Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ch 32 Secondary GN > SLE > Flashcards

SLE Flashcards

1
Q

What 2 populations where SLE is more often associated with severe nephritis?

A
  1. CHILDREN
  2. MALES
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 entry criteria for renal involvement in LN?

A
  1. PROTEINURIA
    >500mg/dL/day or 3+
  2. CELLULAR URINARY CASTS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What class is Minimal mesangial LN?

A

CLASS I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What class is Mesangial proliferative LN?

A

CLASS 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What class is Focal LN?

A

CLASS 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What class is Diffuse LN?

A

CLASS 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What class is Membranous LN?

A

CLASS 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What class is advanced sclerosing LN?

A

CLASS 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What LN classes has active, chronic, active & chronic lesions?

A

CLASS 3 & 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What Class of LN is characterized by:
LM - normal-appearing glomeruli
IF/EM - mesangial immune deposits

A

CLASS 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What Class of LN has
IF/EM - purely mesangial hypercellularity, with mesangial immune deposits

A

CLASS 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What class is defined as focal segmental and/or global endocapillary and/or extracapillary glomerulonephritis affecting < 50% of the total glomeruli sampled?

A

CLASS 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What class is defined as focal segmental and/or global endocapillary and/or extracapillary glomerulonephritis affecting > 50% of the total glomeruli sampled?

A

CLASS 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Class 4 lesions may have similar features with what type of GN?

A

MPGN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What Class of LN is defined by regular subepithelial immune deposits producing a membranous pattern with the coexistence of mesangial immune deposits and mesangial hypercellularity?

A

CLASS 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What differentiates Primary MN vs Membranous LN

A

Primary MN - SUBEPITHELIAL IMMUNE COMPLEX DEPOSITS only

Membranous LN -
SUBEPITHELIAL IMMUNE COMPLEX DEPOSITS + MESANGIAL IMMUNE DEPOSITS & HYPERCELLULARITY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Wwhat Class of LN is characterized by > 90% of the glomeruli sclerotic and no residual activity?

A

CLASS 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What class is characterized by mild global mesangial hypercellularity?

A

CLASS 2 LN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What Class is characterized by focal segmental endocapillary proloferation?

A

Class 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What class is characterizwd by global endocapillary proliferation with infiltrating neutrophils & segmental wore loop deposits?

A

CLASS 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What staining on IF is highly suggestive of LN?

A

“FULL HOUSE” STAINING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is meant by “FULL HOUSE” staining on IF?

A

Presence of:
1. ALL 3 Igs: IgG, IgA, IgM
2. 2 COMPLEMENTS: C3, C1q

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the deposits seen on EM in LN?

A

• electron-dense
• granular
• “fingerprint” substructure
• tubuloreticular inclusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the intracellular branching tubular structures measuring 24 nm in diameter located within dilated cisternae of the endoplasmic reticulum of glomerular and vascular endothelial cells, commonly observed in SLE biopsies?

A

TRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

TRIs are present in what 3 disease conditions?

A
  1. SLE
  2. HIV
  3. VIRAL INFECTIONS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the 6 histologic features for Activity index?

A
  1. Endocapillary hypercellularity
  2. Glomerular neutrophil infiltration/Karyorrhexis
  3. Interstitial inflammation
  4. Wire loop lesions
  5. Fibrinoid necrosis
  6. Fibrocelullar/cellular crescents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the maximum activity incex score?

A

24

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the maximum chronicity index score?

A

12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the 2 severe lesions and assigned double weight in activity index score?

A
  1. Fibrinoid necrosis
  2. Crescents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the 4 histologic features for chronicity index?

A
  1. GLOMERULOSCLEROSIS (focal/segmental)
  2. FIBROUS CRESCENTS
  3. TUBULAR ATROPHY
  4. INTERSTITIAL FIBROSIS
31
Q

What acitivity and chronicity index score is associated with a poor 10-year renal survival rate?

A

High Activity index > 12
High Chronicity index >4

32
Q

What 4 inflammatory infiltrates can be seen in active tubulointerstitial lesions?

A
  1. T LYMPHOCYTES
  2. B LYMPHOCYTES
  3. MONOCYTES
  4. PLASMA CELLS
33
Q

What are the 2 lab findings in active lupus serology?

A
  1. HIGH ANTI-DNA TITER
  2. LOW SERUM COMPLEMENT
34
Q

What Class of LN present with the most active clinical features?

A

CLASS 4

35
Q

What Class of LN is predisposed to thrombotic complications such as renal vein thrombosis and pulmonary emboli?

A

CLASS 5

36
Q

What Class of LN where levels of anti-DNA antibodies and serum complement levels often normalize?

A

CLASS 6

37
Q

What are the 4 antibodies found in SLE?

A
  1. ANA (against nuclear antigens)
  2. ANTI-DNA (against DNA)
  3. ANTI-dsDNA (against dsDNA)
  4. ANTI-ssDNA (against ssDNA)
38
Q

What are the 2 antibodies included in the ACR criteria?

A
  1. ANA
  2. ANTI-DNA
39
Q

Wjat are the 2 antibodies used yo monitor course of SLE?

A
  1. ANA
  2. ANTI-DNA
40
Q

What is a highly sensitive screening teat for SLE?

