Sketchy Path: The Nephrotic Syndrome Flashcards
The basement membrane is normally ___________ charged.
negatively (like the flat minus signs on the wall)
One of the main processes disrupted in nephrotic syndrome is _____________.
the podocyte layer (like the scared foot soldier turning his back and cowering)
____________ have been implicated in podocyte effacement.
Cytokines (like the fallen bag of coins by the foot soldier)
_______________ cells do not play a role in nephrotic syndrome.
Inflammatory
They are involved in nephritic syndrome.
Nephrotic syndrome is defined by what five signs and symptoms?
- Proteinuria: 3.5 grams per day (like the meat falling off the cart with 3.5 on it)
- Hypoalbuminemia (like the woman dropping her photo album)
- Peripheral edema (like the swollen King Edward)
- Hyperlipidemia (like the butter next to King Edward)
- Lipiduria (like the pigs in the yellow river by the woman with the albumin)
Other than the five main symptoms and signs, what else can be lost in the urine of those with nephrotic syndrome?
- Antithrombin III (like the cage tumbling behind the wheelbarrow man)
- Gammaglobulin (like the fallen keys next to the beaver cage)
Due to the loss of thrombin, _____________ can occur in nephrotic syndrome.
renal vein thrombosis (like the guy getting stabbed in his flank about the polymerized fibrin sticks)
Patients may report that their urine is ___________.
frothy (like the wheelbarrow guy kicking up froth in the yellow river)
Describe minimal change disease.
- Most common cause of nephropathy in children (like the children too young to fight)
- Occurs due to podocyte effacement)
- Only structural change is visible with EM
- Occurs after URI, allergies, or insect sting (like woman blowing her nose)
Minimal change disease is a little different compared to the other nephrotic syndromes in that it causes the selective loss of ___________.
albumin (like the photos by the kids’ feet)
Most people with minimal change disease respond to _____________.
steroids
What does the “sclerosis” look like in FSGS?
Obliterated capillaries with hyaline deposition
Electron microscopy of those with FSGS will show ______________.
fusion of the podocytes (like the grown-up version of the hugging foot soldiers near William Wallace)
Unlike minimal change disease, FSGS ______________.
(1) causes loss of all proteins, not just albumin; (2) often progresses to end-stage renal disease (like the cracked kidney paper weights
What can cause FSGS?
- Heroin abuse
- HIV
- Hepatitis
- Diabetes
__________________ is thought to play a role in the development of diabetic nephropathy.
Nonenzymatic glycosylation of the basement membrane (like the purple candies stuck in the wall)
_______________ are pathognomonic for diabetes.
Kimmelstiel-Wilson nodules (like the big candy hovering of the mesangium to represent hypocellular mesangium)
Like FSGS, diabetic nephropathy can progress to _____________.
sclerosis with hyaline obliteration of the capillaries (like the second sclerosis dragon flag behind the candy catapult)
In many cases, membranous nephropathy is caused by ________________.
antibodies against phospholipase A2 (like the foot soldier with the shield next to the pink membrane with a bunch of arrows in it)
Where do antibodies and immune deposits accumulate in membranous nephropathy?
In the subepithelial space (like how the arrows are on the foot soldier!)
Membranous nephropathy classically presents with ______________ on electron microscopy.
the “spike and dome” membrane between the immune deposits (like the archer with the spikey dome helmet)
What can cause membranous nephropathy?
- Bugs: HBV, HCV (like the icosahedral lantern on the archer’s belt)
- Drugs including NSAIDs and penicillamine
- Tumors (like the archer’s crab emblem)
- Rheum (like the lupus wolf jumping onto the membrane)
______________ can slow the progres of membranous nephropathy.
Steroids (like the moon shield protecting the foot soldier)
Membranous nephropathy will show _______________ under IF.
bumpy deposits of IgG and C3b
How does amyloidosis damage the glomerulus?
It causes obliteration of the capillaries (like the ArMored LaDieS kicking over the red shields).
_______________ can help diagnose amyloidosis.
Congo staining (like the green smoke)
