Pathoma 12.4 Nephritic syndromes

Question 1

What are the two chcs of nephritic syndromes

Answer 1

Glomerular Infl and bleeding = hematuria

Question 2

proteinuria level in nephritic syndrome

Answer 2

< 3.5g/day

Question 3

What is seen in urine in Nephritic syndome (2)

Answer 3

RBC casts and dysmorphic RBCS

Question 4

electrolyte status in nephritic syndrome

Answer 4

salt retention

Question 5

salt retention leads to what two sequelae in Nephritic synd

Answer 5

periorbital edema and HTN

Question 6

Is azotemia present in Nephritic Synd

Answer 6

yes

Question 7

Biopsy of GLom in neph syndrome

Answer 7

hypercellular, inflammed glomeruli

Question 8

What mediates damage in nephritic Sn (4)

Answer 8

IC deposition activates complement.

C5a attracts neutrophils which do the damage

Question 9

After a GAS infx what NS arises

Answer 9

Poststretococcal Glomerulonephritis (PSGN)

Question 10

What defines a nephritogenic strain of GAS?

Answer 10

M-protein antigen

Question 11

4 things PSGN presents as

Answer 11

hematuria- coke colored urine
oliguria
HTN
periorbital edema

Question 12

PSGN usually occurs in what pop

Answer 12

children

Question 13

What hallmark is seen in EM with PSGN

Answer 13

subepithelial ‘humps’

Question 14

What is the IF in PSGN

Answer 14

granular deposits

Question 15

Crescents in Bowman’s space are comprised of what 2 things

Answer 15

fibrin and macrophages

Question 16

Crescents in BS signify what NS?

Answer 16

Rapidly Progressive Glomerulonephritis (RPGN)

Question 17

RPGN has 6 possible etiologies: name them

Answer 17

Goodpasture syndrome
PSGN
Diffuse Proliferative GN
Wegner's Granulomatosis
Churg Strauss syndrome
Microscopic Polyangiitis

Question 18

What IF finding points to Goodpasture as etiology of RPGN

Answer 18

Linear IF

Question 19

What causes linear IF on Goodpasture

Answer 19

Anti-GBM antibody

Question 20

What 3 organ systems are affected in Wegner’s

Answer 20

nasopharynx
lungs
kidneys

Question 21

What is presentation of Goodpasture synd (2)

Answer 21

hematuria, hemoptysis

Question 22

Grnaular IC deposition on IF points to what 2 dx?

Answer 22

PSGN

Diffuse Proliferative GN

Question 23

Goodpasture classically presents in what pop

Answer 23

young adult males

Question 24

What is the MC renal disease in SLE

Answer 24

Diffuse Proliferative GN

Question 25

c-ANCA and p-ANCA are associated with what syndromes, respectively (3)

Answer 25

c-ANCA = WeCner's (Wegner's)
p-ANCA = Churg Strauss or microscopic polyangiitis

Question 26

What 3 things are present in Churg-Strauss that differentiate it from microscopic polyangiitis?

Answer 26

granulomatous infl
eosinophilia
asthma

Question 27

Berger Disease (aka?) shows deposition where?

Answer 27

IgA nephropathy

IgA deposits in the mesangium

Question 28

What is the MC nephropathy worldwide

Answer 28

IgA nephropathy

Question 29

IgA nephropathy follows what

Answer 29

mucosal infx (gastroenteritis)–> increased IgA production

Question 30

How does IgA neph present?

Answer 30

in childhood with gross or microscopic hematuria

Question 31

IF in IgA neph

Answer 31

shows mesangial deposition

Question 32

progression of IgA Neph

Answer 32

slowly toward renal failure

Question 33

Alport Syndrome is a defect in what

Answer 33

type IV collagen

Question 34

Most common inheritance pattern for Alport Syndr

Answer 34

X-linked

Question 35

What happens to GBM in Alport synd (2)

Answer 35

“thinning and splitting”

Question 36

What is the presentation of Alport Synd (3)

Answer 36

hearing loss (sensory), ocular disturbances, oliguria

Question 37

hallmark of Alport

Answer 37

isolated Hematuria