Norton2

Question 1

Pauci-immune. No anti-GBM abs or immune complexes. Circulating ANCA.
Light microscopy > crescents.
See nothing on Immunofluorescence.
EM > ruptures in GBM

Answer 1

Rapidly progressive (crescent) glomerulonephritis - type 3

Question 2

Hematuria and RBC casts in urine. Mild proteinuria, edema, HTN. Mild may resolve. Severe may progress to severe oliguria.

Answer 2

Rapidly progressive (crescent) glomerulonephritis

Question 3

Treatment includes steroids and cytotoxic agents. For goodpastures you want to do ____________

Answer 3

Rapidly progressive (crescent) glomerulonephritis. 
Plasmapheresis

Question 4

Hemoptysis and pulmonary hemorrhage

Answer 4

Goodpastures - Rapidly progressive (crescent) glomerulonephritis type one

Question 5

Many pts progress to dialysis and need a transplant

Answer 5

Rapidly progressive (crescent) glomerulonephritis

Question 6

Microscopic polyangiitis ________ ANCA

Answer 6

MPO

Question 7

Wegners ____ ANCA

Answer 7

PR3

Question 8

Anti-nuclear abs

Answer 8

Lupus

Question 9

Anti GBM abs

Answer 9

Goodpastures

Question 10

Increased permeability of BM (slit diaphragm not holding in proteins). Urinary loss of plasma proteins

Answer 10

Nephrotic syndrome

Question 11

Proteinuria (>3.5 grams/day), hypoalbuminemia, edema, hyperlipidemia, and lipiduria

Answer 11

Nephrotic syndrome

Question 12

Lipiduria

Answer 12

Fat in urine

Question 13

Need to do a 24 hour urine collection to measure proteinuria

Answer 13

Nephrotic syndrome -

Question 14

Immune complex deposition.
Light microscopy > crescents.
Immunofluorescence > granular immune complex deposits.
EM > ruptures in GBM and deposits

Answer 14

Rapidly progressive (crescent) glomerulonephritis - type two

Question 15

Common cause of nephrotic syndrome in adults

Answer 15

Membranous nephropathy

Question 16

Immune complex mediated and usually indolent

Answer 16

Membranous nephropathy

Question 17

Primarily idiopathic (85% cases) but can be secondary to drugs, malignancies, lupus, and infections (antigens related to underlying disease present in immune complexes)

Answer 17

Membranous nephropathy

Question 18

Light microscopy > normal glomeruli or diffuse thickening of glomerular capillary wall

Answer 18

Membranous nephropathy

Question 19

Immunofluorescence > granular IgG and C3.

EM > spikes and domes of immune complex deposits between GBM and epithelial cells. Effaced foot processes

Answer 19

Membranous nephropathy

Question 20

> 60% have persistent proteinuria and 40% develop renal insufficiency

Answer 20

Membranous nephropathy

Question 21

Spontaneous remission occurs in women and pts with less proteinuria

Answer 21

Membranous nephropathy

Question 22

Insidious onset of nonselective proteinuria

Answer 22

Membranous nephropathy

Question 23

Hematuria, mild HTN. Can progress to ^ glomerulosclerosis, ^ serum Cr, and ^ HTN

Answer 23

Membranous nephropathy