Glomerulonephritis Flashcards Preview

Nephrology Board Review Pearls > Glomerulonephritis > Flashcards

Flashcards in Glomerulonephritis Deck (121)
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1

hypo-complementemic GNs

- lupus GN
- PIGN
- cryoglobulinemic GN
- MPGN

2

GNs with normal complements

- IgA nephropathy
- ANCA-associated GN
- anti-GBM nephritis

3

GNs with granular pattern on IF

- lupus GN
- PIGN
- cryoglobulinemic GN
- MPGN
- membranous nephropathy
- IgA nephropathy

4

ONLY GN with LINEAR pattern on IF

anti-GBM nephritis

5

ONLY GN with pauci-immune pattern on IF

ANCA-associated GN

6

IgA nephropathy presentation

- variable clinical presentation
- asymptomatic hematuria with mild proteinuria
- gross hematuria (sometimes with flank pain) within a FEW days of URI

7

mechanism of AKI in IgA nephropathy

- crescentic IgA nephropathy
- tubular obstruction from erythrocytes

8

treatment of IgA nephropathy if proteinuria < 1 g/day

conservative therapy: ACEI/ARB, fish oil, vitamin d, and statin

9

treatment of IgA nephropathy if proteinuria > 1 g/day

- conservative therapy: ACEI/ARB, fish oil, vitamin d, and statin
IN ADDITION TO
- steroids x 6 months
- if crescentic (RPGN), ADD cyclophosphamide

10

LN classification
- normal glomeruli on LM
- mesangial immune deposits on IF

class 1; minimal mesangial LN

11

LN classification
- purely mesangial hypercellularity of any degree or mesangial matrix expansion on LM
- mesangial immune deposits

class 2; mesangial proliferative LN

12

LN classification
- active or inactive focal, segmental or global
- endo- or extracapillary GN involving < 50% of all glomeruli
- typically with focal subendothelial immune deposits, with or without mesangial alterations

class 3; focal LN

13

LN classification
- active or inactive focal, segmental or global
- endo- or extracapillary GN involving > 50% of all glomeruli
- typically with diffuse subendothelial immune deposits, with or without mesangial alterations
- this class is subdivided into S (segmental) when 50% of involved glomeruli have segmental lesions, and G (global) when 50% of involved glomeruli have global lesions

class 4; diffuse LN

14

LN classification
- global or segmental subepithelial immune deposits or their morphologic sequelae on LM and on IF or EM, with or without mesangial alterations

class 5; membranous LN

15

histological prognostic features in LN

- class 4 (diffuse proliferative LN)

- high activity and chronicity on biopsy
- crescents
- interstitial fibrosis
- segmental necrotizing lesions

16

clinical prognostic features in LN

- HTN
- anemia
- high baseline Cr
- high baseline proteinuria
- delay in treatment

17

epidemiologic prognostic features in LN

- black race
- low socioeconomic status

18

induction therapy of class 3 or class 4 LN with or without class 5 LN

- steroids and cyclophosphamide (standard NIH protocol)
OR
- steroids and MMF (noninferior to CP)

19

maintenance therapy of class 3 or class 4 LN with or without class 5 LN

MMF

20

ANCA GN clinical presentation
- kidneys

brown, tea-colored urine

21

ANCA GN clinical presentation
- joints

pain and swelling

22

ANCA GN clinical presentation
- trachea and lungs

- cough (often mistaken for PNA)
- hemoptysis
- dyspnea

23

ANCA GN clinical presentation
- skin

- purpura
- pruritus
- hives
- rash

24

ANCA GN clinical presentation
- sinus/nose

- rhinorrhea
- nose pain
- nasal congestion
- epistaxis
- crusting of nares (poor prognostic factor indicative of relapse)

25

ANCA GN clinical presentation
- GIT

- abdominal pain
- hematochezia/melena

26

ANCA GN clinical presentation
- eyes

- eye pain
- blurry vision
- headache

27

ANCA GN clinical presentation
- ears

- hearing loss

28

ANCA GN clinical presentation
- neuro

foot drop; mononeuritis multiplex

29

MC presenting symptom of ANCA

"I just don't feel right"

30

vasculitis symptoms

# flu-like symptoms including;
- fever
- body aches
- poor appetite
- weight loss