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Rezi FC > Nefro > Flashcards

Nefro Flashcards

1
Q

Elementele care au rol in desfasurarea/impiedicarea filtrarii

A

EndoteliuMBGPodocite

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2
Q

Din ce este alcatuita bariera de filtrare glomerulara (diafragma cu sita)?

A

Endoteliul fenestratMBGCelule epiteliale viscerale diferentiate (podocite)

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3
Q

Proteinele ce realizeaza diafragma cu fante

A

NefrinaPodocinaP-cadherinaAlfa si beta-cateninaProteina asociata CD2 (CD2AP)TRPC6ZO1

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4
Q

Citoscheletul de actina poate fi modificat prin:

A

Anomalii ale proteinelor citoscheletale (alfa actinina 4 -> GSFS ereditara)Leziuni/anomalii ale proteinelor diafragmei cu fantaModificari ale MBGInjurie podocitara directa

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5
Q

Ce poate determina injurie podocitara directa?

A

Infectii viraleMedicamenteToxineActivare locala de SRAA

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6
Q

Leziuni imune ce pot aparea la nivel glomerular si antreneaza leziuni secundare

A

Depunerea de fibrinaAgregarea plachetaraInfiltrarea neutrofilelorInjuriile provocate de radicalii liberi

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7
Q

Glomerulopatiile sunt a …(a) cauza de BRT si reprezinta … (b) din cazuri

A

a = treiab = 10-15%

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8
Q

Frecventa NTI ca reactie de HS la medicamente

A

70% cazuriCel mai des* penicilina* AINS* IPP

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9
Q

Unele sindroame nefrotice mostenite implica mutatii ale unor gene ce codifica proteine podocitare precum

A

Nefrina (tipul finlandez)PodocinaAlfa-actinina 4Gena supresoare a tumorii Wilms

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10
Q

Proteinuria posturala poate fi semn precoce de leziuni glomerulare grave precum

A

GNMGSFSNefropatia IgANefropatia diabeticaAmiloidoza

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11
Q

Frecventa proteinuriei posturale si valoarea ei

A

> 50% din pacientii cu functie renala normalaMasoara de obicei < 1g/zi

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12
Q

Proteinuria usoara/tranzitorie poate acompania:

A

Starile febrileBolile infectioaseICC

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13
Q

MO in HIVAN

A

Colaps glomerularPodocitele sunt- marite de volum (hipertrofice)- hiperplazice- vacuolate grosier (contin picaturi de absorbtie ale proteinelor)Capilarele adiacente - diferite grade de colaps + plicaturare a peretilor

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14
Q

Markeri specifici podocitelor

A

SinaptopodinaFactor tumoral Wilms

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15
Q

Clinica HIVAN

A

Proteinurie nefroticaEdemeBCR - posibil rapid progresiva

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16
Q

Mutatia APOL1 creste susceptibilitatea la GSFS ca raspuns la insulte precum

A

HTAHIVLES

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17
Q

Mutatia APOL1 protejeaza impotriva

A

Bolii somnului (tripanosomiazei africane)

18
Q

Ce gene MHC pot creste susceptibilitatea la glomerulonefrita primara?

A

HLA-A1HLA-B8HLA-DR2HLA-DR3

19
Q

Cu ce se asociaza HLA-DQA1?

A

GNM idiopatica cu ac anti-PLA2R

20
Q

Hematuria cu/fara proteinurie subnefrotica poate duce la descoperirea timpurie a unei glomerulopatii potential grave precum

A

LESPHSGNPIHipercalciurie idiopatica la copii

21
Q

Ce boli glomerulare secundare pot sa suprapuna si GNRP?

A

Nefropatia IgAGNMGNPI

22
Q

GNRP cu model liniar

A

GNRP anti-MBG (idiopatica mediat de Ac)Goodpasture

23
Q

GNRP cu model granular

A

GNRP idiopatica mediata de CIAsociat cu GN primare* GNMC (tip 2 > tip 1)* Nefropatie IgA* GNMAsociat cu GN secundare* GNPI* LES* PHS* Crioglobulinemie

24
Q

Microorganisme ce pot determina GNPI non-streptococica

A

StaphylococcusS. pneumoniaeLegionellaT. pallidum (sifilis)VaricelaOreionVHB, VHCEBVEchovirusToxoplasmaPlasmodium (malarie)SchistosomaTrichinella

25
Q

Obiective tratament GNMC la copii

A

Urmarire regulataControl TAAgenti antiproteinuriciCorectia tulburarilor lipidice

26
Q

Caracteristici extraglomerulare ale NL

A

NTI (75%)Tromboza de vena renalaStenoza de artera renala

27
Q

Manifestari trombotice asociate NL

A

Infarct glomerular segmentarMicroangiopatie tromboticaVasculita

28
Q

In ce nefropatii se poate administra rituximab?

A

GNLMGNMAmiloidoza ALVasculiteGamapatia monoclonala cu semnificatie renala (MGRS)Nefrita lupicaNefropatia CG

29
Q

Ce nefropatii au depozite subepiteliale?

A

GNM

30
Q

GNRP se poate suprapune glomerulopatiilor secundare precum

A

Nefropatie IgAGNMGNPI

31
Q

In ce boli mai apare IgA crescut

A

PHSHepatopatii croniceCancere (mai ales bronsice)SpA seronegativaPsoriazisBCMycosis fungoides

32
Q

Cauze reversibile de BCR

A

Obstructie de tract urinarHTAStenoza de artera renalaGlomerulonefrite/vasculite sistemice

33
Q

Prevalenta BCR in functie de varsta

A

<65 ani = 1.5%65-74 ani = 15.9%75-84 ani = 30.9%>85 ani = 33.4%

34
Q

Medicatie GNLM

A

GC doze mariCiclosporina/tacrolimusRituximabCFS + GCLevamisol

35
Q

Medicatie GSFS I

A

PrednisolonCiclosporina/tacrolimusCFS/clorambucil/AZTAbataceptACTH - gel topic

36
Q

Medicatie GNM

A

Toti pacientii - IEC (doza maxima tolerata), diuretic, statina, anticoagulantRituximabCiclosporina/tacrolimusCFS + prednisolon oral alternativClorambucil + prednisolon oral alternativGC orali dar NU singuri

37
Q

Medicatie nefropatie IgA

A

IEC/sartan - toti pacientiiGCAmigdalectomie

38
Q

Medicatie vasculite ANCA+

A

GC orali doze mari + CFS iv pulsuri - inductieRituximab - varianta de inductieAZT/CFS/MMF/Rituximab - mentinere

39
Q

Cel mai eficient in mentinerea remisiei in vasculite ANCA+

A

Rituximab la 3 luni in D fixa

40
Q

Medicatie NL

A

HTA, edemele - tratate mereuRituximab - cazuri refractare severeMMF/AZT - mentinereGC + D mari de CFS/MMF - inductieCFS - la albiMMF - la negri si hispanici

41
Q

Cel mai bun in mentinerea remisiei in NL

A

Micofenolat

Rezi FC (28 decks)

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