Glomerular Disease Details Flashcards Preview

Step 1 > Glomerular Disease Details > Flashcards

Flashcards in Glomerular Disease Details Deck (65)
Loading flashcards...
1

Signs of glomerulonephritis

RBC casts!
Axotemia, oliguria, HTN, proteinuria

2

Acute Poststreptococcal GN Presentation

- KIDS
- 2-4 wks after Group A strep infection of pharynx or skin
- Peripheral or periorbital edema, cola-colored urine, HTN
- Positive strep titers/serologies, decreased complement levels due to consumption

3

Acute Poststreptococcal GN LM

Glomeruli enlarged and hypercellular

4

Acute Poststreptococcal GN IF

"Starry sky"
Granular appearance ("lumpy bumpy")
Due to IgG, IgM, and C3 deposition along GBM and mesangium

5

Acute Poststreptococcal GN EM

SUBEPITHELIAL IC humps

6

Acute Poststreptococcal GN Treatment

Usually resolves spontaneously, supportive rx
- Kids rarely progress to renal failure
- Some adults develop RPGN - only 60% of adult cases resolve completely (increased age --> poor px)

7

What type of HSN rxn is Acute Poststreptococcal GN?

Type III (Ab-Ag complexes)

8

Presentation of Rapidly Progressive (Crescentic) Glomerulonephritis

- Rapidly deteriorating renal function
- Poor px

9

Disease proceses that result in Rapidly Progressive (Crescentic) Glomerulonephritis?

- Goodpasture
- Granulomatosis with polyangiitis (Wegener)
- Microscopic polyangiitis

10

Presentation of Goodpasture?
- RPGN

Hematuria and hemoptysis
YA male

11

Type of HSN rxn is Goodpasture?
- RPGN

Type II HSN rxn (cytotoxic Ab mediated)

12

Pathogenesis of Goodpasture?
- RPGN

Ab to GBM and alveolar basement membrane (type IV collagen)

13

Goodpasture IF
- RPGN

Linear

14

Goodpasture Treatment
- RPGN

Emergent plasmapheresis

15

Presentation of Wegener's?
- RPGN

Nasopharynx + lungs + kidneys
Middle aged male

16

Wegener's IF?
- RPGN

Negative (pauci-immune)

17

Wegener's markers?
- RPGN

PR3-ANCA/c-ANCA (anti-proteinase 3)

18

Microscopic polyangiitis presentation
- RPGN

Lungs + kidneys + palpable purpura
NO nasopharyngeal involvement
NO granulomas

19

Microscopic polyangiitis IF
- RPGN

Negative (pauci-immune)

20

Microscopic polyangiitis marker
- RPGN

MPO-ANCA/p-ANCA (anti-myeloperoxidase)

21

Rapidly Progressive (Crescentic) Glomerulonephritis LM and IF?

- Cresent moon shape - consist of FIBRIN and plasma proteins (C3b) with glomerular parietal cells, monocytes, and MACS

22

Diffuse proliferative GN caused by?

SLE (common CoD)
Membranoproliferative glomerulonephritis

23

Diffuse proliferative GN LM

"wire looping" of capillaries

24

Diffuse proliferative GN EM

SUBENDOTHELIAL and sometimes intramembranous IgG-based ICs
Often with C3 deposition

25

Diffuse proliferative GN IF

Granular

26

IgA Nephropathy (Berger DZ) presentation

- Childhood
- Episodic gross hematuria that occurs concurrently with respiratory or GI tract infections (IgA is secreted by mucosal lining)

27

What condition is IgA Nephropathy (Berger DZ) associated with?

Henoch-Schonlein Purpura (GI, kidneys, skin, joints)

28

IgA Nephropathy (Berger DZ) LM

Mesangial proliferation

29

IgA Nephropathy (Berger DZ) EM

Mesangial IC depositis

30

IgA Nephropathy (Berger DZ) IF

IgA based IC deposits in mesangium