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Lecture 3

Glomerular Disease II

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)
Created by: UVAPATH3