Pathology of Nephritic Syndrome Flashcards

1
Q

The presence of crescents correlates with ______ and carries a ______ prognosis.

A

RPGN; poor

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1
Q

What is cryoglobinemia?

A

Antibodies that precipitate in the cold and cause a small vessel vasculitis

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2
Q

Name 5 characterstics of nephritic syndrome.

A
  1. Reduction in GFR (an elevated serum creatinine) 
  2. Active urine sediment (RBC’s, WBC’s, and RBC casts)
  3. Proteinuria (usually sub-nephrotic) 
  4. Edema 
  5. Hypertension
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2
Q

The presence of ______ correlates with RPGN and carries an ominous prognosis.

A

crescents

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2
Q

What is the tx for Post-infectious Glomerulonephritis?

A

none- it’s usually self limiting

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4
Q

Positive ANA and Anti-DS DNA indicates?

A

lupus

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5
Q

What are the path findings in IgA nephropathy?

A
  • Light microscopy shows an increase in mesangial cell number and matrix
  • IF shows IgA, IgG, and C3 in a mesangial pattern
  • EM shows mesangial immune deposits.
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5
Q

This is IgA nephropathy with fever, rash, GI complaints, and renal disease.

A

Henoch-Schonlein purpura

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6
Q

What do the following findings indicate?

  • IgG, IgM, C3 deposition on the GBM with subepithelial humps
  • Infiltrates of PMNs and monocytes
A

Post-infectious Glomerulonephritis

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7
Q

What is another name or Bergers Syndrome?

A

IgA nephropathy

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7
Q

What is the tx for Alport Syndrome?

A

none

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8
Q

Patients with _____ have hematuria, dysmorphic red blood cells and/or red blood cell casts, and proteinuria.

A

nephritic syndrome

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8
Q

What do these findings indicate?

  • Lumpy bumpy
  • C3, IgG, IgM, IgA, and C1q
  • mesangial, subendo, and subepi deposits
A

Lupus Nephritis

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9
Q

What is Henoch-Schonlein purpura?

A

IgA nephropathy with fever, rash, GI complaints, and renal disease

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10
Q

What are the pathologic findings of Post-infectious Glomerulonephritis?

A
  • IgG, IgM, C3 deposition on the GBM with subepithelial humps
  • Infiltrates of PMNs and monocytes
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10
Q

This is a form of mesangial proliferative glomerulonephritis in which there is a predominance of IgA immune deposits in the mesangium and rarely in subendothelial areas.

A

IgA nephropathy

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11
Q

What do the following pathological findings indicate?

  • Light microscopy shows an increase in mesangial cell number and matrix
  • IF shows IgA, IgG, and C3 in a mesangial pattern
  • EM shows mesangial immune deposits
A

IgA nephropathy

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12
Q

Low C4 with + Rheumatoid factor is indicative of?

A

cryoglobinemia

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13
Q

What are the positive lab findings for cryoglobinemia?

A
  • Low C4
  • Rheumatoid factor
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15
Q

What nephritic syndrome occurs after a group A strep infection?

A

Post-infectious Glomerulonephritis

15
Q

What are the pathology findings in Lupus Nephritis?

A
  • Lumpy bumpy
  • C3, IgG, IgM, IgA, and C1q mesangial, subendo, and subepi deposits
16
Q

This is an X-linked disorder of type IV collagen.

A

Alport Syndrome

17
Q

What are the pathologic findings of Pauci-Immune Renal Vasculitis?

A
  • No immune complex deposition
  • Fibroid necrosis and crescents
    • p-ANCA to MPO and PR-3
18
Q

What is the tx for cryoglobinemia?

A
  • Antivirals
  • rituximab
  • plasmapheresis
20
What do these characteristics indicate?  * Reduction in GFR (an elevated serum creatinine) * Active urine sediment (RBC's, WBC's, and RBC casts) * Proteinuria (usually sub-nephrotic)  * Edema  * Hypertension
nephritic syndrome
22
Why is GFR reduced in nephritic syndrome?
the inflammatory process within the glomerulus results in glomerular vasoconstriction and/or occlusion or thrombosis
24
Lesions on light microscopy are termed _____ if they involve part of one glomerulus; _____ is the word used if only some glomeruli are involved.
segmental; focal
26
What lab findings indicate Post-infectious Glomerulonephritis?
* positive ASO * decreased C3
27
In light microscopy, _____ are a special term when there is a proliferation of cells in Bowman’s capsule.
crescents
29
How does Post-infectious Glomerulonephritis usually present?
sudden onset edema and weight gain
30
Which nephritis presents concurrently with a viral infection?
Bergers/IgA nephropathy
32
\_\_\_\_\_\_ is the most common type of acute glomerulonephritis now seen worldwide and usually presents in males 15 to 35 years old.
IgA nephropathy
33
What do these path findings indicate? * No immune complex deposition * Fibroid necrosis and crescents * + p-ANCA to MPO and PR-3
Pauci-Immune Renal Vasculitis
34
IgA nephropathy is the most common type of acute glomerulonephritis now seen worldwide and usually presents in \_\_\_\_\_.
males 15 to 35 years old
35
Nephritic syndrome is caused by \_\_\_\_\_.
glomerular inflammation
36
Positive ASO with decreased C3 indicates?
Post-infectious Glomerulonephritis
37
What is another name for IgA nephropathy?
Bergers Syndrome
38
Positive ASO indicates?
post-infectious/post-strep nephritis
38
What is the tx for Pauci-Immune Renal Vasculitis?
* Steroids + cyclophosphamide or rituximab * plasma exchange
39
What 2 syndromes are associated with cryoglobinemia?
* HCV * Sjögren’s syndrome
40
Post-infectious Glomerulonephritis occurs after ____ infection.
group A strep
41
What is IgA nephropathy?
a form of mesangial proliferative glomerulonephritis in which there is a predominance of IgA immune deposits in the mesangium and rarely in subendothelial areas
42
What is the tx for Bergers/IgA nephropathy?
* ACEI/ARBs * Steroids +/- azathioprine
44
What are these path findings associated with? Membranoproliferative pattern with subendo immune deposits of IgM Fingerprint pattern of appearance
cryoglobinema
45
Positive Anti-neutrophil cytoplasmic antibodies (ANCA) indicates?
Pauci-immune vasculitis
46
What are Sjögren’s syndrome and HCV associated with?
cryoglobinemia
47
What is the tx for Lupus Nephritis?
* High dose corticosteroids * mycophenolate mofetil * cyclophosphamide
48
Positive Anti-GBM antibodies indicates?
Anti-GBM disease, Goodpasture’s syndrome
49
What are the pathologic findings of cryoglobinemia?
Membranoproliferative pattern with subendo immune deposits of IgM Fingerprint pattern of appearance