome
membranous nephropathy
80
Hep C mainly associated with what nephrotic syndrome
MPGN
81
65 yr old male, membranous nephropathy; what to screen for
malignancy
82
Renal vein thrombosis. MCD, FSGS or Membranous?
membranous (high risk for thromboembolism)
83
urine test to order
urine protein/creatinine ratio

URN Biweekly 1 (21 decks)

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