Nephrotic Syndrome Overview

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Questions and Answers

Which condition is most commonly associated with nephrotic syndrome in children?

  • Membranous Nephropathy
  • Minimal Change Disease (correct)
  • Nephronophthisis
  • Focal Segmental Glomerulosclerosis

What characteristic finding is associated with Focal Segmental Glomerulosclerosis on H&E stain?

  • Focal and segmental sclerosis (correct)
  • Thickened basement membrane
  • Granular deposits with spike appearance
  • Tram-track appearance

Which of the following is a common cause of nephrotic syndrome in Caucasian adults?

  • Membranoproliferative Glomerulonephritis
  • Minimal Change Disease
  • Membranous Nephropathy (correct)
  • Focal Segmental Glomerulosclerosis

What distinguishes Membranoproliferative Glomerulonephritis from other nephrotic syndromes?

<p>Evidence of immune complex deposition (B)</p> Signup and view all the answers

What is a common complication due to hypoalbuminemia in nephrotic syndrome?

<p>Pitting edema (B)</p> Signup and view all the answers

Which type of nephrotic syndrome is associated with a poor response to steroids and may progress to chronic renal failure?

<p>Both B and C (C)</p> Signup and view all the answers

In which condition is hypercoagulability primarily due to the loss of antithrombin III?

<p>Nephrotic Syndrome in general (B)</p> Signup and view all the answers

What finding on electron microscopy is characteristic of Membranous Nephropathy?

<p>Spike and dome appearance (B)</p> Signup and view all the answers

Flashcards

Minimal Change Disease (MCD)

A common type of nephrotic syndrome in children, often with no known cause. It can sometimes be linked to Hodgkin lymphoma.

Focal Segmental Glomerulosclerosis (FSGS)

A leading cause of nephrotic syndrome among Hispanic and African American individuals, often with no clear reason. There can be a connection to HIV, heroin use, or sickle cell disease.

Membranous Nephropathy

A type of nephrotic syndrome most common in white adults, often without a known cause. It's sometimes linked to conditions like hepatitis B or C, tumors, lupus, or certain medications.

Membranoproliferative Glomerulonephritis

A serious form of nephrotic syndrome characterized by a thick glomerular basement membrane, often with a 'tram-track' appearance. It's due to abnormal immune complexes and involves the complement system.

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Nephrotic Syndrome

A type of glomerular disorder marked by proteinuria (more than 3.5 grams of protein in urine daily) leading to several complications.

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Microalbuminuria

A condition where a small amount of protein is found in the urine, often caused by a temporary problem.

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Nephritic Syndrome

An abnormal condition associated with proteinuria and other symptoms, but unlike Nephrotic Syndrome, it doesn't involve such a large amount of protein in the urine.

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Study Notes

Nephrotic Syndrome

  • Characterized by proteinuria greater than 3.5 grams per day
  • Leads to hypoalbuminemia (low albumin) causing pitting edema
  • Also causes hypogammaglobulinemia (low immunoglobulins), increasing infection risk
  • Associated with a hypercoagulable state due to antithrombin III loss
  • Hyperlipidemia and hypercholesterolemia may result in fatty casts in urine

Minimal Change Disease (MCD)

  • Most common cause of nephrotic syndrome in children
  • Usually idiopathic (no known cause)
  • May be associated with Hodgkin lymphoma

Focal Segmental Glomerulosclerosis (FSGS)

  • Common nephrotic syndrome cause among Hispanics and African Americans
  • Often idiopathic, but associated with HIV, heroin use, and sickle cell disease
  • Characterized by focal and segmental sclerosis in glomeruli
  • Shows effacement of foot processes on EM (electron microscopy)
  • Poor response to steroids, often progressing to chronic renal failure

Membranous Nephropathy

  • Most common nephrotic syndrome in Caucasians
  • Often idiopathic but associated with Hepatitis B or C, cancers, or autoimmune diseases
  • Characterized by thick glomerular basement membrane
  • Subepithelial deposits with "spike and dome" appearance on EM (electron microscopy)
  • Poor response to steroids, progresses to chronic renal failure

Membranoproliferative Glomerulonephritis

  • Characterized by a thick glomerular basement membrane often with a "tram-track" appearance
  • Caused by immune complex deposition, indicated by granular immunofluorescence
  • Two types: Type I (subendothelial deposits; often with HBV and HCV) and Type II (intramembranous deposits; associated with C3 nephritic factor)
  • Often poor response to steroids, progresses to chronic renal failure

Diabetes Mellitus

  • High serum glucose causes non-enzymatic glycosylation of the glomerular basement membrane
  • Results in hyaline arteriolosclerosis

Systemic Amyloidosis

  • Kidney is a common target organ
  • Characterized by amyloid deposits in the mesangium, causing nephrotic syndrome
  • Shows apple-green birefringence under polarized light after Congo red staining

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