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Flashcards in HSP PBL Deck (20)
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1
Q

HSP most commonly affected patient population?

A

Children – 90% of cases

2
Q

Common predecessor of HSP?

A

URI

especially group A Strep

3
Q

Genetic risk for HSP: HLA______.

A

HLA DRB*01

4
Q

Genetics for decreased HSP: HLA________.

A

HLA-DRB*07

5
Q

Genetics for increased HSP Nephritis: HLA_______.

A

HLA-B35

HLA-DQA1 —nephropathy

6
Q

Two conditions associated with HSP:

A

Familial Mediterranean Fever

Inflammatory Bowel Disease

7
Q

Severe cases of HSPN worrisome for what histologically?

A

circumferential crescents in glomeruli

infiltration with neutrophils

8
Q

Immunofluorescence looking for what in HSP?

A

IgA deposition

9
Q

Definition of leukocytoclastic?

A

destruction of WBCs

10
Q

Presenting symptom in 100% of HSN cases?

A

palpable purpura

11
Q

Cells in the kidney that proliferate when they endocytose IgAs?

A

mesangial cells in the glom

12
Q

Why is proliferation of mesangial cells a problem?

A

Decreased GFR –> decreased filtrate at macula densa –> increased renin secretion –> increased BP

13
Q

NephrOtic syndrome characterized by:

A

MASSIVE proteinuria

hypoalbuminemia

edema

hyperlipidemia –> hyperlipiuria

14
Q

Nephr-i-tic syndrome characterized by:

A

hematuria

oliguria

azotemia (elevated serum Cr and BUN)

HTN

15
Q

PE findings in HSP:

A

low grade fever

palpable purpuric rash

nonmigratory arthritis of joints (usually knees/ankles)

arthralgia

occult blood in stool

16
Q

PE findings when HSP progresses to HSPN:

A

HTN

edema

pulm edem –> incr RR, possibly rhales

17
Q

Mechanism of proteinuria in HSP:

A

injury to glom epithelial cells via immune complex deposition and inflammation
–>
effacement of podocytes
–>
increased permeability to large negatively charged molecules (ie. albumin)

18
Q

Mechanism of hematuria in HSP:

A

immune deposits in small vessels of kidney
–>
inflammation
–>
vascular necrosis
–>
leak blood into urine (RBCs not reabsorbed)

19
Q

Portion of the nephron affected by HSP?

A

glomerulus–mesangium, subendothelium, subepithelium

20
Q

Review two mechanisms of Angiotensin II activity that elevate BP?

A
  1. contraction of arteriolar smooth muscle
  2. stimulate release of aldosterone
    –>
    increased reabsorption of Na+ in distal tubule
    –>
    increased plasma volume