Nephrotic vs Nephritic

Question 1

Nephrotic Syndrome

Answer 1

Proteinuria (>3.5g/d)

Hypoalbuminemia (

Question 2

Nephritic Syndrome

Answer 2

Decreased renal function
Hypertension
RBC and RBC casts
Edema
Proteinuria (

Question 3

nephrotic

general management

Answer 3

low salt diet
diuretics
BP control
Other:
-cholesterol lowering drugs
-ACE inhibitors
-vitamin D
-normal/low protein diet

Question 4

glomerular diseases
primarily renal
nephritic

Answer 4

post strep GN
IgA nephropathy
RPGN
-anti-GMB
-idiopathic

Question 5

glomerular diseases
primarily renal
nephrotic

Answer 5

hereditary nephrotic syndromes
minimal change disease (MCD)
focal segmental glomerulosclerosis
membranous nephropathy (MN)
membranoproliferative GN (MPGN)

Question 6

glomerular diseases
systemic
nephrotic

Answer 6

diabetes
amyloid and light chain disease
SLE (membranous)

Question 7

glomerular diseases
systemic
nephritic

Answer 7

vasculitis
immune complex
-SLE
-HSP

Question 8

Minimal Change Disease

Presentation

Answer 8

Peak incidence: 2-6 y/o
more common in males
Edema, ascites,
Hypertension (20%)

Question 9

minimal change disease

labs

Answer 9

renal function is normal or slightly depressed

urinalysis: 4+ proteinuria, hyaline casts, rare microscopic hematuria

Question 10

minimal change disease

associations

Answer 10

history of allergy/atopy
Hodgkin’s lymphoma
nonsteroidal drugs (idiosyncratic rxn)

Question 11

minimal change disease

pathophysiology

Answer 11

T cell disorder??
loss of charge barrier
effacement of podocytes

Question 12

Focal Segmental Glomerulosclerosis

presentation

Answer 12

proteinuria, hypertension

urinary sediment often w/ RBCs

Question 13

FSGS treatment

Answer 13

Steroids (6 mo); relapse is high

Question 14

most common cause of nephrotic syndrome in young adults and African Americans

Answer 14

focal segmental glomerulosclerosis (FSGS)

Question 15

FSGS etiology

Answer 15

Idiopathic or related to previous minimal change disease
IV heroin
HIV
Other (sickle cell, obesity)

Question 16

HIV Nephropathy

Answer 16

Collapsing focal and segmental glomerulosclerosis, reticuloendothelial inclusions
5-10% of all AIDS patients
80% black, 50% IVDA

Question 17

HIV Nephropathy treatment

Answer 17

Anti-retrovirals

Question 18

FSGS pathogenesis

Answer 18

circulating factor: soluble UPAR

pathology factor: APO lipoprotein L1

Question 19

Membranous nephropathy (MN) etiology

Answer 19

Primary (idiopathic): due to antibodies to phospholipase A2 on the podocyte
Secondary:
Hepatitis B; Drugs (gold, mercury); SLE; Cancer

Question 20

Membranous nephropathy

types of cancer

Answer 20

carcinoma

lung, breast, GI tract, renal

Question 21

Membranoproliferative glomerular nephropathy (MPGN)

associations

Answer 21

Hepatitis C
Nephrotic or nonnephrotic proteinuria, hypertension, elevated creatinine
low C3 and C4 (complement disorder)
treat with interferons

Question 22

nephritic syndrome

Answer 22

Reduction in GFR (elevated serum creatinine)
Active urine sediment (RBC, WBC, RBC casts)
Proteinuria (usually sub-nephrotic)
Edema
Hypertension

Question 23

glomerulonephritis workup

Answer 23

CBC
electrolytes
24 hr urine
liver function tests
serologies (?)