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DIT Nephrology > Ren 7 - Nephrosis And Nephritis > Flashcards

Ren 7 - Nephrosis And Nephritis Flashcards

1
Q

What would be the terminology for a kidney biopsy with less than half of the glomeruli are affected?

A

Focal.

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2
Q

What would be the terminology for a kidney biopsy with more than half of the glomeruli are affected?

A

Diffuse.

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3
Q

What would be the terminology for a kidney disease when the basement membrane is thickened in a biopsy?

A

Membranous.

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4
Q

What is the difference between primary glomerular disease and secondary glomerular disease?

A

Primary is only the kidneys and secondary is more of a systemic disease.

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5
Q

What is the difference between nephrosis versus nephritis?

A

Nephrosis: More than 3.5 grams of protein in urine during the day; heavy proteinuria.
-Nephritis: Less than 3.5 g of protein in urine per day.

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6
Q

What are the symptoms of nephritis?

A
  • Light proteinuria.
  • Hematuria.
  • RBC casts.
  • Azotemia.
  • Hypertension.
  • Decreased urine volume.
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7
Q

What type of reaction causes post-streptococcal glomerulonephritis?

A

Type III hypersensitivity: Immune complexes that are deposited in the glomerulus.

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8
Q

When does post-strep glomerulonephritis happen?

A

In 1 to 3 after Group A strep streptococcal infection.

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9
Q

What would we see in kidney biopsy in post-strep glomerulonephritis?

A

Hypercellular glomeruli and neutrophils.

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10
Q

What do we see in electron microscope in post-strep glomerulonephritis?

A

Subepithelial humps on the top of the basement membrane and inside the podocyte foot processes.

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11
Q

What happens to the complement C3 levels in post strep glomerulonephritis?

A

They decrease due to the activation of complements.

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12
Q

What does Anti-streptolysin O titer check for and what does it overlook? What must we test for what was overlooked?

A

The anti-streptolysin O titer checks if you did infact have a strep throat and/or pharyngitis. However, it may not be elevated in cases of strep impetigo, which can still cause strep glomerulonephritis.
-In cases of strep impetigo, we must use Anti-DNase B that is elevated in both strep impetigo and strep throat.

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13
Q

What substance is elevated in both strep throat and strep impetigo?

A

Anit-DNase B.

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14
Q

What is another name for IgA nephropathy?

A

Berger disease.

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15
Q

What type of vasculitis is IgA nephropathy associated with?

A

Henoch-Schonlein purpura.

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16
Q

What are the symptoms of Henoch-Schonlein purpura?

A

Classic triad:

  1. Purpura: usually on legs and buttocks.
  2. Arthritis.
  3. Abdominal pain.
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17
Q

What is the pathophysiology of IgA nephropathy?

A

There is an increase in IgA serum, and IgA immune complexes get deposited in the mesangium of the glomerulus. There is also a proliferation of mesangial cells.

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18
Q

What are the symptoms of IgA nephropathy?

A
  • Hematuria.
  • RBC casts.
  • Flares up after URI.
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19
Q

What is the pathophysiology of Alport syndrome?

A

Defect in type IV collagen (basement membrane). On kidney basement membrane, they thin out and widen into two.

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20
Q

What are the symptoms of Alport syndrome?

A

[Can’t see, can’t pee, can’t hear a high C]

  • Eye problems.
  • Nephritis.
  • Deafness.
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21
Q

What is another name for rapidly progressive glomerulonephritis?

A

Crescentic glomerulonephritis.

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22
Q

What is the pathophysiology of Goodpasture syndrome?

A

Type II hypersensitivity: Antibodies against the glomerular basement membrane. It attacks both the kidneys and the lungs.

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23
Q

What are the two disease that attack both the kidneys and the lungs?

A
  1. Goodpasture syndrome.

2. Granulomatosis with polyangiitis (GPA)

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24
Q

What lab finding is positive in Granulomatosis with polyangiitis (GPA)?

A

-Positive PR3-ANCA/c-ANCA.

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25
Q

What lab finding is positive in Microscopic polyangiitis?

A

-Positive p-ANCA/MPO-ANCA.

26
Q

What are four disease that cause rapidly progressive glomerulonephritis?

A
  1. Goodpasture syndrome.
  2. Granulomatosis with polyangiitis (GPA).
  3. Microscopic polyangiitis.
  4. Lupus.
27
Q

What is the most common, most severe form of lupus nephritis?

A

Diffuse Proliferative Glomerulonephritis.

28
Q

What lab finding is associated with lupus nephritis?

A

Anti-dsDNA.

29
Q

What is finding of lupus nephritis in light microscopy?

A

Anti-dsDNA antibodies lines the mesangium and subendothelially. These deposits line the basement membrane, making a wire-loop appearance in light microscopy.

