Podcast
Questions and Answers
What is indicated for transplant in nephrology management?
What is indicated for transplant in nephrology management?
- Severe dehydration
- Low blood pressure
- If chronic kidney disease (CKD) occurs (correct)
- Normal kidney function
Salt restriction is part of conservative management for nephrology treatment.
Salt restriction is part of conservative management for nephrology treatment.
True (A)
What do decreased levels of C3 and C4 indicate in nephrology?
What do decreased levels of C3 and C4 indicate in nephrology?
Classical complement pathway affected
The presence of ____ deposits is associated with IgA nephropathy.
The presence of ____ deposits is associated with IgA nephropathy.
Match the following terms with their corresponding conditions:
Match the following terms with their corresponding conditions:
Which demographic is more commonly affected by MPGN and IgA Nephropathy?
Which demographic is more commonly affected by MPGN and IgA Nephropathy?
More than 50% of patients with IgA Nephropathy present with asymptomatic microhematuria and proteinuria.
More than 50% of patients with IgA Nephropathy present with asymptomatic microhematuria and proteinuria.
What percentage of patients with IgA Nephropathy is expected to develop chronic kidney disease (CKD)?
What percentage of patients with IgA Nephropathy is expected to develop chronic kidney disease (CKD)?
A primary indicator of bad prognosis in MEST-C scoring is the presence of __________ deposits outside the mesangium.
A primary indicator of bad prognosis in MEST-C scoring is the presence of __________ deposits outside the mesangium.
Match the prognosis indicators with their significance:
Match the prognosis indicators with their significance:
What is the most common clinical presentation of IgA Nephropathy?
What is the most common clinical presentation of IgA Nephropathy?
IgA Nephropathy guarantees a good prognosis.
IgA Nephropathy guarantees a good prognosis.
What type of immunoglobulin is predominantly associated with IgA Nephropathy?
What type of immunoglobulin is predominantly associated with IgA Nephropathy?
IgA Nephropathy is also known as ___ disease.
IgA Nephropathy is also known as ___ disease.
Match the following clinical findings with their descriptions:
Match the following clinical findings with their descriptions:
What percentage of childhood nephrotic syndrome is attributed to MCD?
What percentage of childhood nephrotic syndrome is attributed to MCD?
Selective proteinuria in MCD means that only albumin and transferrin are lost.
Selective proteinuria in MCD means that only albumin and transferrin are lost.
What is the preferred steroid sparing agent for FRNS?
What is the preferred steroid sparing agent for FRNS?
About _____% of patients with nephrotic syndrome experience infrequent relapse.
About _____% of patients with nephrotic syndrome experience infrequent relapse.
Match the treatments to their corresponding conditions:
Match the treatments to their corresponding conditions:
Which liver disease is most commonly associated with collapsing FSGS?
Which liver disease is most commonly associated with collapsing FSGS?
Immune complexes generated from IgA are effectively cleared by the liver.
Immune complexes generated from IgA are effectively cleared by the liver.
What is the most common glomerular disease associated with cirrhosis?
What is the most common glomerular disease associated with cirrhosis?
Damage to the mucosa leads to increased production of ______ that is deficient in galactose.
Damage to the mucosa leads to increased production of ______ that is deficient in galactose.
Match each liver disease with its associated glomerular disease:
Match each liver disease with its associated glomerular disease:
Which antigen is primarily associated with primary Membranous Nephropathy?
Which antigen is primarily associated with primary Membranous Nephropathy?
The Rule of 1/3 in Membranous Nephropathy indicates that one-third of patients experience spontaneous remission.
The Rule of 1/3 in Membranous Nephropathy indicates that one-third of patients experience spontaneous remission.
What is the key feature observed in Electron Microscopy for Membranous Nephropathy?
What is the key feature observed in Electron Microscopy for Membranous Nephropathy?
The only extrinsic antigen identified in Membranous Nephropathy is the ______ specific antigen.
The only extrinsic antigen identified in Membranous Nephropathy is the ______ specific antigen.
Match the following immunofluorescence findings with their corresponding types of Membranous Nephropathy:
Match the following immunofluorescence findings with their corresponding types of Membranous Nephropathy:
Which variant of FSGS is associated with the worst prognosis?
Which variant of FSGS is associated with the worst prognosis?
Tip Variant FSGS has a poor prognosis similar to that of Classical FSGS.
Tip Variant FSGS has a poor prognosis similar to that of Classical FSGS.
What specific findings are associated with Collapsing FSGS under electron microscopy?
What specific findings are associated with Collapsing FSGS under electron microscopy?
The lesion location in Tip Variant FSGS is at the tip of the ______.
The lesion location in Tip Variant FSGS is at the tip of the ______.
Match the variant of FSGS with its associated observation:
Match the variant of FSGS with its associated observation:
What is a characteristic finding in the biopsy of IgM Nephropathy?
What is a characteristic finding in the biopsy of IgM Nephropathy?
FSGS is associated with poor prognosis compared to MCD.
FSGS is associated with poor prognosis compared to MCD.
What treatment is given at a dosage of 1 mg/kg/day for FSGS?
What treatment is given at a dosage of 1 mg/kg/day for FSGS?
In FSGS, ______________ material can obliterate glomeruli.
In FSGS, ______________ material can obliterate glomeruli.
