Nephrotic Synd

jatadescargas's version from 2016-02-16 16:55


Question Answer
Minimal change disease (lipoid nephrosis) LMLM—normal glomeruli (lipid may be seen in PCT cells).
Minimal change disease (lipoid nephrosis) IFIF ⊝.
Minimal change disease (lipoid nephrosis) EMEM—effacement of foot processes A .
Minimal change disease (lipoid nephrosis) Causes and RXMost common cause of nephrotic syndrome in children. Often 1° (idiopathic) and may be triggered by recent infection, immunization, immune stimulus. Rarely, may be 2° to lymphoma (eg, cytokine-mediated damage). 1° disease has excellent response to corticosteroids
Focal segmental glomerulosclerosis LMsegmental sclerosis and hyalinosis
Focal segmental glomerulosclerosis IFoften ⊝, but may be ⊕ for nonspecific focal deposits of IgM, C3, C1..
Focal segmental glomerulosclerosis EMeffacement of foot process similar to minimal change disease.
Focal segmental glomerulosclerosis Causes and RXMost common cause of nephrotic syndrome in African Americans and Hispanics. Can be 1° (idiopathic) or 2° to other conditions (eg, HIV infection, sickle cell disease, heroin abuse, massive obesity, interferon treatment, chronic kidney disease due to congenital malformations). 1° disease has inconsistent response to steroids. May progress to chronic renal disease
Membranous nephropathy (membranous glomerulonephritis) LMLM—diffuse capillary and GBM thickening
Membranous nephropathy (membranous glomerulonephritis) IFIF—granular as a result of immune complex deposition. Nephrotic presentation of SLE.
Membranous nephropathy (membranous glomerulonephritis) EMEM—“spike and dome” appearance with subepithelial deposits.
Membranous nephropathy (membranous glomerulonephritis) Causes and rxMost common cause of 1° nephrotic syndrome in Caucasian adults. Can be 1° (eg, antibodies to phospholipase A2 receptor) or 2° to drugs (eg, NSAIDs, penicillamine), infections (eg, HBV, HCV), SLE, or solid tumors. 1° disease has poor response to steroids. May progress to chronic renal disease
Amyloidosis LMCongo red stain shows apple-green birefringence under polarized light due to amyloid deposition in the mesangium
Diabetic glomerulonephropathy LMLM—mesangial expansion, GBM thickening, eosinophilic nodular glomerulosclerosis (Kimmelstiel-Wilson lesions
Diabetic glomerulonephropathy causesNonenzymatic glycosylation of GBM Žincrease  permeability, thickening. Nonenzymatic glycosylation of efferent arterioles increaseŽ  GFR andŽ mesangial expansion. Most common cause of end-stage renal disease in the United States.

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