Pearls in Glomerular Diseases Pathology and the General Management of Glomerular DIseases Flashcards
Diabetes
SOlid tumor
Lymphoprolif
Multiple myeloma
HIV
Hep C
Hep B
Drugs
DN
MN
MCD
Amyloidosis
FSGS
MPGN
MN
MCD or MN
Spikes Tram track Full house Wire loops Podocyte effacement
Membranous lesion…subepi immune deposits - MN
Splitting of GBM in MPGN
ALl Ig classes - lupus
SLE-thick subendo immune complexes
Usually MCD
Humps Sausage deposits Cresencr Dysmorphic Fibrinoid necrosis
POst-infectious subepi
Dense and dark C3 in MPGN 2 (DDD)
RPGN
Glomerular hematuria
Cresentic
C3 and C4 low
C3 low and C4 normal
Classical path…SLE, endocarditis, MPGN 1 and 3
APSGN MPGN 2 (dense deposit)
IF
Membranous PSGN MPGN 1 MPGN 2 IgA SLE Anti-GBM or GPS
Capillary spikes…IgG and C3
Capillary loops (humps) - IgG and C3
Capillary loops (subendo) and mesangial IgG adn C3
Capillary C3 (Only!)
Mesangial IgA and C3
Full house
Linear IgG and C3
BP control
Under 130/80 goal
Na restirction
ACEI/ARB - lower intraglomerlular pressure due to efferent arteriole vasodilation
Diuretics
Reduction of proteinuira
ACEI and ARB are antiproteinuric agents by reducing pressure and decreasing permeabilty of GM
Also reduce TGF-Beta
Managmenet of
Edema
Hyperlipidemia
Hypercoagulailiy
Vit D
Na restirction and diuretics…b ed rest
Statins
Anticoags
Microalbuminuria
30-300 mg/d
Detected by special dipstiks
ID’d early diabetic neprohpathy and assessing CV risks in HTN patients
Loss of GBM neg charges
Minimal change disease
RVT screen
Duplex U/S to the renal veins
Pt over 50 with membranou
Rule out solid organ cancer
Nodular glomerular sceloris
Diabetes