What is the primary treatment protocol for 70% of patients with membranous glomerulopathy?
What is the primary treatment protocol for 70% of patients with membranous glomerulopathy?
Match the following conditions with their biopsy findings:
Match the following conditions with their biopsy findings:
ACE inhibitors and ARBs are only used for symptomatic patients with podocytopathies.
ACE inhibitors and ARBs are only used for symptomatic patients with podocytopathies.
Name the two medications prescribed during the modified Ponticelli regimen.
Name the two medications prescribed during the modified Ponticelli regimen.
The use of __________ is recommended if there is no response to the Ponticelli regimen.
The use of __________ is recommended if there is no response to the Ponticelli regimen.
Match the following terms with their descriptions:
Match the following terms with their descriptions:
What is the principal immunofluorescence finding in Type 1 MPGN?
What is the principal immunofluorescence finding in Type 1 MPGN?
Type 2 MPGN is associated with a 80% recurrence post transplant.
Type 2 MPGN is associated with a 80% recurrence post transplant.
What appearance do deposits have on electron microscopy in MPGN?
What appearance do deposits have on electron microscopy in MPGN?
MPGN is also known as __________ Glomerulonephritis.
MPGN is also known as __________ Glomerulonephritis.
Match the types of MPGN with their characteristics:
Match the types of MPGN with their characteristics:
Study Notes
Membranoproliferative Glomerulonephritis (MPGN)
- MPGN is also known as mesangiocapillary glomerulonephritis.
- MPGN is a rare disease.
- MPGN Type 1, also known as classical MPGN, features IgG, IgM, and C3 deposits in the capillary wall and mesangium.
- 80% of MPGN Type 1 cases experience recurrence after a transplant.
- MPGN Type 1 can be associated with plasma cell dyscrasias, infections like Hepatitis C, infective endocarditis, leprosy, and malaria, shunts like ventriculoperitoneal shunts, autoimmune diseases like SLE, Sjogren's, and scleroderma, and malignancies.
- MPGN Type 2, also known as C3GN, features C3 deposits with or without IgG in the capillary wall and mesangium.
- 100% of MPGN Type 2 cases experience recurrence after a transplant.
- MPGN Type 2 can be associated with chronic lymphoid leukemia (CLL), acquired partial lipodystrophy of the face, and optic nerve drusen.
- Electron microscopy reveals a "train track" or "double contour" appearance due to deposits in the subendothelial and mesangial areas.
IgA Nephropathy
- IgA nephropathy is the most common glomerular disease.
- It is also known as Henoch-Schönlein nephritis or Berger's disease.
- IgA nephropathy is characterized by IgA deposits in the mesangium.
- It can present with hematuria, proteinuria, and even nephrotic syndrome.
- It typically progresses to chronic kidney disease (CKD).
Focal Segmental Glomerulosclerosis (FSGS)
- FSGS can be classified into different histological variants.
- Classical FSGS is the most common variant.
- Secondary perihilar FSGS is another variant.
- Tip variant FSGS is characterized by lesions at the tip of the glomerulus and has a good prognosis.
- CollapsingToolbar FSGS is the most severe variant and often leads to end-stage renal disease.
- Collapsing FSGS is associated with HIV infection, heroin use, and interferon (IFN) α.
- Collapsing FSGS has a worse prognosis than other FSGS variants.
Membranous Nephropathy (MN)
- MN is characterized by thickening of the glomerular basement membrane.
- It is associated with antibody-mediated immune complex deposition.
- The immune complexes are usually located in the subepithelial space, leading to a "spike and dome" appearance under electron microscopy.
- MN can be either primary or secondary.
- Primary MN is associated with antibodies against phospholipase A2 receptor (PLA2R).
- Secondary MN is usually triggered by other conditions such as lupus nephritis or infections.
- MN may spontaneously remit, progress to end-stage renal disease, or have stable disease with continued proteinuria.
- Transplantation can be a treatment option for MN, but recurrence is possible.
Minimal Change Disease (MCD)
- MCD is a common cause of nephrotic syndrome in children.
- It is characterized by podocyte effacement under electron microscopy.
- The pathogenesis involves changes in podocyte proteins, particularly those related to the slit diaphragm.
- MCD commonly relapses, with upper respiratory tract infections (URTI) often triggering relapses.
- Treatment of MCD involves corticosteroids, but some cases are steroid resistant or steroid dependent.
- Treatment for MCD with frequent relapses includes steroid-sparing agents such as cyclophosphamide and mycophenolate mofetil (MMF).
Other Points
- Mucosal injury can be a contributing factor to glomerular diseases.
- Cirrhosis can lead to immune complex deposition in the glomeruli due to deficient clearance of immune complexes by the liver.
- Spondyloarthritis can be linked to glomerular diseases through an immune response.
- Polymorphic alleles may have a role in the development of FSGS.
- IgM nephropathy is a rare glomerular disease resembling MCD but with a worse prognosis.
- Anti-phospholipase A2 receptor (PLA2R) antibodies are a significant biomarker for MN.
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Description
This quiz explores the types, characteristics, and associations of Membranoproliferative Glomerulonephritis (MPGN). It covers the intricacies of MPGN Type 1 and Type 2, including their clinical implications and recurrence after transplantation. Test your knowledge on this rare kidney disease and its underlying causes.
