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Lecture 3
Glomerular Disease II
Question | Answer |
---|---|
How does the kidney compensate for a significantly reduced glomerular filtration rate | re-absorption of Na+ from the tubules |
If you detect RBC Casts in Fresh Urine you can make the diagnosis of? | Nephritic Syndrome |
The majority of patients with with this nephritic syndrome present one to two weeks after either a streptococcal throat or skin infection with hematuria, oliguria, edema (mild) and hypertension | acute proliferative glomerulonephritis |
What types of Strep are responsible for Acute Proliferative Glomerulonephritis | Group A Beta-hemolytic Strep Types 12,4, and 1 |
Does treatment with antibiotics for strep infection prevent renal complications | no |
If Acute Proliferative Glomerulonephritis progresses what does it progress to? | Crescentic GN |
What is the prognosis related to acute proliferative glomerulonephritis | in children close to 100%, in adults 40-50% |
Crescentic GN is also known as? | Rapidly Progressive GN |
What are the three types of PRGN | with anti-GBM antibody, with immune complex, and without immune complex (Pauci-Immune) |
What do you see on IF with RPGN with anti-GBM antibody | IgG deposited in a LINEAR fashion along GBM |
People with Pauci-immune RPGN are often positive for this serum antigen | Positive for ANCA |
what are the two types of ANCA in pts with GN | P and C-ANCA |
What is P-ANCA directed at? | myeloperoxidase in neutrophils |
What is C-ANCA directed at? | proteinase 3 in neutrophils, in patients with Wegener's granulomatosis |
What are other problems associated with Wegener's besides GN? | sinusitis, nose bleed, hemoptysis from lung inflammation |
In patients with Membranoproliferative GN what complement components are depleted | C3,5,6,7 (alternative pathway) |
What is the common pathological finding in Membranoproliferative GN? | INTERPOSITION of the mesangial cells between the endothelial and epithelial cells within the GBM of the peripheral capillary loop |
In addition to IgA nephropathy abundant IgA deposition is also seen in? | SLE Gn, and Henoch-Schoenlein allergic purpura |
GN that presents as Hematuria, purpura with increased bleeding tendency, arthritis, and acute abdominal pain | Henoch Schoenle in Allergic Purpura |
What are the two broad categories of Cyroglobulinemic GN | essential mixed and monoclonal |
Essential mixed cyroglobulinemic GN has a major association with ? disease | Hepatitis C infection |
What GN presents with palpable purpura, Raynaud's, Leg ulcers, arthralgias, hepatosplenomegally, lymphadenopathy | Essential mixed cyroglobulinemic GN |
What is monoclonal Cryoglobulinemic GN associated with? | underlying Lymphoproliferative disorders |
Almost 100% of SLE patients are positive for? | ANA |
WHO type I Lupus Nephritis | No histological abnormality |
WHO type II Lupus Nephritis | Mesangial Lupus Nephritis (IgA nephropathy) |
WHO type III Lupus Nephritis | Focal Lupus Nephritis |
WHO type IV Lupus Nephritis | Diffuse Membranoproliferative Lupus GN that may have epithelial crescents |
Common histopathologic findings in type IV SLE GN | Wire loop and Hematoxylin body |
WHO type V Lupus Nephritis | Membrane Lupus Nephritis (membranous GN) |