Renal - Nephritic/ Nephrotic

Question 1

Goodpasture Syndrome presentation and cause

Answer 1

RPGN-(w/ wegeners)

Nephritic and pulmonary hemorrhage

hematuria, hemoptyisis, proteinuria and RBC casts

IgG to Basement Membrane(type 4 collagen)
Type II Hypersensitivity

Question 2

Post streptococcal glomerulonephritis

Answer 2

Nephritic syndrome

lumpy bumpy appearance

IgG, IgM and and C3 deposition in GBM and mesangium

Question 3

Berger’s Disease

Answer 3

Nephritic

Mesangial IgA deposits

Question 4

Alport Syndrome cause and presentation

Answer 4

Nephritic syndrome w/ deafness
-sometimes eye problems

Mutation in Type iV collagen

X linked

Question 5

RPGN types(3) and presentation

Answer 5

Crescent moon shape w/ fibrin and plasma proteins - Nephritic

Goodpastures
 - lungs and kidney
Wagners 
-cANCA, gramulomas w/ polyangiitis
Microscopic polyangitis 
-pANCA

Question 6

Focal Segmental Glomeruloscerosis

• histology
• Associations (5)

Answer 6

Nephrotic
Most common cause in adults
segmental sclerosis and effacement of foot processes

Associated w/
HIV, heroine, obesity, IFN Rx, chronic kidney disease

Question 7

Membranous nephropathy

• Histology
• Associations(4)

Answer 7

Nephrotic Syndrome

Spike and dome
diffuse capillary and GBM thickening

Second most common cause in adults

Associated w/
drugs, infection, SLE, solid tumors

Question 8

Minimal change disease

• Histology
• Associations(2)

Answer 8

Nephrotic

Normal glomeruli

Most common in kids 2-6 yrs
Maybe triggered by infection or immune stim

Question 9

Membrano-proliferative glomerulonephritis

• Histology
• associations

Answer 9

2 Types
Primarily nephrotic can be nephritic

Type 1 - tram track appearance of GBM due to splitting from mesangial ingrowth

-associated w/ HBV, HCV

Type 2 - dense deposits intramembranous
-associated w/ C3 nephritic factor

Question 10

Diabetic glomerulonephropathy

-histology

Answer 10

Nephrotic

Nonenzymatic glycosylation

Mesangial expansion,

Kimmelstiel wilson lesions: esinophilic nodular glomerulosclerosis (PAS positive)
- hyaline masses

Question 11

Glomerulonephritis w/ decrease C3 and C4 (2)

Answer 11

SLE

Poststrept Glomerulonephritis

Question 12

Metabolic acidosis profile and cause

Answer 12

Primary - Low bicarb (<40)

• MUDPILES
• Breathing fast to blow off CO2 and compensate

Question 13

Metabolic Alkalosis Profile and Cause

Answer 13

Primary -High bicarb (>24)

Secondary high PCO2 (>40)

-throwing up H,
breathing slow to try and retain CO2

Question 14

Respiratory Acidosis Profile and Cause

Answer 14

Primary - High PCO2 (>40)

Secondary - high bicarb (>24)

• blockage/obstruction and kidneys retain bicarb to compensate

Question 15

Respiratory Alkalosis Profile and Cause

Answer 15

Primary - Low PCO2 (<24)

• hyperventilating and blowing off CO2 faster than necessary. Kidneys are not resorbing bicarb to compensate