Pathoma Nephrotic Syndromes Flashcards
nephrotic syndrome is characterized by what in the urine?
- protein
> 3.5g/day
nephrotic syndrome characterized by proteinuria along with
- hypoalbuminemia
- hypogammaglobulinemia
- hyper coagulable state
- hiperlipidemia and hypercholesterolemia
hypoalbuminemia causes
- pitting edema
hypogammaglobulinemia causes
- increased risk of ifnection
hyper coagulable state in nephrotic syndrome due to
- loss of antithrombin III
result of hyperlipidemia and hypercholesterolism
- fatty casts in urine
what is the most common cause of nephrotic syndrome in children
- minimal change disease
minimal change disease associated with
- Hodgkin lymphoma
minimal change disease - on H&E stain
- normal glomeruli
minimal change disease - pathology
- effacement of foot process
minimal change disease - immune complex deposits?
- none
minimal change disease - on immunoflouresence
- negative
minimal change disease - what proteinuria occurs?
- selective
- loss of albumin but not immunoglobulin
minimal change disease - response to steroids
- excellent response
minimal change disease - damage is mediated by
- cytokines from T cells
what is the most common cause of nephrotic syndrome in hispanics and African Americans
- focal segmental glomerulosclerosis
focal segmental glomerulosclerosis associated with
- HIV
- heroin use
- sickle cell disease
focal segmental glomerulosclerosis - on H&E stain
sclerosis of
- some glomeruli
- only part of glomerulus
focal segmental glomerulosclerosis - on EM
- effacement of foot processes
focal segmental glomerulosclerosis - immune deposits?
- none
focal segmental glomerulosclerosis - IF
- negative
focal segmental glomerulosclerosis - response to steroids
- negative
focal segmental glomerulosclerosis can progress to
- chronic renal failure
what is the most common cause of nephrotic syndrome in caucasian adults
- membraneous nephropathy
membraneous nephropathy associated with
- Hep B or C
- solid tumors
- SLE
- drugs
what drugs is membraneous nephropathy associated with
- NSAIDS
- penicillamine
membraneous nephropathy on H&E
- thick glomerular basement membrane
membraneous nephropathy - immune complexes?
- yes
- due to immune complex deposition
membraneous nephropathy - IF
- granular
membraneous nephropathy - EM
- sub epithelial deposits with spike and dome appearance
membraneous nephropathy response to steroids
- poor
membranoproliferative glomerulonephritis on H&E
- thick glomerular basement membrane
- tram-track appearance
membranoproliferative glomerulonephritis due to
- immune complex deposition
membranoproliferative glomerulonephritis dividid into two types based on
- location of deposits
membranoproliferative glomerulonephritis type I deposited where
- sub endothelial
membranoproliferative glomerulonephritis type I associated with
- HBV and HCV
membranoproliferative glomerulonephritis type II deposits
- intramembraneous
membranoproliferative glomerulonephritis type II associated with
- C3 nephritic factor
role of C3 nephritic factor
- stabilized C3 convertase
- leads to over activation of complement
C3 levels in membranoproliferative glomerulonephritis
- low
membranoproliferative glomerulonephritis response to steroids
- poor response to steroids
diabetes mellitus glomerulonephropathy - high serum glucose leads to
- nonenzymatic glycosylation of the vascular basement membrane resulting in hyaline ateriolosclerosis
diabetes mellitus glomerulonephropathy - which arteriole more effected
- leads to
- efferent arteriole
- high glomerular filtration pressure
diabetes mellitus glomerulonephropathy - hyper filtration leads to
- microalbuminuria
diabetes mellitus glomerulonephropathy progresses to
- nephrotic syndrome
diabetes mellitus glomerulonephropathy - characterized by
- sclerosis of mesangium
- formation of Kimmelstiel-Wilson nodules
diabetes mellitus glomerulonephropathy - treatment
- ACE inhibitors slow progression of hyper filtration induced damage
systemic amyloidosis - organ most involved
- kidney
systemic amyloidosis - amyloid deposits in
resulting in
- mesangium
- nephrotic syndrome
systemic amyloidosis - characterized by which test
- Congo red stain
- apple green birefringence