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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
Q

2 things that promote platelet production and aggregation

A

hypoalbuminemia
hypercholesterolemia

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26
Q

to treat thrombembolic complications

A

anticoags (not heparin b/c low anti-thrombin III already)

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27
Q

effects of hyperlipidemia and lipiduria

A

increased cholesterol
TG’s
LDL
and decreased HDL

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28
Q

treat hyperlipidemia

A

statins and ACEIs/ARBs

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29
Q

goal serum LDL for nephrotic patients

A

<70

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30
Q

why are nephrotic patients susceptible to infections

A

low levels of IgG (lost in urine)

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31
Q

primary nephrotic syndrome seen in children

A

minimal change disease

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32
Q

primary nephrotic syndrome seen in adults

A

focal and segmental glomerular sclerosis

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33
Q

primary nephrotic syndrome seen in adults >60

A

membranous nephropathy

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34
Q

children
proteinuria
edema
low GFR

A

Minimal change disease

35
Q

EM:

A

minimal change disease

36
Q

light microscopy normal in this nephrotic syndrome

A

minimal change disease

37
Q

this syndrome can be associated with hematologic malginancies

A

minimal change disease

38
Q

main treatment for minimal change disease

A

glucocorticoids

39
Q
A

focal segmental glomerular sclerosis

40
Q

affects some of the glomeruli and parts of the glomeruli

A

focal segmental glomerular sclerosis

41
Q

18-35 yr old african american seen with high proteinuria

A

FSGS

42
Q
A

FSGS collapsing variant

43
Q

what causes FSGS collapsing variant

A

HIV, COVID, SLE, drug use

44
Q

acute onset causes ____ FSGS

A

primary

45
Q

maladaptive response to hyperfiltration causes what

A

secondary FSGS

46
Q

nephron loss can cause what

A

secondary FSGS

47
Q

drugs and toxins can cause what

A

FSGS

48
Q

viruses can cause what

A

secondary FSGS

49
Q

main treatment for primary FSGS

A

glucocorticoids

50
Q

have to rule out malignancies w/ this nephrotic syndrome

A

membranous nephropathy

51
Q

high risk for thromboembolic disease with this nephrotic syndrome

A

membranous nephropathy

52
Q

what to look at to differentiate b/t primary and secondary membranous nephropathy

A

serum PLA2R Ab’s

53
Q

2 main causes of secondary membranous nephropathy

A

Hep B
carcinoma

54
Q

to diagnose membranous nephropathy

A

renal biopsy

55
Q

what would you expect to see in histologic slide of membranous nephropathy

A

basement membrane thickening
deposits in subepithelial GBM
spikes

56
Q

thickened GBM

A

membranous nephropathy

57
Q
A

subepithelial deposits seen in membranous nephropathy

58
Q
A

spikes seen in membranous nephropathy

59
Q

treatment for membranous nephropathy is based on what

A

risk of progression

60
Q

treatment of membranous nephropathy with high risk for progression

A

glucocorticoids + cyclophosphamide

61
Q

nephrotic syndrome due to extracellular deposits of beta pleated sheets

A

Amyloidosis

62
Q

stain used to detect amyloidosis

A

congo red

63
Q

this is indicative of amyloidosis when ____ turns apple-green birefringence under ____ light

A

congo red; polarized

64
Q
A

Amyloidosis

65
Q

primary amyloidosis

A

AL

66
Q

secondary amyloidosis

A

AA

67
Q

neoplastic proliferation of plasma cells that can cause nephrotic syndrome

A

multiple myeloma

68
Q

bone pain
increased total serum protein
-mabs in serum or urine
anemia
proteinuria

A

multiple myeloma

69
Q

due to Hep B and C infections (more hep C)

A

membranoproliferative glomerulonephrosis (MPGN)

70
Q

can also be due to autoimmune disorders

A

MPGN

71
Q

to treat MPGN

A

glucocorticoids

72
Q

sickle cell disease can lead to what two nephrotic syndromes

A

FSGS
MPGN

73
Q

Heavy proteinuria
>3.5 grams/ 24 hours

Hypoalbuminemia

Peripheral edema

Hyperlipidemia

A

nephrotic syndrome

74
Q

urine microscopy shows lipid droplets, oval fat bodies, and fatty casts

A

nephrotic syndrome

75
Q
A

maltese crosses (nephrotic syndrome)

76
Q

goal LDL for nephrotic syndrome

A

<70 mg/dl

77
Q

FSGS collapsing variant
tubuloreticular inclusions

A

HIV

78
Q

30 yr old african american male w/ nephrotic syndrome

A

FSGS

79
Q

Hep B mainly associated with what nephrotic syndrome

A

membranous nephropathy

80
Q

Hep C mainly associated with what nephrotic syndrome

A

MPGN

81
Q

65 yr old male, membranous nephropathy; what to screen for

A

malignancy

82
Q

Renal vein thrombosis.MCD, FSGS or Membranous?

A

membranous (high risk for thromboembolism)

83
Q

urine test to order

A

urine protein/creatinine ratio

URN Biweekly 1 (21 decks)

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