Nephrology-Notes

Question 1

What are some examples of nephrotic syndromes?

Answer 1

membranous nephropathy
minimal change disease
focal segmental glomerulosclerosis
membranoproliferative glomerulonephritis
diabetic nephropathy
amyloidosis

Question 2

What are some examples of nephritic syndromes?

Answer 2

diffuse proliferative glomerulonephritis
post strep glomerulonephritis
RPGN
IgA nephropathy
Alport syndrome
thin BM disease

Question 3

What are the features of membranous nephropathy?

Answer 3

nephrotic
granular immune complex deposition
diffuse capillary thickening
spike and dome (subepithelial immune complex deposits)

Question 4

What are important features of minimal change disease?

Answer 4

nephrotic
good steroid response
cytokine damages podocytes

Question 5

What are the features of focal segmental glomerulosclerosis?

Answer 5

segmental sclerosis and hyalinosis

nephrotic

Question 6

Membranoproliferative glomerulonephritis?

Answer 6

immune complex deposition
subendothelial humps
increased GBM and mesangial matrix
tram tracks
decreased complements
due to HBV, HCV, cryoglobulinemia

Question 7

Diabetic nephropathy?

Answer 7

nephrotic
massive mesangial proliferation
gbm thickening
kimmelstein-wilson nodules

Question 8

Diffuse proliferative glomerulonephritis?

Answer 8

nephritic
anti-dsDNA deposits in mesangium and subepithelium
wire loop appearance, dense BM
lupus

Question 9

Post strep glomerulonephritis?

Answer 9

nephritic
subepithelial humps
coarsy granular deposits of C3
hypercellular glomeruli
granular pattern of immune complex deposition
\+ASO
decreased C3

Question 10

RPGN?

Answer 10

nephritic
crescent formation in glomerulus
fibrin in the crescents

Question 11

Goodpasture’s?

Answer 11

RPGN Type I

linear immune complexes

Question 12

HSP?

Answer 12

purpura on back of arms and legs
abdominal pain
RPGNII

Question 13

Wegener’s?

Answer 13

necrotizing granulomatous vasculitis
involves the nasopharynx, lungs, kidney
c-ANCA (PR3ANCA)

Question 14

Microscopic polyangitiis?

Answer 14

no nasopharynx involving
just lung and kidney
p-ANCA

Question 15

IgA Nephropathy?

Answer 15

aka Berger’s
dark dense deposits IgA in mesangium
associated with URIs

Question 16

Alport syndrome?

Answer 16

type 4 collagen defect
BM splits
nephritis, deafness, cataracts
can’t see, pee, hear high C

Question 17

Thin BM disease?

Answer 17

benign familial hematuria

Question 18

Painless hematuria? that is gross, visible

Answer 18

cancer of the kidney or bladder

Question 19

When do you see low complement levels?

Answer 19

postinfectious GN
lupus nephritis
MPGN
mixed cryoglobulinemia (associated with Hep C)

Question 20

Symptoms associated with nephrotic syndrome?

Answer 20

massive proteinuria>3.5g/d

hypoalbuminemia (

Question 21

Symptoms associated with nephritic syndromes?

Answer 21

not a lot of proteinuria

Question 22

What is the usual cause of nephrotic syndromes in children and adults?

Answer 22

children-primary kidney lesion

adults-systemic disease, diabetes, lupus etc.

Question 23

What is the workup for nephrotic syndrome?

Answer 23

UA with micro
24 hour protein
HbA1c, ANA/ds-DNA, C3/C4, Hep panel
renal biopsy

Question 24

Wilm’s tumor, nephroblastoma?

Answer 24

neoplastic embryonal renal cells

Question 25

What are some associated factors with wilm's tumor?

Answer 25

``` WAGR: wilm's aniridia GU abnormalities Retardation ``` Beckwith-Wiedemann macrosomia, macroglossia omphalocele, umbilical hernia neonatal hypoglycemia hemihyperplasia (R side larger than left) Wilm's tumor, hepatoblastoma, adrenal cortical carcinoma

Question 26

What is the surveillance for beckwith wiedemann syndrome?

Answer 26

serum AFP abdominal u/s renal u/s

Question 27

What is the workup for Wilm's tumor?

Answer 27

abdominal u/s CT scan CXR (for mets) treat with surgery, chemo, radiation

Question 28

Features of neuroblastoma?

Answer 28

2nd most common solid tumor | infant tumor

Question 29

What are the symptoms of a neuroblastoma in the neck?

Answer 29

horner's syndrome

Question 30

What are the symptoms of a neuroblastoma in the thorax?

Answer 30

respiratory distress | abnormal CXR

Question 31

What are the symptoms of a neuroblastoma in the abdomen?

Answer 31

mass abdominal pain HTN due to compression of the kidneys infant with RUQ mass and pallor without jaundice

Question 32

Symptoms of VIPoma?

Answer 32

watery diarrhea

Question 33

What is the workup for a neuroblastoma?

Answer 33

``` abdominal us cbc urine/serum VMA/HVA CXR CT histo: malignancy of neural crest cells small round blue cells, uniform with hyperchromatic nuclei and scant cytoplasm (small cell rosettes) ``` treat with surgery, chemo, radiation