Nephrotic

Question 1

qualifications for nephrotic syndrome / consequences

Answer 1

urine protein over 3.5 g/day
hypoalbuminemia - edema
hypogammaglobulinemia- infection
hypercoaguable state- loss of AT III
hyperlipidemia - fatty casts

Question 2

MCD

Answer 2

m/c in kids, selective loss of albumin, due to massive cytokine release that causes effacement of foot processes, meds respond to steroids, adults may not

Question 3

gene assoc with rare cases of MCD/FSGS

Answer 3

NPHS2 (podocin)

Question 4

microscopic findings in MCD

Answer 4

EM- effacement of foot processes

Question 5

FSGS

Answer 5

m/c in AA and hispanic adults, non-selective protein loss, poor response to steroids

Question 6

associations with FSGS (3)

Answer 6

heroin, HIV, sickle cell

Question 7

microscopic findings in FSGS

Answer 7

LM- focal/segmental hyalinosis

EM- effacement of foot processes

Question 8

membranous nephropathy

Answer 8

m/c in caucasian adults, autoantibodies directed at podocytes, loss of ATIII (hypercoaguable)

Question 9

associations with membranous nephropathy (5)

Answer 9

HBV, HCV, solid tumors, SLE, drugs (gold, penicillamine, NSAIDs)

Question 10

microscopic findings in membranous nephropathy

Answer 10

LM- thick glomerular BM
EM- subepithelal, spike and dome
IF- granular

Question 11

membranoproliferative GN “apperance”

Answer 11

tram track

Question 12

MPGN type I location of deposits, assoc

Answer 12

deposits- sub endothelial

assoc- HBV, HCV

Question 13

MPGN type II location of deposits, assoc

Answer 13

deposits- intra-BM

assoc- C3 nephritic factor (low serum C3)

Question 14

microscopic findings in MPGN I/II

Answer 14

LM: thick BM, hypercellular mesangium
EM: I- subendo, II- intra-BM
IF: granular

Question 15

m/c cause of ESRD in the US

Answer 15

DM

Question 16

pathogenesis of diabetic nephropathy

Answer 16

high glucose leads to hyaline arteriolosclerosis, affects efferent arteriole more, hyper filtration occurs, progresses to nephrotic syndrome

Question 17

microscopic findings in DM nephropathy

Answer 17

KW nodules

Question 18

first lab elevated in DM nephropathy

Answer 18

microalbumin

Question 19

AL, AA

Answer 19

AL- blood cell dyscrasia, idiopathic

AA- chronic inflammation

Question 20

microscopic findings in renal amyloidosis

Answer 20

apple green birefringence on congo-red staining

Question 21

characteristic change for diffuse proliferative GN

Answer 21

wire loop

Question 22

2 m/c causes of asymptomatic hematuria

Answer 22

IgA nephropathy, benign familial hematuria (thin BM disease)

Question 23

cells that proliferate in MPGN

Answer 23

mesangial cells

Question 24

medullary sponge kidney

Answer 24

linear striations, small cysts

Question 25

AD PKD is assoc with defects in

Answer 25

polycystin

Question 26

nephronophthisis

Answer 26

AR defect in kids. NPHP1