kidney nephritic and nephrotic
Terms
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- Sx of nephrotic syndrome
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proteinuria >3.5 g/day
hypoalbuminemia
gernalized edema
hyperlipidemia
lipiduria - 4 diseases of nephrotic syndrome
-
minimal change (lipoid nephrosis)
membranous glomerulonephritis (nephropathy)
focal segmental glomerulosclerosis
membranoproliferative glomerulonephritis -
MCC nephrotic syndrome in kids
foot process effacement
selective proteinuria - minimal change (lipoid nephrosis)
-
diffuse thickening of GBM
30-50 year olds
subepithelial depositis
spike and dome
non-selective proteinuria - membranous glomerulonephritis
-
sclerosis in some but not all glomeruli
effects parts but not all of each glomeruli affected
hyalinosis - focal segmental glomerulosclerosis
-
sub-endothelial deposits
2/3 of cases - type I membranoproliferative glomerulonephritis
- ribbon like lamina densa and subendothelial space of GBM due to deposit of unknown substance
-
Type II membranoproliferative glomerulonephritis
Dense Deposit Disease - C3 nephritic factor
- found in Type II membranoproliferative glomerulonephritis
- Tram Trak
- Membranoproliferative glomerulonephritis
- spike and dome
- membranous glomerulonephritis
- nephritic syndrome symptoms
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hematuria
dysmorphic RBCs
RBC casts
oliguria
azotemia
hypertension - Nephritic syndrome diseases
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1. Acute proliferative (post-infectious) glomerulonephritis
2. rapidly progressive (crescentic) glomerulonephritis
3. IgA nephropathy (Berger disease)
4. Hereditary nephritis (alport's)
5. chronic glomerulonephritis -
immune complexes depositing in all glomeruli of both kidneys
smoky brown urine
hypocomplimentemia
granular deposit of IgG
sub-epithelial hump - acute proliferative postinfectious glomerulonephritis
- formation of crescents between Bowman's capsule and glomerular tuft
- Rapidly progressive (crescentic) glomerulnephritis
- Goodpasture's
- Type I rapidly progressive (crescentic) glomerulonephritis
-
immune complex mediated
lumpy bumpy staining - type II rapidly progressive (crescentic) glomerulonephritis
-
pauci immune type
no anti GBM Ab's
no immune complexes
pt's have ANCA (like in Wegener's or PAN) - type II rapidly progressive (crescentic) glomerulonephritis
- kids with hematuria after upper respiratory infections
- IgA nephropathy (Berger's)
-
IgA in kidney
in skin - purpuric rash
in GI- abdominal pain
in joints- arthritis - Henoch-Schonlein Purpura
-
20-50 yr old men
nephritis
deafness
eye disorders
basket weave lamina densa - Alport syndrome