Minimal Change Disease Quiz
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Questions and Answers

What is the main characteristic of minimal change disease on light microscopy?

  • Mesangial proliferation
  • Glomerular hypercellularity
  • Glomerular sclerosis
  • Minimal changes in the glomerular structure (correct)
  • What is the primary mechanism of proteinuria in minimal change disease?

  • Increased permeability of the glomerular capillary wall
  • T-cell mediated glomerular injury
  • Loss of glomerular anionic charge barrier (correct)
  • Decreased glomerular filtration rate
  • What is the most common presentation of minimal change disease?

  • Nephritic syndrome
  • Chronic kidney disease
  • Nephrotic syndrome (correct)
  • Acute kidney injury
  • What is the typical finding on immunofluorescence microscopy in minimal change disease?

    <p>Negative or minimal deposits</p> Signup and view all the answers

    What is the characteristic finding on electron microscopy in minimal change disease?

    <p>Fusion of podocyte foot processes</p> Signup and view all the answers

    What is the typical age range affected by minimal change disease?

    <p>Children (80-90%) and adults (10-20%)</p> Signup and view all the answers

    Study Notes

    Minimal Change Disease

    Definition

    • A type of glomerulonephritis characterized by minimal changes in the glomerular structure on light microscopy
    • Also known as lipoid nephrosis or nil lesion

    Pathophysiology

    • Immune-mediated disease, likely involving T-cell dysfunction
    • Increased permeability of the glomerular capillary wall, leading to proteinuria
    • Loss of glomerular anionic charge barrier, allowing albumin to pass through the glomerular filtration barrier

    Clinical Features

    • Most common cause of nephrotic syndrome in children (80-90%)
    • Rare in adults (10-20%)
    • Presents with:
      • Nephrotic syndrome (proteinuria, edema, hypertension, lipiduria)
      • Hematuria (microscopic or gross)
      • Normal or slightly elevated serum creatinine

    Diagnosis

    • Renal biopsy:
      • Light microscopy: normal or minimal changes
      • Immunofluorescence: negative or minimal deposits
      • Electron microscopy: fusion of podocyte foot processes
    • Urinalysis: massive proteinuria (>3.5 g/24 hours)
    • Serum albumin: low (<3 g/dL)

    Treatment

    • Steroids (prednisone) are the first-line therapy
    • Response to steroids: 80-90% of patients achieve remission
    • Relapse rate: 30-50%
    • Additional immunosuppressive therapy (e.g., cyclophosphamide, mycophenolate mofetil) may be required in resistant or relapsing cases

    Minimal Change Disease

    Definition

    • Characterized by minimal changes in glomerular structure on light microscopy
    • Also known as lipoid nephrosis or nil lesion

    Pathophysiology

    • Immune-mediated disease involving T-cell dysfunction
    • Increased permeability of glomerular capillary wall leads to proteinuria
    • Loss of glomerular anionic charge barrier allows albumin to pass through glomerular filtration barrier

    Clinical Features

    • Most common cause of nephrotic syndrome in children (80-90%)
    • Rare in adults (10-20%)
    • Presents with:
      • Nephrotic syndrome (proteinuria, edema, hypertension, lipiduria)
      • Hematuria (microscopic or gross)
      • Normal or slightly elevated serum creatinine

    Diagnosis

    • Renal biopsy:
      • Light microscopy: normal or minimal changes
      • Immunofluorescence: negative or minimal deposits
      • Electron microscopy: fusion of podocyte foot processes
    • Urinalysis: massive proteinuria (>3.5 g/24 hours)
    • Serum albumin: low

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    Test your knowledge of minimal change disease, a type of glomerulonephritis characterized by minimal changes in the glomerular structure. Learn about its pathophysiology and clinical features.

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