Goljan Renal Path 1
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| What are podocytes? | visceral epithelial cells
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| What are the spaces between the podocytes called? | split pores
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| Which cells synthesize the glomerular BM? | visceral epithelial cells (podocytes)
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| What keeps albumin out of urine? | strong negative charge of Glomerular BM
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| What is responsible for charge of GBM? | Heparan Sulfate (strong negative charge)
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| damage to visceral epithelial cell results in what? | damage to BM and leaking of albumin into urine --> nephrotic syndrome
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| linear pattern outlining BM on Immunofluorescence | goodpasture syndrome
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| subendothelial immune complex deposits in glomeruli on EM (granular) | lupus
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| subepithelial immune complex deposits in glomeruli EM (granular) | post-strep glomerulonephritis
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| only glomerulonephritis one can diagnose with IF | IgA glomerulonephritis
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| granular pattern on IF. what does it mean? | immunocomplex type III disease (membranous glomerulonephritis = immune complexes)
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| anti BM antibodies is what type of immune complex disease? | Type II
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| RBC casts in urine is unique to what class of diseases | nephritic syndromes
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| serum ANA shows rim pattern. what does that mean? | anti-DNA --> lupus
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| crescentic glomerulonephritis is most commonly seen in what syndrome? | goodpasture's syndrome
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| cholesterol casts in urine that when polarized look like maltese crosses. what is the diagnosis? | nephrotic syndrome
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| why does lipoid nephrosis occur (Minimal change disease)? | loss of negative charge of GBM
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| Nephrotic syndrome associated with HIV | FSGS
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| glomerular problem in HBV | diffuse membraneous glomerulonephritis
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| glomerular problem in HCV | Membranoproliferative glomerulonephritis
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| vasculitis associated with HBV | polyarteritis nodosa
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| large golf-ball appearing glomeruli on H&E | diabetic nephropathy
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| what happens to the GFR and creatinine clearance in early diabetic nephropathy? | hyalinization of efferent arterioles, so Cr clearance and GFR increase. Also nonenzymatic glycosylation of BM cause microalbuminuria
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| ACE inhibitors do what to glomerular arterioles? | less angiotensin II dilates efferent arteriole
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| mesangial cells split BM on EM. C3 deposited adjacent to but not within dense deposits. serum C3 is very low. what is the diagnosis? | Type II membranoproliferative glomerulonephritis
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| properties of BUN | blood urea nitrogen - secreted and reabsorbed in PCT
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| properties of Creatinine | end-product of creatine - only filtered in kidney, neither reabsorbed nor secreted in kidney (can be in other places in very high levels)
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| normal BUN and Cr levels | BUN: 9-10 Cr: 1 mg/dl
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| normal BUN/Cr | 10
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| pre-renal azotemia | normal kidneys, but reduced Cardiac Output (e.g. CHF), ergo, GFR decreases. BUN/Cr >20
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| most common cause of acute renal failure | ischemic acute tubular necrosis
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| Cardiac output decreases and oliguria, what do you worry about most? | ischemic acute tubular necrosis
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| Acute tubular necrosis associated with? | renal ischemia (eg shock), crush injury (myoglobinuria), toxins
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| Acute renal failure values: BUN/Cr | Prerenal: >20 Renal: <15 Postrenal: >15
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| Acute renal failure values: Urine Osmolality | Prerenal: >500 Renal: <350 Postrenal: <350
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| Acute renal failure values: Urine Na | Prerenal: <10 Renal: >20 Postrenal: >40
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