Flashcards in Renal 3 Deck (22)
Name 4 key features (symptoms/lab tests) of nephrotic syndrome
1. generalied edema
2. high grade proteinuria (>3.5 g/24 hrs)
3. hypoalbuminemia (<3g/dL plasma)
Name three primary causes of nephrotic syndrome and one secondary cause
-minimal change disease
-focal segmental glomerulosclerosis
What's the most common cause of nephrotic syndrome in children?
minimal change disease (looks normal on light and IF microscopy)
How would you treat minimal change disease?
What would you see on EM microscopy for minimal change disease?
epithelial foot process effacement
Focal segmental glomerulosclerosis is a form of _____ syndrome and presents most often in ______
1. nephrotic syndrome
2. african americans
What would you see microscopically in focal segmental glomerulosclerosis (FSGS)?
T/F- hypertension is rarely seen in focal segmental glomerulosclerosis
False, it is often seen
Describe the microscopic appearance of glomeruli in FSGS for light, IF, and EM
LM: segmental sclerosis
IF: mild IgM and C3 or could be negative
EM: diffuse epithelial cell injury
T/F- FSGS always responds to steroids just like minimal change disease
False, FSGS response is variable to steroids, unlike MCD which almost always responds to steroids
Where will immune deposits be located in membranous nephropathy?
Sub-epithelial deposits causing "spikes" by silver stain
T/F- chronic membranous nephropathy presents with waxing and waning of proteinuria
Name the gene associated with membranous nephropathy (recently discovered)
Name the conditions associated with membranous nephropathy in each category:
2. Infectious disease
Infectious disease= hepatitis B
T/F- Diabetic nephropathy usually presents with a linear glomerulosclerosis
False, it is a nodular glomerularsclerosis
Define thrombotic microangiopathy
Pathological entity characterized by endothelial injury resulting in widespread thrombosis in the microcirculation and arteriolar necrosis.
What 3 things does thrombotic microangiopathy lead to?
1. microangiopathic hemolytic anemia
3. in some cases, renal failure
What will you see histologically for hrombotic microangiopathy?
fragmented red cells in arteriolar wall, fibrinoid necrosis of arteriole, and onion skinning of arteriole
What are the 3 common causes of thrombotic microangiopathy?
1. hemolytic uremic syndrome/Thrombotic thrombocytopenia
2. malignant hypertension
3. anti-phospholipid syndrome
What chromosome is the autosomal dominant mutation in ADPKD present on (polycystin-1 protein)?
What decade of life does autosomal dominant polycystic kidney disease present with symptoms?