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Flashcards in Renal 3 Deck (22):
1

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)
4. hyperlipidemia

2

Name three primary causes of nephrotic syndrome and one secondary cause

primary
-minimal change disease
-focal segmental glomerulosclerosis
-membranous nephropathy
seconary
-diabetic nephropathy

3

What's the most common cause of nephrotic syndrome in children?

minimal change disease (looks normal on light and IF microscopy)

4

How would you treat minimal change disease?

steroids

5

What would you see on EM microscopy for minimal change disease?

epithelial foot process effacement

6

Focal segmental glomerulosclerosis is a form of _____ syndrome and presents most often in ______

1. nephrotic syndrome
2. african americans

7

What would you see microscopically in focal segmental glomerulosclerosis (FSGS)?

-microscopic hematuria

8

T/F- hypertension is rarely seen in focal segmental glomerulosclerosis

False, it is often seen

9

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

10

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

11

Where will immune deposits be located in membranous nephropathy?

Sub-epithelial deposits causing "spikes" by silver stain

12

T/F- chronic membranous nephropathy presents with waxing and waning of proteinuria

True

13

Name the gene associated with membranous nephropathy (recently discovered)

PLA2R

14

Name the conditions associated with membranous nephropathy in each category:
1. Autoimmune
2. Infectious disease
3. Drugs

Autoimmune= Lupus
Infectious disease= hepatitis B
Drugs= Penicillamine

15

T/F- Diabetic nephropathy usually presents with a linear glomerulosclerosis

False, it is a nodular glomerularsclerosis

16

Define thrombotic microangiopathy

Pathological entity characterized by endothelial injury resulting in widespread thrombosis in the microcirculation and arteriolar necrosis.

17

What 3 things does thrombotic microangiopathy lead to?

1. microangiopathic hemolytic anemia
2. thrombocytopenia
3. in some cases, renal failure

18

What will you see histologically for hrombotic microangiopathy?

fragmented red cells in arteriolar wall, fibrinoid necrosis of arteriole, and onion skinning of arteriole

19

What are the 3 common causes of thrombotic microangiopathy?

1. hemolytic uremic syndrome/Thrombotic thrombocytopenia
2. malignant hypertension
3. anti-phospholipid syndrome

20

What chromosome is the autosomal dominant mutation in ADPKD present on (polycystin-1 protein)?

chr 16

21

What decade of life does autosomal dominant polycystic kidney disease present with symptoms?

4th

22

What causes subarachnoid hemorrhage in pts with ADPKD?

berry/saccular anuerysms in the circle of willis