Glomerular Diseases (extras) Flashcards
(25 cards)
What type of HS reaction is involved in GN?
- types II, III, and IV are involved
Secondary Causes of Renal Nephropathy
- SLE, vasculitis, diabetes, amyloidosis, infection, protein deposition diseases (such as myeloma)
Which GNs are associated with low C3 AND C4?
- MCGN (mesangiocapillary glomerulonephritis) AKA membranoproliferative GN type I
- cryoglobulinemia
- GN secondary to SLE
Which GNs are associated with only low C3 (C4 is normal)
- MCGN (mesangiocapillary glomerulonephritis) AKA membranoproliferative GN types II and III
- post-strep GN
- GN secondary to SLE
Depositions in the sub-epithelium yield:
- sub-epithelial humps
Depositions in the sub-endothelium yield:
- tram-tack appearance
Primary Nephrotic GNs
- minimal change disease, FSGN, membranous nephropathy
Secondary Nephrotic GNs
- diabetic nephropathy, amyloidosis
Primary Nephritic GNs
- mesangiocapillary glomerulonephritis (AKA membranoproliferative GN)
Secondary Nephritic GNs
- SLE, cryoglobulinemic GN, Henoch Schonlein syndrome
Put the following in order of incidence: nephrotic syndrome, nephritic syndrome, isolated proteinuria, isolated hematuria, undefined renal dysfunction.
- nephrotic > nephritic > undefined renal dysfunction > isolated proteinuria > isolated hematuria
Put the following in order of incidence: IgA nephropathy, minimal change disease, post-infectious GN, FSGS, membranous nephropathy, cryoglobulinemic GN
- IgA nephropathy > FSGS > cryoglobulinemic GN > membranous nephropathy > MCD > post-infectious GN
Pathogenesis of GN secondary to Cryoglobulinemia
- cryoglobulinemia is a condition where the blood has large amounts of cryoglobins (proteins that become insoluble in blood at low temperatures)
- at low temperatures, these cryoglobins precipitate and get caught in the glomerulus
Pathogenesis of Membranous Nephropathy (MN)
- antipodocyte antibodies (anti-phospholipase A2 antibodies) target the basement membrane; IC formation and clustering; complement involvement
How do we treat Membranous Nephropathy (MN)?
- treatment w/ steroids + alkylating agents to increase probability of remission and protect liver function
- (treatment w/ steroids alone is ineffective)
- treatment with CNI to reduce proteinuria and to increase probability of remission; unknown effects on liver function
- treatment with ACTH or Rituximab can reduce proteinuria
How long after an infection does PSGN occur?
- 1 - 2 weeks following throat infections
- 3 - 6 weeks following skin infections
Most common cause of nephrotic syndrome in children is _________; in adults is _________; most common cause of nephritic syndrome is _________; most common kidney disease is __________.
- nephrotic children: MCD
- nephrotic adults: MN
- nephritic: IgA nephropathy
- most common: IgA nephropathy
IgA Nephropathy is an immune complex disease in the:
- mesangium
Mesangiocapillary / Membranoproliferative GN Type I has discrete immune deposits in the ________ and ________.
- mesangium and subendothelial space
Mesangiocapillary / Membranoproliferative GN Type III has discrete immune deposits in the:
- mesangium, subendothelium, subepithelium and/or in the membrane
Mesangiocapillary / Membranoproliferative GN Type II has highly electron DENSE immune deposits in the ________, _________, and ________.
- mesangium, in the membrane, and in Bowman’s capsule
RPGN is associated with:
- crescents
RPGN Type I
- linear IF (Abs target the basement membrane)
- Goodpasture syndrome
RPGN Type II
- negative IF (Pauci-immune)
- p-ANCA: microscopic polyangiitis, Churg-Strauss
- c-ANCA: Wegener granulomatosis
