Pathoma 12.4 Nephritic syndromes Flashcards
What are the two chcs of nephritic syndromes
Glomerular Infl and bleeding = hematuria
proteinuria level in nephritic syndrome
< 3.5g/day
What is seen in urine in Nephritic syndome (2)
RBC casts and dysmorphic RBCS
electrolyte status in nephritic syndrome
salt retention
salt retention leads to what two sequelae in Nephritic synd
periorbital edema and HTN
Is azotemia present in Nephritic Synd
yes
Biopsy of GLom in neph syndrome
hypercellular, inflammed glomeruli
What mediates damage in nephritic Sn (4)
IC deposition activates complement.
C5a attracts neutrophils which do the damage
After a GAS infx what NS arises
Poststretococcal Glomerulonephritis (PSGN)
What defines a nephritogenic strain of GAS?
M-protein antigen
4 things PSGN presents as
hematuria- coke colored urine
oliguria
HTN
periorbital edema
PSGN usually occurs in what pop
children
What hallmark is seen in EM with PSGN
subepithelial ‘humps’
What is the IF in PSGN
granular deposits
Crescents in Bowman’s space are comprised of what 2 things
fibrin and macrophages
Crescents in BS signify what NS?
Rapidly Progressive Glomerulonephritis (RPGN)
RPGN has 6 possible etiologies: name them
Goodpasture syndrome PSGN Diffuse Proliferative GN Wegner's Granulomatosis Churg Strauss syndrome Microscopic Polyangiitis
What IF finding points to Goodpasture as etiology of RPGN
Linear IF
What causes linear IF on Goodpasture
Anti-GBM antibody
What 3 organ systems are affected in Wegner’s
nasopharynx
lungs
kidneys
What is presentation of Goodpasture synd (2)
hematuria, hemoptysis
Grnaular IC deposition on IF points to what 2 dx?
PSGN
Diffuse Proliferative GN
Goodpasture classically presents in what pop
young adult males
What is the MC renal disease in SLE
Diffuse Proliferative GN
c-ANCA and p-ANCA are associated with what syndromes, respectively (3)
c-ANCA = WeCner's (Wegner's) p-ANCA = Churg Strauss or microscopic polyangiitis
What 3 things are present in Churg-Strauss that differentiate it from microscopic polyangiitis?
granulomatous infl
eosinophilia
asthma
Berger Disease (aka?) shows deposition where?
IgA nephropathy
IgA deposits in the mesangium
What is the MC nephropathy worldwide
IgA nephropathy
IgA nephropathy follows what
mucosal infx (gastroenteritis)–> increased IgA production
How does IgA neph present?
in childhood with gross or microscopic hematuria
IF in IgA neph
shows mesangial deposition
progression of IgA Neph
slowly toward renal failure
Alport Syndrome is a defect in what
type IV collagen
Most common inheritance pattern for Alport Syndr
X-linked
What happens to GBM in Alport synd (2)
“thinning and splitting”
What is the presentation of Alport Synd (3)
hearing loss (sensory), ocular disturbances, oliguria
hallmark of Alport
isolated Hematuria
