Podcast
Questions and Answers
What is a key characteristic of nephritic syndrome?
What is a key characteristic of nephritic syndrome?
- Hypoalbuminemia with ascites
- Presence of RBC casts in urine (correct)
- Elevated creatinine without oliguria
- Massive proteinuria (> 3.5 g/day)
Which condition is commonly associated with crescent formation in Bowman space?
Which condition is commonly associated with crescent formation in Bowman space?
- Poststreptococcal glomerulonephritis (PSGN)
- Rapidly Progressive Glomerulonephritis (RPGN) (correct)
- Minimal Change Disease
- Chronic Kidney Disease
Which immunofluorescence finding is associated with Goodpasture syndrome?
Which immunofluorescence finding is associated with Goodpasture syndrome?
- Granular pattern
- Crescentic pattern
- Linear pattern (correct)
- Negative IF
What is the most likely outcome for children with Poststreptococcal Glomerulonephritis (PSGN)?
What is the most likely outcome for children with Poststreptococcal Glomerulonephritis (PSGN)?
Which feature is commonly observed in the urinalysis of patients with nephritic syndrome?
Which feature is commonly observed in the urinalysis of patients with nephritic syndrome?
What clinical sign is most indicative of salt retention in nephritic syndrome?
What clinical sign is most indicative of salt retention in nephritic syndrome?
Poststreptococcal Glomerulonephritis is mediated by which mechanism?
Poststreptococcal Glomerulonephritis is mediated by which mechanism?
Which demographic is most commonly affected by Poststreptococcal Glomerulonephritis?
Which demographic is most commonly affected by Poststreptococcal Glomerulonephritis?
Flashcards
Nephritic Syndrome
Nephritic Syndrome
A group of kidney diseases characterized by inflammation and bleeding in the glomeruli, resulting in limited protein in urine (proteinuria), decreased urine output (oliguria), and increased waste in blood (azotemia).
Poststreptococcal Glomerulonephritis (PSGN)
Poststreptococcal Glomerulonephritis (PSGN)
A type of nephritic syndrome that develops after infection with group A β-hemolytic streptococcus, commonly causing skin (impetigo) or throat infections.
Immune Complex Deposition
Immune Complex Deposition
The process in PSGN where antibodies and antigens (from the streptococcus) clump together and deposit in the glomeruli, triggering inflammation.
Rapidly Progressive Glomerulonephritis (RPGN)
Rapidly Progressive Glomerulonephritis (RPGN)
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Crescents
Crescents
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Goodpasture Syndrome
Goodpasture Syndrome
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Diffuse Proliferative Glomerulonephritis
Diffuse Proliferative Glomerulonephritis
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Pauci-Immune RPGN
Pauci-Immune RPGN
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Study Notes
Nephritic Syndrome
- Characterized by glomerular inflammation and bleeding
- Limited proteinuria (less than 3.5 g/day)
- Oliguria and azotemia
- Salt retention causing periorbital edema and hypertension
- Red blood cell (RBC) casts and dysmorphic RBCs in urine
- Biopsy shows hypercellular, inflamed glomeruli (Figure 12.12)
Poststreptococcal Glomerulonephritis (PSGN)
- Arises after group A beta-hemolytic streptococcal infection (skin or pharynx)
- Occurs 2-3 weeks post-infection
- Presents with hematuria (cola-colored urine), oliguria, hypertension, and periorbital edema
- Primarily affects children, but can affect adults
- Immune complex deposition causes granular IF and subepithelial "humps" on electron microscopy (EM)
- Treatment is supportive
- Rare progression to renal failure in children
- Some adults may develop rapidly progressive glomerulonephritis (RPGN)
Rapidly Progressive Glomerulonephritis (RPGN)
- Nephritic syndrome progressing to renal failure within weeks to months
- Immunofluorescence patterns vary depending on the disease, with linear deposits indicative of Goodpasture syndrome, granular deposits for diseases like PSGN, and negative deposits in some cases.
- Goodpasture syndrome is characterized by antibodies against glomerular basement membrane collagen resulting in hematuria and hemoptysis.
- Diffuse proliferative glomerulonephritis (most common immune complex mediated), Wegener granulomatosis, microscopic polyangiitis, and Churg-Strauss syndrome are examples of diseases that can have a granular IF pattern.
IgA Nephropathy (Berger Disease)
- Most common nephropathy worldwide
- Characterized by IgA immune complex deposition in the glomerular mesangium
- Presents during childhood, often following mucosal infections (e.g., gastroenteritis)
- Increased IgA production during infection
- Characterized by episodic hematuria and presence of RBC casts
- IgA immune complex deposition in the mesangium is visible on immunofluorescence
- May progress slowly to renal failure
Alport Syndrome
- Inherited defect in type IV collagen, often X-linked
- Results in thinning and splitting of the glomerular basement membrane
- Presents with isolated hematuria, sensory hearing loss, and ocular disturbances
Membranous Nephropathy
- Thick glomerular basement membranes
- Subepithelial deposits with 'spike and dome' appearance (Figure 12.9)
Kimmelstiel-Wilson nodules
- Found in diabetic nephropathy (Figure 12.11)
Subendothelial deposits
- Characteristic of membranoproliferative glomerulonephritis (Figure 12.10)
Hypercellular inflamed glomerulus
- Characteristic of nephritic syndrome (Figure 12.12)
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