05.13 - Nephrotic Syndrome 1 (Nichols, Showkat) - PP + Handout Flashcards Preview

Renal > 05.13 - Nephrotic Syndrome 1 (Nichols, Showkat) - PP + Handout > Flashcards

Flashcards in 05.13 - Nephrotic Syndrome 1 (Nichols, Showkat) - PP + Handout Deck (63):
1

Other than Post-infectious GN, Subepithelial humps are seen in

SLE

1

What tx do you use in both Primary and Secondary Nephrotic

Supportive measures to control HTN

2

Granular casts can result from

Aggregates of plasma proteins or breakdown of cellular casts

2

Why do patients with nephrotic syndrome have subcutaneous lipid deposits (Xanthelasma)

Increased hepatic synthesis of cholesterol, TG's and Lipoproteins

2

Estimated glomerular pore radius for spherical molecules

42 angstroms

2

Most common cause of ESRD requiring dialysis

Diabetic Nephropathy

3

3 diseases: Subendothelial space or Mesangial Immune Complex formation and complement activaiton with inflammation

Post-Infectious GN, IgA Nephropathy, Lupus Nephritis

4

Normal rate of protein excretion

40-80 normal; 150 upper limit of normal

4

3.5 mg/day 24 hour urine corresponds with what spot urine protein/creatinine ratio

3.5

4

Spike and Dome is buzzword for

Membranous Nephropathy

4

Buzzword for Alport Syndrome

Basketweave

5

Buzzword for MPGN

Tram Tracks

6

Most important prognostic predictor of nephrotic syndrome

Degree of Proteinuria

7

Nephrotic patients have __ filtration SA, and ___ change in large pores

Loss of filtration surface, increased number of large pores

8

Main site of charge hindrance

Anionic charged lamina rara interna, Fenestrate capillary endothelium

9

Subepithelial deposits tend to cause a ___ picture, wherease Subendothelial and Mesangial deposits tend to cause a ____ picture

Nephrotic, Nephritic

9

Buzzword for Post-Infectious GN

Subepithelial Humps

11

Fatty casts are indicative of

Lipiduria of nephrotic syndrome

12

If there is generalized edema, evaluate for

Proteinuria

12

Tram Tracks is buzzworf for

MPGN

13

Subepithelial humps is buzzword for

Post-Infectious GN

14

Foot process effacement is buzzword for

Minimal Change Disease

15

Most common cause of rapidly progressive GN

Autoimmune Vasculitis

16

Basketweave is buzzword for

Alport Syndrome

17

Earliest clinical manifestation of Diabetic Nephropathy

Microabluminuria

18

BP in Nephrotic vs Nephritic

Elevated in Nephritic

20

If ___ are present, Fatty casts can have ___ pattern under polarized light

Cholesterol or cholesterol esters, Maltese cross

20

A 24-hour collection of urine will have less than __

150 mg of protein

20

Podocyte injury occurs in what 2 diseases

Minimal Change, Focal Segmental Glomerulosclerosis

22

Tubular disease is associated with proteinuria of ___ proteins

LMW

23

Nephrotic patients have __ excretion of SMW dextrans, and ___ excretion of LMW dextrans

Lower, higher

24

Subepithelial space immune complex formation and complement activation, without inflammation

Membranous Nephropathy

25

4 features of Nephrotic Syndrome

Edema, Proteinuria, Hypoalbuminemia, Hyperlipidemia

26

Creatinine in Nephrotic vs Nephritic

Elevated in Nephritic, Normal or mild elevation in Nephrotic

27

Granular casts almost always indicate

significant renal disease

29

2 absolute contraindications to renal bx

Bleeding Diathesis, Uncontrolled HTN

30

4 features of chronic GN

HTN, Renal Insufficiency, Proteinuria, Shrunken Smooth Kidneys on US

31

Does the dipstick detect microalbuminuria

No, Microalbuminuria is 300 mg/day

33

Nephrotic Syndrome mechanisms without glomerular inflammation include glomerular capillary wall deposition in ___, ___, and ___

Diabetic Nephropathy, Amyloidosis, and Light Chain Deposition disease

34

Casts that can be seen in Nephrotic Syndrome

Hyaline, Granular, Fatty, (WBC)

35

Muddy brown casts are a type of ___ almost always seen in ____

Granular Cast, Acute Tubular Necrosis

37

A spot urine protein/creatinine ratio of less than ___ corresponds with 24 hour urine protein of 150

0.15

38

Microalbuminuria is defined as

30-300 mg/day

40

WBC casts are indicative of

Inflammation

40

Nephrotic Syndrome mechanisms without glomerular inflammation include subepithelial immune complex formation and complement activation in

Membranous Nephropathy

41

Macromolecules > ___ nm are completely restricted

4 nm

42

Uncharged macromolecules < ___ nm filter freely

1.8

43

Onion skin in spleen =

Lupus

45

Urinary sediment in Nephrotic Syndrome

Inactive - without dysmorphic RBCs or RBC casts

47

How are proteins reabsorbed in PT

Endocytosis by endothelial cells --> Hydrolyzed in lysosomes into AAs --> Re-enter circulation

48

Proportion of filtered proteins that are reabsorbed

Almost all

50

Main site of size hindrance for larger molecules

Lamina Densa and Slit diaphragm

51

Buzzword for Membranous Nephropathy

Spike and Dome

52

Nephrotic Syndrome mechanisms without glomerular inflammation include podocyte injury in ___ and ___

Minimal Change Disease and Focal Segmental Glomerulosclerosis

54

Loss of more than ___ of protein per day in urine is defined as Nephrotic

3.5 mg

55

Buzzword for Lupus Nephritis

Wire Loops

56

Threshold for protein dipstick

300-500 mg/day

57

2 causes of xanthelasma

Hyperlipidemia in nephrotic syndrome; Amyloidosis

58

Upper limit of normal for spot urine protein/creatinine ratio

0.15

59

Subepithelial deposits tend to cause a ___ picture, as seen most characteristically with

Nephrotic, Membranous Nephropathy

61

Primary Nephrotic syndrome management includes disease modifying tx w/

Corticosteroids and Immunosuppression

62

Major causes of Membranous Nephropathy

Idiopathic or due to Systemic Disorders: SLE, Hep B, Drugs (Gold, penicillamine)

63

Onion-skin is buzzword for

HTN nephropathy; Scleroderma