Term
| What are the 6 main clinical features & lab results of nephritic syndrome? |
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Definition
- Gross hematuria
- Proteinuria (usually subnephrotic; <3.5 g/day)
- Azotemia
- Oliguria
- Hypertension
- Edema
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Term
| What are the inflammatory mechanism and the 2 general microscopic changes seen in all variants of nephritic syndrome? |
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Definition
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Immune-complex deposition --> complement activation --> C5a attracts neutrophils
- Hypercellularity
- RBC casts
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Term
| What are the possible etiologies of rapidly progressive (crescentic) glomerulonephritis based on immunofluorescence? |
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Definition
- Linear IF: Goodpasture syndrome. Antibodies against GMB and alveolar BM. Type II hypersensitivity. Hemoptysis & hematuria. Treatment: plasmapheresis.
- Pauci-immune: Churg-Strauss syndrome, Wegener's granulomatosis, or microscopic polyangiitis. Wegener's: c-ANCA/PR3-ANCA. MP and CSS: p-ANCA/MPO-ANCA.
- Granular: Poststreptoccal or diffuse proliferative.
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Term
| What is the morphology of diffuse proliferative GN (lupus nephritis)? |
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Definition
- H&E: Wire-looping of capillaries
- IF: Granular
- EM: Subendothelial IgG and C3 deposits
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Term
| What is the etiology of Berger's disease (IgA nephropathy)? |
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Definition
| IgA vasculitis (Henoch-Schonlein purpura) due to GIT or RT infection leading to mesangial IgA deposition and proliferation. |
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Term
| What is the classical clinical triad of Alport syndrome? |
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Definition
- Nephropathy
- Retinopathy
- SNHL
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Term
| Describe the two types of membranoproliferative GN. |
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Definition
- Idiopathic or hepatitis B/C associated
- Subendothelial immune complex deposition
- Type II (dense deposit disease):
- Nephritic C3 factor (IgG C3 convertase stabilizer)
- Intramembranous deposits
- Both types: tram track splitting of the GBM on H&E, PAS, and Silver
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