Renal Disorders III Flashcards Preview

MODHIII - Unit 3 > Renal Disorders III > Flashcards

Flashcards in Renal Disorders III Deck (25)
1

Causes of nephrotic syndrome

- primary: minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy
- secondary: diabetic nephropathy

2

Minimal change disease: who does it affect

- most common in children (peak 2-6yrs)

3

Minimal change disease appearance on light and immunofluorescence microscopy

NORMAL

4

Treatment for minimal change disease

- response well to steroids

5

Key feature of minimal change disease: electron microscopy

- diffuse epithelial foot process effacement

6

Focal segmental glomerulosclerosis (FSGS): who does it affect

- common in african americans

7

FSGS signs

- hypertension
- microscopic hematuria

8

FSGS biopsy signs

LM- segmental sclerosis
IF- mild IgM and C3 or negative
EM- diffuse epithelial cell injury

9

FSGS treatment

- response to steroids is variable (UNLIKE minimal change disease)

10

FSGS key features

- segmental glomerular sclerosis (LM)
- epithelial foot process effacement (EM)

11

Membranous nephropathy biopsy

LM: thickened capillary loops
IF: granular capillary loop pattern
EM: sub epithelial deposits (SPIKES)

12

Special stain done with membranous nephropathy and purpose

- silver stain: can see SPIKES better

13

Spikes in membranous nephropathy: pink vs. black

- pink = deposits
- black = basement membrane

14

Membranous nephropathy key feature

- sub epithelial immune deposits causing "spikes" by silver stain

15

Membranous nephropathy causes and clinical course

- idiopathic: 85%
- secondary: 15%
- clinical course: chronic, waxing and waning of proteinuria

16

Conditions associated with membranous nephropathy

1. idiopathic
2. autoimmune diseases: lupus erythematosus
3. infectious diseases: hepatitis B
4. drugs: penicillamine
5. miscellaneous: malignancies

17

Diabetic nephropathy presentation

- proteinuria, nephrotic syndrome or chronic kidney disease

18

Histologic finding with diabetic nephropathy

- nodular glomerulosclerosis

19

Thrombotic microangiopathy: leads to what

1. microangiopathic hemolytic anemia: schistocytes
2. thrombocytopenia
3. kidney injury

20

Features of thrombotic microangiopathy

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

21

Causes of thrombotic microangiopathy

1. hemolytic uremic syndrome/thrombotic thrombocytopenic pupura
2. malignant hypertension
3. anti phospholipid syndrome

22

Adult polycystic kidney disease (APKD): cause

- autosomal dominant inheritance
- defect in PKD1 gene (Cr 16) which encodes the polycystin-1 protein

23

APKD: result

- multiple expanding cysts in the kidney that eventually destroys kidney
- asymptomatic until 4th decade

24

Symptoms of APKD

- flank pain and hematuria
- saccular aneurysms in circle of willis can lead to subarachnoid hemorrhage and death

25

Nephrotic syndrome signs

- edema
- proteinuria, >3.5 g/24hours
- hypoalbuminemia, plasma levels