MKSAP-2 Flashcards
(27 cards)
What is the clinical manifestation and complication of glomerular basement membrane disease?
Hematuria
Proteinuria
Kidney dysfunction
Pathophysiology or additional abnormality
Hereditary?
Macroscopic and microscopic hematuria
No proteinuria
No abnormality in kidney function
Inherited type IV collagen abnormality
Is autosomal dominant
What is a clinical manifestation and complication of Alport syndrome AKA hereditary nephritis?
Microscopic and microscopic hematuria
Proteinuria presents
There will be renal dysfunction
Audio/Hearing and visual abnormalities will be present
Autosomal recessive
Antibodies against___for membranous nephropathy
Phospholipase A2
In a patient that develops nephrotic syndrome and prone to thromboembolic complications, which disease is suspected
Membranous nephropathy
Clots include renal vein thrombosis, lower extremity, PE
Will be positive in lupus nephropathy as far as serological tests in such?
Positive ANA
Positive double-stranded DNA
Low complement levels
Third leading cause of death in patient with ESRD?
Malignancy
RCC comprises only a portion of the malignancy related death
What medications can trigger G6PD
Antimalarial medications i.e. primaqine
Dapsone
TMP-SMX
Macrobid
Isoniazid
Patient has massive intravascular hemolysis, what renal complication can this cause?
Pathophysiology?
Heme pigment nephropathy
Pigment nephropathy can cause ATN with direct heme protein mediated cytotoxicity, intraluminal cast formation
You will see pigmented granular casts and hemoglobinurIa (Not myoglobinuria) but you will also see absence of erythrocytes
Causes of hypophosphatemia
Refeeding syndrome
Malnutrition
Parenteral iron i.e. ferric carboxymaltose
Parathyroidectomy
Rickets, osteomalacia
Medication of choice for primary hyperaldosteronism
MRA
Plasma aldosterone: Plasma renin =___is a positive test for primary hyperaldosteronism
> 15
You will see low complement levels in this glomerulonephritis
Postinfection glomerulonephritis i.e. Poststreptococcal Glomerulonephritis
Lupus nephritis
Cryoglobulinemic glomerulonephritis
Membranoproliferative Glomerulonephritis
___Viral is associated with cryoglobulinemia glomerulonephritis
Noninfectious causes___
Hepatitis C
Connective tissue disorder, lymphoproliferative disorder
What is the clinical presentation of cryoglobulinemic glomerulonephritis
What Will renal biopsy show?
Purpuric rash
Lab results: Low complement levels, positive cryoglobulins
MembranOproliferative glomerulonephritis PBC on renal biopSY
Cryoglobulinemia is type___
Mixed cryoglobulinemia is type___
Is associated with this clinical presentation___
Is associated with these other diseases/infection
Type I
Type II and type III
Raynaud’s phenomenon
Palpable purpura
Ulcers, necrosis, livedo reticularis
Hepatitis C, connective tissue disorder, lymphoproliferative
___Viral is associated with FSGS
___Linked with membranous nephropathy
HIV
Hepatitis B
What is the pathophysiology behind cryoglobulinemia?
Clonal and polyclonal immunoglobulins precipitated in the serum when temperatures go below 37 °C or 98.6 °F, resolves with rewarming
Rapidly progressive glomerulonephritis occurs in these diseases
Goodpasture’s i.e. antiglomerular basement membrane antibody disease
Small vessel vasculitis i.e. pauci-immune
Membranoproliferative glomerulonephritis is associated with these diseases
What are the 2 types?
Hepatitis C
Immune complex disease i.e. lupus
Monoclonal gammopathy
Immune complex form mediated by antigen antibody
Complement mediated form
Patient had strep throat, and Now they might have poststreptococcal glomerulonephritis as seen with the hump shaped subepithelial depositions, what is the treatment here?
Antibiotics, treat the infection, do not do not do not do not do not give steroid!!!!!!!!!!!!!!!!!!
Recommend get___imaging to look for ___complication in___renal (nephrotic)syndrome
Renal Doppler
Looking for renal vein thrombosis
Complication nephrotic syndrome most commonly associated with membranous nephropathy
Patient is 26 weeks gestation, has new onset hypertension, no proteinuria,Only symptom is a mild new headache, can this be considered preeclampsia?
Yes
Preeclampsia can be diagnosed without proteinuria
Can be diagnosed as long as there is evidence of endorgan damage i.e. thrombocytopenia, renal dysfunction, liver dysfunction, pulmonary edema, cerebral sx ie HA-new, new visual disturbances
Serum___level is more sensitive in identifying milder decrement in kidney function than serum creatinine
Cystatin C
Amyloidosis, as seen with characteristic apple green birefringence with Congo red stain under kidney biopsy, has___pathophysiology
And comes with nephritic/nephrotic___syndrome?
Another sensitive test would be___
Extracellular tissue deposition of fibrillary protein
Nephrotic syndrome with copious proteinuria
Serum free light chains quantification and urine and serum protein electrophoresis
