Nephrotic Syndrome Pathology

Question 1

The basic defect in nephrotic syndrome is ______________.

Answer 1

increased permeability of the glomerulus

Question 2

Why does hyperlipidemia arise in nephrotic syndrome?

Answer 2

In nephrotic syndrome, the body loses its albumin through the glomerulus. Hypoalbuminemia induces increased lipid synthesis. Hyperlipidemia creates a hypercoagulable state.

Question 3

Nephrotic syndrome leads to increased susceptibility to infection because of loss of ____________.

Answer 3

immunoglobulins through the glomeruli

Question 4

Loss of ___________ through the glomerulus leads to a hypercoagulable state.

Answer 4

antithrombin

Question 5

What are two non-inflammatory mechanisms of glomerular injury?

Answer 5

1) Activation of complement

2) Antibodies attacking epithelial proteins that prevent attachment of glomerular epithelial cells

Question 6

Focal segmental glomerular sclerosis will histologically display _____________.

Answer 6

higher densities of pink tissue

Question 7

FSGS has a high ________ rate with steroid treatment.

Answer 7

relapse

Question 8

What are four categories of nephrotic syndrome?

Answer 8

Idiopathic
HIV-associated
Heroin-associated
Secondary (due to a lot of causes, including any advanced renal disease)

Question 9

Why are complement and antibody forms of nephropathy considered non-inflammatory?

Answer 9

Because the chemotactic cytokines get flushed (pun-intended) down the collecting duct

Question 10

_______ percent of membranous nephropathies are associated with other diseases.

Answer 10

Fifteen

Question 11

If a glomerulus is hypercellular, what three possibilities could it be?

Answer 11

Crescent
Mesangial
Endocapillary (indicated by closed capillary loops)

Question 12

Histologically, membranoproliferative glomerulonephritis is revealed by ___________.

Answer 12

double membranes (like train tracks)

Question 13

Membranoproliferative glomerulonephritis usually presents as a mixture of __________.

Answer 13

nephritic and nephrotic syndromes

Question 14

MPGN results from ______________.

Answer 14

chronic immune deposits in the sub-epithelial space; when this happens, the endothelium creates additional basement membrane to protect itself

Question 15

In addition to the green appearance under Congo staining, amyloidosis also presents with ___________.

Answer 15

the “spilled spaghetti” sign

Question 16

The two most common causes of chronic renal failure in the United States are ___________.

Answer 16

diabetes (38%) and hypertension (25%)

Question 17

Histologically, diabetes-induced renal failure presents with _____________.

Answer 17

mesangial lysis (hypocellular areas)

Question 18

Four things can cause membranous nephropathy: _____________.

Answer 18

bugs, drugs, tumors, and rheum

Question 19

What will amyloidosis of the kidney show on histological exam?

Answer 19

Pink fluffy material

Question 20

What two kinds of kidney lesions can result from diabetes?

Answer 20

Hyaline arteriolar disease and diabetic glomerulosclerosis

Question 21

Describe the pathophysiology of malignant hypertensive renal disease.

Answer 21

A renal vascular injury leads to fibrinoid necrosis of the arteriole. The kidneys secrete more renin in response to this decrease in blood flow.

Question 22

What are the consequences of uremia in regards to these things: drugs, BUN, EPO, RAAS, and vit D?

Answer 22

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