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Renal Makeup: Atkinson - Glomerular Disease - Nephrotic Syn
Renal Makeup: Atkinson - Glomerular Disease - Nephrotic Syn
19
Medical
Graduate
03/19/2010

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Term
What are the differences btn nephritic and nephrotic syndrome?
Definition
1. Nephritic: hematuria (glomerular related)*, azotemia (uremia), variable proteinuria, oliguria, edem, HTN
2. nephrotic: >3.5g of proteinuria*, hypoalbuminemia, generalized edema, hyperlipidemia, lipiduria (oval fat bodies)
Term
What is involved in chronic renal failrue?
Definition
1. azotemia -uremia progressing for years
2. loss of ability to get rid of Nitrogen over time
Term
How can we classify glomerular diseases?
Definition
1. global, segmental: global affects all,1 part for segmental
2. diffuse, focal: focal - affect some, diffuse - affects all
Term
List the primary glomerulonephritis.
Definition
1. acute diffuse proliferative GN
2. Rapidly progressive (crescentic) GN
3. membranous GN
4. Lipoid nephorsis (minimal change disease) - fat build up in the tubules - trying to reabsorb the fate
5. focal segmental glomerulosclerosis -scarring in glomerulus
6. membranoproliferative GN
7. IgA nephropathy - builds up in glomerulus
8. chronic GN
Term
What are the secondary (systemic) diseases that affect the kidney?
Definition
1. SLE 2. DM 3. amyloidosis - depositition 4. Goodpasture's syndrome - autoimmune vs basement membranes
Term
Describe the immune reactions with GN.
Definition
1. circulating immune complexes (Ag-Ab) - gets caught in the glomerulus, can build up btwn basement membrane and endothelium
2. trapped circulating Ag (like in Lupus) - Ag circulating alone
3. Anti-Glomerulus basemembrane antibodies (like goodpasture's)
Term
T/F iN SLE, Ag can circulate and get trapped in glomerulus or can be a circulating Ag-Ab complex
Definition
true
Term
Describe renal ablation glomerulopathy.
Definition
1. Nonimmune mech
2. involves HTN
3. causes endothelial and epithelial injury
4. mesagnial response, proliferation, intraglomerular coagulation - cause glomerulosclerosis
Term
What are some causes og nephrotic syndrome.
Definition
1. primary glomerular diseasease (minimal change, lipoid nephrosis, slcerosis, membransou GN, membranoprolif GN)
2. systemic disease - DM, SLE, amyloidosis
Term
Who is likely to get lipoid nephrosis (Nil disease/minimal change)? Describe the symptoms.
Definition
1. ages 2-3 2. primary epi cell injury 3. swelling face 4. frothy, bubbly urine 5. glomerulus: looks normal under light microscope, lipid accumulation, loss of podocyte feet ONLY (effacement of foot proceses, but can occur in other primary glomerular diseases)
Term
Describe membranous GN.
Definition
1. Thickened basement membrane
2. a primary glomerular nephrity
3. likely to cause nephrotic
4. effaced foot processes -> spill protein
5. subepithelial deposits (not Ag-Ab complexes, that is involved in secondary nephrities)
Term
Describe focal segmental glomerulosclerosis.
Definition
1. 1. idiopathic
2. tubulointerstitial disease - can cause sclerosis
3. recurrnece of proteinuria after transplant
4. causes nephrotic syn
5. Involves sclerosis, not all glomeruli are involved
Term
Describe membranoproliferative GN.
Definition
1. causes nephrotic syn
2. combination of membranous and prolif
3. see lots of cell, and looks like membranous GN, increased thickness of basement membrane
4. mesangial cells going in btwn cap endothelium and epithelium
Term
Describe acute proliferative (post-strept GN)
Definition
1. gross: smooth, fine, petechial hemorrhage (of kidney)
2. microscopic -is diffuse and hypercellular, see lots of immune cells
3. abrupt, nephritic syndrome, oliguria, hematuria
4. serum complement low, antistretolysin O titers are high
Term
What diseases is rapidly progressive GN (RPGN) associated with?
Definition
1. Postinfectious RPGN (poststrept) - pts present with symptoms quickly
2. SLE
3. polyarteritis
4. goodpastrure's syndrome - very rapidly progressive, "idiopathic"
5. wegener's granulomatosis
6. Henoch-schonelin purpura
7. idiopathic: immune complex, goodpasture, pauci immune
Term
Describe chronic glomerulonephritis.
Definition
1. Grossly- contracted, diffusely granular
2. "end stage kidneys"
Term
What renal lesion is common in DM?
Definition
1. Kimmelstiel - Wilson lesion - have generalized glomerulosclerosis and have DM
2. rounded nodules
3. may have nephritic syndrome
Term
What chronic systemic diseases may be involved in chronic GN?
Definition
1. Lupuse
2. DM
3. amyloidosis
Term
Describe cresentric GN.
Definition
1. sclerosis on one side of glomerulus
2. see "cresents"
3. can occur in RPGN, may even be in goodpasture's
4. To confirm Goodpasture - due fluorescence
5. will probably have nephritic syndrome
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