Norton3

Question 1

Follows a respiratory infection or immunization. Immunologically mediated and responds to steroids.

Answer 1

Minimal change disease

Question 2

See nothing on light microscopy or Immunofluorescence

Answer 2

Minimal change disease

Question 3

EM > effacement of foot process. Flattening, retraction, and swelling of foot processes.
Massive, highly selective albumin proteinuria

Answer 3

Minimal change disease

Question 4

NO HTN, hematuria, or loss renal function. Rapidly responds to corticosteroids

Answer 4

Minimal change disease

Question 5

Visceral epithelial damage (from cytokines or genetics) affecting the slit diaphragm. Hyalinosis and sclerosis from plasma proteins exuding through the hyper permeable areas

Answer 5

Focal segmental glomerulosclerosis

Question 6

Can be idiopathic, associated with (HIV, heroin, sickle cell, obesity), adaptive response to loss of renal tissue, or inherited (not common)

Answer 6

Focal segmental glomerulosclerosis

Question 7

NPHS1 encodes

Answer 7

Nephrin - focal segmental glomerulosclerosis

Question 8

NPHS2 encodes

Answer 8

Podocin - focal segmental glomerulosclerosis

Question 9

Immunofluorescence > IgM and C3 in sclerotic areas.
Light microscopy > focal, segmental sclerosis. Affected capillary loops collapse. Segmental hyalinosis in affected capillary walls

Answer 9

Focal segmental glomerulosclerosis

Question 10

EM > effacement of foot processes in both sclerotic and no sclerotic areas. Focal detachment of epithelial cells and denudation of GBM

Answer 10

Focal segmental glomerulosclerosis

Question 11

Must Distinguish from minimal change disease

Answer 11

Focal segmental glomerulosclerosis

Question 12

Increased incidence of hypertension, hematuria, and decreased GFR. Proteinuria nonselective

Answer 12

Focal segmental glomerulosclerosis

Question 13

Focal segmental glomerulosclerosis has ________ response to steroids

Answer 13

Poor

Question 14

50% develop end-stage renal disease within 10 yrs

Answer 14

Focal segmental glomerulosclerosis

Question 15

Children have better prognosis than adults. 20% ppl have rapid progression. 25-50% have recurrence post transplant

Answer 15

Focal segmental glomerulosclerosis

Question 16

Common cause of nephrotic syndrome in children. 2-6 yrs

Answer 16

Minimal change disease

Question 17

Has two types. Combined nephrotic/Nephritic syndrome

Answer 17

Membranoproliferative glomerulonephritis

Question 18

Types one and 2 Membranoproliferative glomerulonephritis

Answer 18

Primary

Question 19

Always type 1 Membranoproliferative glomerulonephritis

Answer 19

Secondary

Question 20

Secondary causes include chronic immune complex d/o (lupus, hep B, hep C, HIV), alpha1 antitrypsin deficiency, malignancy, hereditary deficiencies of complement proteins

Answer 20

Membranoproliferative glomerulonephritis

Question 21

Immune complexes in glomerulus. Activation of classical and alternative complement pathways

Answer 21

Membranoproliferative glomerulonephritis type one

Question 22

Light microscopy > Hypercellular. Mesangial cell proliferation. Capillary endothelium proliferation. WBC influx. Crescents. Segmental GBM thickening. Glomerular capillary wall tram-track appearance

Answer 22

Membranoproliferative glomerulonephritis both types

Question 23

Tram-track appearance

Answer 23

Membranoproliferative glomerulonephritis both types

Question 24

Immunofluorescence > C3 in granular pattern. IgG, C1q, and C4.
EM > subendothelial electron dense deposits

Answer 24

Membranoproliferative glomerulonephritis