A

ANA

41
Q

What is a more specific test for SLE?

A

ANTI-dsDNA

42
Q

High titers of this antibody correlates well with clinical activity?

A

ANTI-dsDNA

43
Q

What antibody correlates best with renal disease in SLE?

A

ANTI-dsDNA

44
Q

What are the 4 antibodies directed against ribonuclear antigens?

A
  1. ANTI-SM (against ENA)
  2. ANTI-nRNP (against ENA)
  3. ANTI-Ro/SSA (against cytoplasmic RNA)
  4. ANTI-La/SSA (against nuclear RNP)
45
Q

What is the most specific antibody for SLE?

A

ANTI-SM

46
Q

What antibody is important in the pathogenesis of neonatal lupus and cardiac conduction abnormalities in the newborn?

A

MATERNAL ANTI-Ro/SSA

47
Q

What antibody is associated with a unique dermal psoriasiform type of lupus?

A

ANTI-Ro/SSA

48
Q

Levels of which decline before SLE flare?

A

C3, C4

49
Q

What are the 3 lab test used to predict “flare” of SLE/LN?

A
  1. C3 (low)
  2. C4 (low)
  3. ANTI-DNA Titer (high)
50
Q

What drug for LN is contraindicated during pregnancy because of it’s teratogenicity?

A

CYCLOPHOSPHAMIDE

51
Q

What are the 4 drugs for SLE that can been used during pregancy?

A
  1. CORTICOSTEROIDS
  2. AZATHIOPRINE
  3. CYCLOSPORINE
  4. TACROLIMUS
52
Q

What are the 3 risk factors that confers high risk for fetal loss durimg prenancy in LN?

A
  1. ANTICARDIOLIPIN/APL ANTIBODIES
  2. HPN
  3. HEAVY PROTEINURIA
53
Q

What is the duration of dialysis that patients with active SLE should undergo to allow clinical and serologic disease activity to become quiescent before transplantation?

A

3-12 months

54
Q

What are the 6 medications used in the Induction therapy in LN?

A
  1. CORTICOSTEROIDS (IV/Oral)
  2. CYCLOPHOSPHAMIDE (IV/Oral)
  3. MMF
  4. CYCLOSPORINE
  5. TACROLIMUS
  6. RITUXIMAB
55
Q

What is the most widely used induction immunosuppressive regimen for LN?

A

CORTICOSTEROIDS + CYCLOPHOSPHAMIDE

56
Q

Cyclophosphamide SE is least severe in what form? (IV or Oral)

A

IV

57
Q

What is the protocol used for IV cylophosphamide for induction therapy for LN?

A

Once a month x 6 months

58
Q

What are the 3 least common SE with IV Cyclophosphamide?

A
  1. HEMORRHAGIC CYSTITIS
  2. ALOPECIA
  3. NEOPLASMS
59
Q

What are the 2 mcm SE of IV Cyclophosphamide?

A
  1. MENSTRUAL IRREGULARITIES
  2. PREMATURE MENOPAUSE
60
Q

What cytoprotective agent is used to reduce bladder complications from Cyclophosphamide?

A

MESNA

61
Q

What drug is comparable to cyclophosphamide for the treatment of LN?

A

MMF

62
Q

What 2 regimens is supported by ACR & (KDIGO) guidelines as first-line therapy for severe LN?

A
  1. CYCLOPHOSPHAMIDE
  2. MMF
63
Q

What 2 drugs are recommended by ACR & KDIGO for maintenance therapy for LN?

A
  1. MMF
  2. AZATHIOPRINE
64
Q

What is a chimeric monoclonal antibody which depletes CD20 B cells?

A

RITUXIMAB

65
Q

What is the drug used in patients resistant to other treatments and in those who do not tolerate conventional treatment?

A

RITUXIMAB

66
Q

What therapy is used for LN patients with:
1. severe pulmonary hemorrhage
2. TTP-like syndrome
3. Those with APL antibodies and a clotting episode who cannot be anticoagulated due to hemorrhage

A

PLASMAPHERESIS

67
Q

What therapy is used to treat thrombocytopenia in LN?

A

IVIG

68
Q

Class 5 MN should be treated with this 4 therapies?

A
  1. ANTI-HPN
  2. ANTI-PROTEINURIC
  3. LIPID LOWERING AGENTS
  4. ANTICOAGULANT (should be individualized)
69
Q

What 3 drugs are used to prevent glucocorticoid-induced osteoporosis?

A
  1. CALCIUM
  2. VIT. D SUPPLEMENTS
  3. BISPHOSPHONATES
70
Q

Plasmapheresis is used for what 3 groups of LN patients?

A
  1. Pulmonary hemorrhage (severe)
  2. TTP-like syndrome
  3. Those with APL antibodies and a clotting episode who cannot be anticoagulated due to hemorrhage
71
Q

What are the 2 antibodies against ENA?

A
  1. ANTI-SM
  2. ANTI-nRNP
72
Q

What is the antibody against cytoplasmic RNA?

A

ANTI-Ro/SSA

73
Q

What is the antibody against nuclear RNA?

A

ANTI-La/SSA

Ch 32 Secondary GN (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions