Glomerulonephritis

Question 1

clinical picture of acute nephritic syndrome

Answer 1

1. eGFR: rapid decrease
2. Urine volume: oliguria
3. Hematuria: microscopic/macroscopic+ dismorphic, Cast
4. Proteinurtia: subnephrotic 1-3g/day
5. albumin: normal
6. edema: a bit
7. blood pressure: high-extremal high

Question 2

Clinical picture of Rapidly progressive glomerulonephritis syndrome?

Answer 2

1. eGFR: profound decrease over weeks
2. urin volume: oliguria (less common then Acute nectritc syndrome)
3. Hetmauria: microscopic, dysmorphic, casts
4. Proteinuria: subnephrotic 1-3g/d
5. Albumin: normal
6. edema: nope
7. blood pressure: not nesseserly high

Question 3

what can cause acute nephritic syndrome?

Answer 3

1. Post streptococcal GN

2. Schönlein hennoch purpura

Question 4

what can cause RPGN?

Answer 4

common
1. SLE
2. ANCA vasculitis
not common
3. Good pasture 
4. IgA nephrophaty 
5. Post streptococcal 
6. Membranoproliferative GN

Question 5

what can cause Chronic nephritic syndrom?

Answer 5

IgA nephropahty

Question 6

What can cause Nephrotic syndrom?

Answer 6

Common:

1. Diabetic
2. Membranous nephropathy
3. FSGN
4. SLE
5. MCD
   uncommon:
6. Amyloidosis
7. IGA nephropathy
8. Membranoproliferative GN

Question 7

how to proceed after choosing syndrom:

Answer 7

1. Special lab

2. Renal biopsy

Question 8

what are special factors in nephritic syndrome?

Answer 8

1. Compleemtn
2. ANA
3. Anti-dsDNS
4. Anti-C1q
5. ANCA
6. Anti- GBM
7. Ig G, A, M

Question 9

what are special factors in nephrotic syndrome?

Answer 9

1. Compleemtn
2. ANA
3. Anti-dsDNS
4. Anti-C1q
5. Ig G, A, M
6. Kappa, Lambda
7. Anti-PLA2R

Question 10

what’s Anti PLA2R?

Answer 10

Podocyte marker

Question 11

what markers for SLE?

Answer 11

Anti ds-DNS
Anti C1q
ANA

Question 12

what marker for Good pasture sy?

Answer 12

Anti-GBM

Affects plumo and renal

Question 13

special labs for Membranoproliferative GN?

Answer 13

low C4

normal C3

Question 14

how to diagnose Focal segmental glomeroluscleoruisis?

Answer 14

nephrotic syndrom

plus derecesed GFR!!!!!!!

Question 15

special lab for Membranous nephropathy?

Answer 15

anti-PLA2R

Question 16

Tx for Acute nephritis?

Answer 16

1. control of volume and salt intake
2. Loops (furosemide)
3. Antihypertensives CCB
4. renal replacement therapy

Question 17

Tx for Chronic Nephritis (IgA)

Answer 17

Antihypertensives

2. Fish oil
3. Corticosteroids for 6 months

Question 18

tx for RPGN

Answer 18

1. aggressive immunosuppression
2. 1 induction steroids!!!
3. 2. plasmapheresis
4. 3. maintaince treatment no steroids

Question 19

Treatment for minimal change disease?

Answer 19

Great responds to steroids

Question 20

Tx FSGS

Answer 20

Long steroid treatment

Question 21

Tx for Membranous nephrophathy?

Answer 21

Steroids + Cyclophosphamide/cyclosporins

maybe Rituximab

Question 22

Tx Diabetic Nephropathy?

Answer 22

glycemic controll
ACEI/ARB for Bp controll
decreased salt intake

Question 23

Clinical picture of chronic nephritic syndrom?

Answer 23

1. eGFR: low over years
2. urin volume: normal
3. Hematouria: microscopic + dysmorphia
4. proteinurea: less then 3g
5. albumin: normal
6. Edema: no
   7: BP: elevated
   8: systemic: none

Question 24

Clinical picture for nephrotic syndrom:

Answer 24

1. eGFR: normal/decresed slightly
   2: urin output: normal
2. hemtouria: none
3. Proteinuria: more the 3g
4. albumin: low
5. edema: face and extremities
6. BP: low
7. systemic: none

Question 25

generally how do we treat nephrotic syndromes?

Answer 25

1. low sodium diet 2. anti hypertensive vs HTN 3. diuretics vs edema 4. Statins vs hypercholessterolemia 5. substitute vit D (if defficent) with glucocorticoids