Flashcards in glomerular disesases Deck (22):
Nephrotic vs nephritic
nephrOtic: predominant feature: proteinuria
Nephritic: proteinuria + RBC cast
-hematuria= determine if its glomerular vs nonglomerular
Dysmorphic RBC or *RBC cast**indication of glomerulonephritis
-renal failure can occur and can be rapidly progressive
what correlates with glomerular damage
and the severity of this can relate to progression of underlying renal disease
which glomerulnoephritis disease does not usually have renal biopsy performed? why not?
patient will have no kidney disease, no proteinuria
what are the 3 major finding on biopsy for asymptomatic hematuria
normal, thin basement membrane nephropathy, IgA nephropathy
mesangial cell proliferation indicates what?
what is IgA nephropathy
asymptomatic hematuria with proteinuria
presence of cellular crescents indicates what?
Rapidly progressive glomerulonephritis
Main causes of rapidly progressive glomerulonephritis
direct immunoglobin attack
immune complex deposition
which nephritic syndrome is considered a medical emergency
rapidly progressive glomerulonephritis
which has linear deposits of IgG and has continuous IgG ribbon like pattern?
Direct immunoglobulin attack
what is the most common acute glomerulnoephritis?
post-infectious glomerulonephritis: immune complex formation due to glomerular deposition of strep nephritiogenic antigens. could be due to strep/bacterial, viral, or parasitic.
what is pulmonary renal syndrome?
acute glomerular nephritis + pulmonary hemorrhage
-Anti-GBM (good pasture syndrome)
-systemic vasculitis (wegener syndrome)
which will have abscence of staining?
what are the characteristics to nephrotic syndrome
lipiduria (lipid cast in urine)
which will have granular pattern, more diffuse deposition in glomerulus
immune complex depsition
most common cause of nephrotic syndrome in children? adults?
children: minimal change disease
Membranous glomerulopathy: elderly
Focal segemental glomerulsclerosis: common in adults/AA
what will you see under electron-microscopy for minimal change disease? tx?
effacement of foot processes
IMMEDIATELY tx with steroids; dont biopsy
characteristics of membranous glomerulopathy?
thickening of basement membrane due to*** sub-epithelial deposits****
Spikes on basement membrane
effaced foot processes similar to minimal change disease
what is the marker for intraglomerular HTN an can also directly cause renal damage
Indication for percutaneous renal biopsy
-cause cannot be predicted with reasonable accuracy by less invasive procedure
-diff dx included disease that have diff tx or prognosis
-signs/symptoms suggest disease can be dx by pathologic evaluation