Norton Flashcards
Hematuria, RBC casts in urine
Nephritic syndrome
Azotemia, hypertension, mild proteinuria, edema, oliguria
Nephritic syndrome
Acute proliferative glomerulonephritis (post streptococcal/post infectious), nonstreptococcal acute glomerulonephritis, and rapidly progressive crescent glomerulonephritis
Nephritic syndrome
1-4wks post strep infection, children 6-10 yrs
Acute proliferative glomerulonephritis
Group A beta hemolytic strep
Acute proliferative glomerulonephritis
Immune complex mediated with granular immune deposits in glomeruli
Acute proliferative glomerulonephritis
Increased anti-strep antibodies and decreased complement levels
Acute proliferative glomerulonephritis
Light microscopy shows proliferation > Hypercellular glomeruli. Neutrophil and Monocyte infiltration
Acute proliferative glomerulonephritis
EM shows humps of immune complexes subepithelially (on epithelial side of BM)
Acute proliferative glomerulonephritis
Immunofluorescence shows granular deposits of IgG, IgM, and C3 along mesangium and GBM
Acute proliferative glomerulonephritis
Abrupt onset oliguria, hematuria, peri-orbital edema, hypertension, mild proteinuria, RBC casts
Acute proliferative glomerulonephritis
> 95% children recover with conservative trainer with Na and water balance
Acute proliferative glomerulonephritis
Adults more atypical. Have sudden onset HTN, edema, and ^ BUN. Only 60% recover promptly. Over 40% get persistent proteinuria, hematuria, HTN, chronic glomerulonephritis, rapidly progressive glomerulonephritis
Acute proliferative glomerulonephritis
After other bacterial, viral, or parasitic infection. Immunofluorescence shows granular deposits and EM shows subepithelia humps
Nonstreptococcal acute glomerulonephritis
Inflammatory rupture of glomerular capillaries > bleeding into urinary space
Nephritic syndrome
Severe glomerular injury causes rapid and progressive loss of renal function. Severe oliguria. Caused by ruptures in GBM
Rapidly progressive (crescent) glomerulonephritis
Immunologically mediated with crescent formation
Rapidly progressive (crescent) glomerulonephritis
Crescents (proliferation of parietal epithelial cells lining Bowman’s capsule) from ruptures in GBM allowing leakage into urinary space
Rapidly progressive (crescent) glomerulonephritis
Crescents formed from proliferation of _____ epithelial cells lining Bowman’s space
Parietal
Has 3 types and untreated results in death in weeks/months
Rapidly progressive (crescent) glomerulonephritis
Can be renal limited or progress to goodpasture’s syndrome
Rapidly progressive (crescent) glomerulonephritis - type one
Anti-GBM abs that cross rx with pulmonary alveolar BM
Goodpastures. Rapidly progressive (crescent) glomerulonephritis - type one
Light microscopy > crescents.
Immunofluorescence > Ig and complement linearly along GBM.
EM > ruptures in GBM
Rapidly progressive (crescent) glomerulonephritis - type one
