Renal - Nephritic Syndromes Flashcards
Name four diseases that can cause nephritic syndrome.
(1) __________ __________itis
(2) __________ __________ __________itis
(3) IgA nephropathy (Berger’s disease)
(4) Alport syndrome
Name four diseases that can cause nephritic syndrome.
(1) Poststreptococcal glomerulonephritis
(2) Rapidly progressive glomerulonephritis
(3) IgA nephropathy (Berger’s disease)
(4) Alport syndrome
Name four diseases that can cause nephritic syndrome.
(1) Poststreptococcal glomerulonephritis
(2) Rapidly progressive glomerulonephritis
(3) ______ __________ (__________’s disease)
(4) __________ syndrome
Name four diseases that can cause nephritic syndrome.
(1) Poststreptococcal glomerulonephritis
(2) Rapidly progressive glomerulonephritis
(3) IgA nephropathy (Berger‘s disease)
(4) Alport syndrome
Nephritic syndromes are a series of glomerular disorders characterized by glomerular _________ and _________.
Nephritic syndromes are a series of glomerular disorders characterized by glomerular inflammation and bleeding.
Nephritic syndromes are characterized by a proteinuria of ___ 3.5 g/day.
Nephritic syndromes are characterized by a proteinuria of < 3.5 g/day.
Nephritic syndromes are characterized by ____temia and _____uria.
Nephritic syndromes are characterized by azotemia and oligouria.
What is found in the urine in patients with nephritic syndromes?
RBC casts and dysmorphic RBCs
__________ syndromes are characterized by azotemia, limited proteinuria (< 3.5 g/day), oliguria, and salt retention (resulting in hypertension and periorbital edema).
Nephritic syndromes are characterized by azotemia, limited proteinuria (< 3.5 g/day), oliguria, and salt retention (resulting in hypertension and periorbital edema).
What will a biopsy reveal in patients with nephritic syndrome?
Hypercellular, inflammed glomeruli
Nephritic syndrome ________-________ deposition activates complement; ____ then attracts neutrophils, which mediate the glomerular damage.
Nephritic syndrome immune-complex deposition activates complement; C5a then attracts neutrophils, which mediate the glomerular damage.
_________ syndrome immune-complex deposition activates complement; C5a then attracts _________, which mediate the glomerular damage.
Nephritic syndrome immune-complex deposition activates complement; C5a then attracts neutrophils, which mediate the glomerular damage.
What cause of nephritic syndrome can result following S. pyogenes skin or pharyngeal infection?
Poststreptococcal glomerulonephritis
Poststreptococcal glomerulonephritis typically only occurs following infections with _______genic strains of S. pyogenes.
Poststreptococcal glomerulonephritis typically only occurs following infections with nephritogenic strains of S. pyogenes.
True/False.
Poststreptococcal glomerulonephritis may arise following infection with some nonstreptococcal organisms as well.
True.
How does poststreptococcal glomerulonephritis typically present?
Hematuria;
oliguria;
hypertension;
periorbital edema
Poststreptococcal glomerulonephritis is typically seen in ________ (age group) but may present in ________ (age group).
Poststreptococcal glomerulonephritis is typically seen in children but may present in adults.
How does poststreptococcal glomerulonephritis typically present on light microscopy with H&E stain?
Hypercellularity;
inflammed glomeruli
Poststreptococcal glomerulonephritis is mediated by _________-_________ deposition that presents as __________ ‘humps’ on electron microscopy.
Poststreptococcal glomerulonephritis is mediated by immune-complex deposition that presents as subepithelial ‘humps’ on electron microscopy.
Treatment for poststreptococcal glomerulonephritis is ___________.
Treatment for poststreptococcal glomerulonephritis is supportive.
How frequently does poststreptococcal glomerulonephritis progress to renal failure in afflicted children?
Rarely
(1% of cases)
Some adults with poststreptococcal glomerulonephritis develop a ________ ________ glomerulonephritis.
Some adults with poststreptococcal glomerulonephritis develop a rapidly progressive glomerulonephritis (RPGN).
What is rapidly progressive glomerulonephritis?
Nephritic syndrome that progresses to renal failure in weeks to months
In addition to the clinical picture, how does rapidly progressive glomerulonephritis appear on imaging?
Light microscopy on H&E: crescents in Bowman’s space (comprised of fibrin and macrophages)
In rapidly progressive glomerulonephritis, the crescents seen on light microscopy are comprised of what?
Fibrin and macrophages
What is the most common cause of nephropathy worldwide?
IgA nephropathy (Berger’s disease)
IgA nephropathy (Berger’s disease) is characterized by IgA ________-________ depositions in the glomerular ___________.
IgA nephropathy (Berger’s disease) is characterized by IgA immune-complex depositions in the glomerular mesangium.
IgA nephropathy (Berger’s disease) typically presents in __________ (age group) as gross or microscopic hematuria with ______ ______.
IgA nephropathy (Berger’s disease) typically presents in children as gross or microscopic hematuria with RBC casts.
_____ nephropathy (Berger’s disease) typically presents in children as gross or microscopic _________ with RBC casts.
IgA nephropathy (Berger’s disease) typically presents in children as gross or microscopic hematuria with RBC casts.
Via what imaging modality can the mesangial immune deposits associated with IgA nephropathy (Berger’s disease) be visualized?
Immunofluorescence
True/False.
IgA nephropathy (Berger’s disease) may slowly progress to renal failure.
True.
IgA nephropathy (Berger’s disease) presents with immune-complex depositis in what location?
The glomerular mesangium
IgA nephropathy (Berger’s disease) usually follows what?
Mucosal infection
(e.g. gastroenteritis)
Which cause of nephritic syndrome is characterized by the presence of episodic hematuria and RBC casts present in the urine?
IgA nephropathy
(Berger’s disease)
Alport syndrome is an inherited defect of what?
Type IV collagen
Alport’s syndrome most commonly follows what inheritance pattern?
X-linked
(typically affects the males in a family)
Alport’s syndrome results in thinning and splitting of the glomerular _________ _________.
Alport’s syndrome results in thinning and splitting of the glomerular basement membrane.
What are the three major S/Sy of Alport’s syndrome?
(1) Isolated hematuria
(2) Sensory deafness
(3) Ocular disturbances
Linear immunofluorescence indicates which rapidly progressive glomerulonephritis?
Goodpasture syndrome
Granular immunofluorescence indicates which two etiologies of rapidly progressive glomerulonephritis?
(1) Poststreptococcal glomerulonephritis (MC)
(2) Diffuse proliferative glomerulonephritis
A lack of immunofluorescence could indicate which three etiologies of rapidly progressive glomerulonephritis?
(1) Granulomatosis with polyangiitis (Wegener’s granulomatosis)
(2) Microscopic polyangiitis
(3) Eosinophilic granulomatosis with polyangiitis (Churg-Strauss disease)