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Flashcards in Nephro Deck (96):
1

Most common cause of death in SLE

Lupus nephritis

2

SLE peak incidence

15-45

3

Male vs female: SLE

Female

4

Male vs female: Lupus nephritis

Equal

5

Children vs adults: Lupus nephritis is worse

Children

6

Male vs female : Lupus nephritis is worse

Male

7

Hallmark of lupus nephritis

Deposition of circulating immune complexes and in situ formation of others

8

Subendothelial vs subepthelial: Circulating immune complexes

Subendothelial (and mesangial)

9

Subendothelial vs subepthelial: Complexes formed in situ

Subepithelial

10

Subendothelial deposits in SLE nephritis form

Wireloops

11

Mgt of SLE: Induction/emergency

Methylprednisolone

12

Mgt of SLE: Maintenance

Prednisone

13

Most common drugs used in the mgt of SLE (4)

1) Steroids
2) Cyclophosphamide
3) Mycophenolate mofetil
4) Azathioprine

14

Drug for SLE that causes hemorrhagic cystitis

Cyclophosphamide

15

Pathognomonic lesion of DM nephropathy

Kimmelsteil-Wilson Lesion

16

% of Type 2 DM that already have nephropathy when diagnosed

20%

17

30-40% of Type 2 DM develop diabetic nephropathy within __years of diagnosis

10

18

When microalbuminuria is observed in 40% Type 1 DM patients

Next 5-10 years of disease

19

Normal urine protein

150 mg/day

20

Microalbuminuria

150-300 mg/day

21

Macroalbuminuria

>300 mg/day

22

BP ctrl recommended for DM

Less than 130/80 mmHg

23

First line of therapy for all patients with diabetes and htn

ACEI

24

Alternative to ACEI in treatment of Htn in pxs with DM and Htn who also have asthma exacerbations

ARB

25

Most important and commone type of tubulointerstitial inflammation

Acute pyelonephritis

26

Most common organism obtained in urine culture of patients with pyelonephritis

E. coli

27

2 routes in the devt of pyelonephritis

1) Ascending
2) Hematogenous

28

Most common route in the devt of pyelonephritis

Ascending

29

Important morphologic hallmark of acute pyelonephritis (3)

1) Patchy interstitial suppurative inflamm
2) Intralobular aggregates of neutrophils
3) Tubular necrosis

30

Pyelonephritis: Caseous necrosis

Tuberculous

31

Pyelonephritis: Proteus mirabilis

Xanthogranulomatous pyelonephritis

32

Drug that can cause tubulointerstitial nephritis via interstitial immunologic reaction

Methicillin

33

Form of adult polycystic kidney disease associated with polycystic liver disese

Juvenile

34

Syndrome: 1) Hemangioblastoma or hemangioma of cerebellum, brain stem or retina

Von Hippel-Lindau

35

Internist's tumor

Renal cell CA

36

90-95% of renal neoplasms arise from

Kidney

37

Response of renal cell CA to radio and chemotherapy

Resistant

38

4 hereditary syndromes associated with renal cell CA

1) VHL
2) HPRC
3) FRO
4) HRC

39

All (>50%) glomeruli involved

Diffuse

40

Proportion (less than 50%) of glomeruli affected

Focal

41

Entire glomerulus involved

Global

42

Portion of glomerulus involved

Segmental

43

Reduction of GFR to __% heralds progression to end stage renal failure

30-50%

44

2 major histologic conditions in progressive glomerular disease

1) FSGS
2) Tubulointerstitial damage

45

APGN: Prototypical exogenous pattern

PSGN

46

APGN: Prototypical endogenous pattern

SLE

47

Organism that causes rheumatic fever and PSGN

GABHS

48

PSGN is most frequent in this age group

6-10 y/o

49

Etiopathogenesis of PSGN

Deposition of ICs

50

PSGN develops ____ days/weeks after strepthroat infection

5-21 days or ~10 days

51

PSGN develops ____ days/weeks after impetigo

4-6 weeks

52

Protein responsible for tropism to heart

M protein

53

Histologic morphology of PSGN

Humps (electron dense deposits)

54

__% of children with PSGN recover spontaneously

95

55

RPGN types

I, II, III

56

Type I RPGN causes

Goodpasture syndrome

57

Type II RPGN causes

1) SLE
2) HSP
3) IgA nephropathy

58

Type III RPGN causes

1) Wegener's granulomatosis
2) Microscopic polyarteritis

59

Earliest symptom of nephrotic syndrome in adults

Bipedal edema

60

Earliest symptom of nephrotic syndrome in children

Periorbital edema

61

Massive/ nephrotic range proteinuria

>3.5 g/day

62

Plasma albumin levels in nephrotic syndrome

Less than 3g/dL

63

Normal albumin excretion

Less than 30 mg/day

64

Primary vs secondary: Most cases of nephrotic syndrome in adults and children

Primary

65

Most common primary glomerular disease causing nephrotic syndrome in adults

Membranous glomerulonephritis

66

Most common primary glomerular disease causing nephrotic syndrome in children

MCD

67

Most common primary glomerular disease causing nephrotic syndrome in all ages

FSGS

68

Most common systemic diseases causing nephrotic syndrome (3)

1) DM
2) SLE
3) Amyloidosis

69

Drugs that may cause membranous GN (2)

1) Penicillamine
2) Captopril

70

Salts that may cause membranous GN (2)

1) Gold
2) Mercury

71

Proteinuria in membranous GB is probably caused by

MAC (C5b-C9)

72

Peak incidence of MCD

2-6 y/o

73

Incidence of MCD is increased in patients with

Hodgkin's disease

74

Response of MCD to steroids

Dramatic

75

Most common CA in children

Leukemia

76

Most common leukemia in children

ALL

77

Drugs that cause ischemic nephrotoxic nephropathy (3)

1) Aminoglycosides
2) Amphotericin B
3) Contrast agents

78

Most common vasculitis in children

HSP

79

2nd most common vasculitis in children

Kawasaki

80

Common involvements in HSP

1) Purpuric skin lesions on extensor surfaces
2) Abdominal
3) Renal
4) Arthritis

81

Hallmark of HSP

Palpable purpura on legs and buttocks

82

Hallmark of FSGS

Epithelial damage

83

__% of patients with FSGS progress to chronic GN

50-80%

84

FSGS: Deposits seen on IF (2)

1) Ig
2) C3

85

Histologic morphology of MPGN

Double contour or tram-track appearance caused by duplication of GBM with mesangial and monocyte interposition

86

Most common type of GN worldwide

IgA nephropathy

87

Common symptom of IgA nephropathy

Hematuria after a respiratory infection

88

IgA nephropathy is also known as

Berger's disease

89

Hereditary form of GB associated with nerve deafness

Alport's syndrome

90

Defect in Alport's syndrome

a5 chain of collagen type IV

91

Where Type I collagen is typically found

Bone

92

Where Type II collagen is typically found

Cartilage

93

Where Type III collagen is typically found

Reticular fibers of blood vessels

94

Where Type IV collagen is typically found

Basement membrane

95

Disease where Type V collagen is typically defective

Ehler's Danlos

96

Drug associated with feral renal agenesis

ACEI