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P&T Block 5 Renal > SG Diseases > Flashcards

Flashcards in SG Diseases Deck (15)
1

Describe acute nephrotic syndrome

Proteinuria > 3.5g
See oval fat bodies: lipid in urine
- Hypoalbuminemia
- Hyperlipidemia (compensation by liver)

2

Clinical picture of acute nephrotic syndrome

Weight gain - dep edema, ascities
Hypercoag state

3

Does nephrotic syndrome edema respond to diuretics?

No b/c low intravasc vol

4

Clinical picture of acute nephritic syndrome

Edema face + hands
Acute HTN
Oliguria
BUN:Cr > 15

5

Is urine sediment abnormal during nephritic syndrome?

Yes - high urine sediment
RBCs
RBC casts
Moderate proteinuria

6

Describe rapidly progressive renal glomerular nephritis, RPGN (renal failure)

Rapid loss glomerular filtration
Severe progressive of nephritic
Acute rise Cr + urine sediment
1. Edema (weight gain)
2. Proteinuria - indicates glomerular process (not high enough for nephrotic)
3. HTN

7

What would you see on biopsy if the pathologic process of RPGN is of glomerular origin?

Crescents in most glomeruli

8

Describe chronic renal failure

Gradual deterioration of renal fxn
↓GFR
HTN + edema - late in disease once ↓↓GFR

9

Name the causes of low complement glomerular nephritis

1. Post-strep GN
2. SLE
3. MPGN (Hep C related)
4. Secondary MPGN - SLE of HBV
5. Atheroembolic renal
6. HUS/TTP - check peripheral blood smear

10

What is the light microscopy for post-strep GN

Hypercellular throughout - more mesangium
Obliterated capullary lumina

11

IF and EM for post-strep GN

IF: "granular" lumpy bumpy due to deposit of IgG + IgM + C3 on basement membrane
EM: sub-epi deposits of Ig in humps

12

Ddx for nephrotic syndrome

Minimal change (kids)
Membranous nephropathy - Hep B, SLE
Focal Seg GS - HIV
Mesangial proliferative
Diabetes
Amyloid
Membrano-proliferative (nephritic or nephrotic)

13

What would you see for minimal change disease

EM only - effacement of foot processes
LM and IF are normal!!

14

What are the 3 categories of RPGN?

ALL THE SAME ON LM
1. Granular IF = immune complex mediated
2. Linear IF = anti-GBM
3. Nothing IF = Pauci-immune

15

Quiz 1: pt with facial + hand edema, low FE Na, proteinuria, hematuria, HTN - which syndrome

Acute nephritic
Think:
- Post infectious GN