Nephrotic Syndrome Pathology Flashcards
The basic defect in nephrotic syndrome is ______________.
increased permeability of the glomerulus
Why does hyperlipidemia arise in nephrotic syndrome?
In nephrotic syndrome, the body loses its albumin through the glomerulus. Hypoalbuminemia induces increased lipid synthesis. Hyperlipidemia creates a hypercoagulable state.
Nephrotic syndrome leads to increased susceptibility to infection because of loss of ____________.
immunoglobulins through the glomeruli
Loss of ___________ through the glomerulus leads to a hypercoagulable state.
antithrombin
What are two non-inflammatory mechanisms of glomerular injury?
1) Activation of complement
2) Antibodies attacking epithelial proteins that prevent attachment of glomerular epithelial cells
Focal segmental glomerular sclerosis will histologically display _____________.
higher densities of pink tissue
FSGS has a high ________ rate with steroid treatment.
relapse
What are four categories of nephrotic syndrome?
Idiopathic
HIV-associated
Heroin-associated
Secondary (due to a lot of causes, including any advanced renal disease)
Why are complement and antibody forms of nephropathy considered non-inflammatory?
Because the chemotactic cytokines get flushed (pun-intended) down the collecting duct
_______ percent of membranous nephropathies are associated with other diseases.
Fifteen
If a glomerulus is hypercellular, what three possibilities could it be?
Crescent
Mesangial
Endocapillary (indicated by closed capillary loops)
Histologically, membranoproliferative glomerulonephritis is revealed by ___________.
double membranes (like train tracks)
Membranoproliferative glomerulonephritis usually presents as a mixture of __________.
nephritic and nephrotic syndromes
MPGN results from ______________.
chronic immune deposits in the sub-epithelial space; when this happens, the endothelium creates additional basement membrane to protect itself
In addition to the green appearance under Congo staining, amyloidosis also presents with ___________.
the “spilled spaghetti” sign
The two most common causes of chronic renal failure in the United States are ___________.
diabetes (38%) and hypertension (25%)
Histologically, diabetes-induced renal failure presents with _____________.
mesangial lysis (hypocellular areas)
Four things can cause membranous nephropathy: _____________.
bugs, drugs, tumors, and rheum
What will amyloidosis of the kidney show on histological exam?
Pink fluffy material
What two kinds of kidney lesions can result from diabetes?
Hyaline arteriolar disease and diabetic glomerulosclerosis
Describe the pathophysiology of malignant hypertensive renal disease.
A renal vascular injury leads to fibrinoid necrosis of the arteriole. The kidneys secrete more renin in response to this decrease in blood flow.
What are the consequences of uremia in regards to these things: drugs, BUN, EPO, RAAS, and vit D?
Drugs: renally cleared drugs will rise in concentration
BUN: will rise
EPO: will lower (because the kidneys make it) and anemia results
RAAS: will increase, because the kidneys sense decreased flow
Vit D: osteomalacia