30
Q

What are symptoms of nephrotic syndrome?

A
  1. Proteinuria greater than 3.5 gram a day.
  2. Hypoalbuminemia.
  3. Edema.
  4. Increased risk of infection.
  5. Increased risk of thrombosis
  6. Hyperlipidemia.
31
Q

What type of kidney disease is minimal change disease?

A

Nephrotic syndrome.

32
Q

What is the most common cause of nephrotic syndrome in children?

A

Minimal change disease.

33
Q

What are the causes of minimal change disease?

A
  1. Most common cause of nephrotic syndrome in children.
    - Triggered by infections or immunizations.
    - There is abnormal podocyte foot processes.
34
Q

What is the treatment for minimal change disease?

A

Corticosteroids.

35
Q

What is the most common cause of nephrosis in adults?

A

Focal segmental glomerulosclerosis.

-More prevalent in blacks and latinos.

36
Q

What would be the most common type of nephrotic syndrome in HIV patients?

A

Focal segmental glomerulosclerosis.

37
Q

What does membranous nephropathy cause to the basement membranes?

A
  • Thickening of the basement membranes.
  • Domes caused by subepithelial immune complex deposits.
  • Causes “spike and dome” appearance: Thickened basement pushing between the domes.
38
Q

What histological difference do we see between membranoproliferative GN, post strep GN, and membranous nephropathy?

A
  • Membranoproliferative GN: Subendothelial humps.
  • Post strep GN: Subepithelial humps.
  • Membranous nephropathy: Subepithelial domes.
39
Q

What histological changes do we see in membranoproliferative glomerulonephritis?

A
  • IgG immune complexes that cause subendothelial humps.
  • Tram track (double glomerular basement membrane).
  • Anormal foot processes.
40
Q

What are some pathologies that can cause membranoproliferative glomerulonephritis?

A
  • Hepatitis C.
  • Hepatitis B.
  • Lupus.
  • Subacute bacterial endocarditis.
41
Q

How does diabetes affect the kidneys?

A

Causes non-enzymatic glysycolation of basement membrane, making it thick and disfunctional (in form of Kimmelstiel-Wilson nodules) and arterioles, causing the mesangium to proliferate.

  • Causes progressive proteinuria.
  • Causes
42
Q

Which part of the kidney does the amyloid deposit in amyloidosis?

A

At the mesangium.

43
Q

What stain do we use for amyloidosis?

A

Congo red stain.

44
Q

What disease causes linear pattern of IgG deposition on Immunoflourescence?

A

Goodpastrue syndrome.

45
Q

What disease causes lumpy-bumpy deposits of IgG, IgM, and C3 in the mesangium in kidneys?

A

Poststreptococcal glomerulonephritis.

46
Q

What disease causes deposits of IgA in the mesangium?

A

IgA nephropathy.

47
Q

What disease causes anti-GBM antibodies, hematuria, and hemoptysis?

A

Goodpasture syndrome.

48
Q

What disease causes nephritis, deafness and cataracts?

A

Alport syndrome.

49
Q

What disease cause crescent formation in the glomeruli?

A

Rapidly progressive glomerulonephritis.

50
Q

What disease causes wire-loop apperance on light microscopy?

A

Lupus nephritis which causes diffuse Proliferative glomerulonephritis.

51
Q

What disease causes Kimmelstiel-Wilson lesions (nodular glomerulosclerosis)?

A

Diabetic nephropathy.

52
Q

What disease causes effacement of epithelial foot processes on electron microscopy?

A

Minimal change disease.

53
Q

What disease is a nephrotic syndrome associated with hepatitis B?

A

Membranoproliferative glomerulonephritis.

54
Q

What nephrotic syndrome is associated with HIV?

A

Focal segmental glomerulosclerosis.

55
Q

What disease has subendothelial humps and tram-track appearance on EM (electron microscopy)?

A

Membranoproliferative glomerulonephritis.

56
Q

What disease is associated with segmental sclerosis and hyalinosis on LM (light microscopy)?

A

Focal segmental glomerulosclerosis.

57
Q

What disease is associated with purpura on back of arms and legs, abdominal pain, IgA nephropathy?

A

Henoch-Schonlein purpura.

58
Q

What disease causes apple-green birefringence with Congo red stain under polarized light?

A

Amyloidosis.

59
Q

What disease causes spiking of the GBM due to subepithelial deposits on EM?

A

Membranous nephropathy.

60
Q

RFF: Nodular hyaline deposits in the glomeruli.

A

Kimmelstiel-Wilson nodules (diabetic nephropathy).

61
Q

RFF: Glomerulonephritis plus pulmonary vasculitis.

A
  1. Granulomatosis w/ polyangiitis.

2. Goodpasture syndrome.

DIT Nephrology (9 decks)

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