Epi/PE
The most common physical exam finding in patients with nephrotic syndrome is ________
What is pitting edema
Initially in diabetic nephropathy, non-enzymatic glycosylation of renal vasculature causes hyalinization of _________ glomerular arterioles which causes a _______ in GFR.
What is: efferent, increase
Urinary loss greater than _____ g/day indicate proteinuria in nephrotic syndrome
What is 3.5
The diseases that cause primary nephrotic syndrome (3)
What are:
-Minimal Change Disease
-Membranous Nephropathy
-Focal Segmental Glomerulosclerosis
The diseases that cause secondary nephrotic syndrome (3)
What are:
-SLE
-Amyloidosis
-Diabetic Nephropathy
This disease is the most common cause of nephrotic syndrome in the US
What is diabetic nephropathy
In membranous nephropathy, patients have autoantibodies to _____________
What are podocyte antigens (PLA-2 receptor in 70-80% of cases)
Hypoalbuminemia causes a _______ in plasma oncotic pressure and ______ the synthesis of alpha-2 macroglobulin
What is:
decrease, increases
The characteristic histologic appearance of the GBM in membranous nephropathy
What is "spike and dome"
Which of these diseases present as a combination of nephrotic and nephritic syndrome
What is SLE
This disease is the most common cause of nephrotic syndrome in children
In minimal change disease, immune reaction to podocytes leads to the loss of _________. This property of the GBM plays a critical role in the reabsorption of albumin.
What is negative charge
(provided by heparan sulfate which repels small negatively charged proteins like albumin)
Hyperlipidemia and hypercholesterolemia in nephrotic syndrome is due to this
What is increased hepatic synthesis of albumin and lipoproteins
Electron microscopy shows podocyte effacement in these diseases (2)
What are:
-Minimal change disease
-FSGS
DOUBLE JEOPARDY
Name 3 lab findings used in the diagnosis of Lupus Nephritis
What is hematuria, proteinuria, positive serology (ANA antibodies and anti-DNA antibodies)
This disease is the most common cause of nephrotic syndrome in African Americans & Hispanics
What is FSGS
The two most common causes of FSGS
What are:
-heroin use
-HIV
The hypercoagulable state seen in these patients due to loss of _______, _________, and ________ in the urine
What are:
-protein C (factor 19)
-protein S (factor 20)
-antithrombin III (factor 17)
Both of these diseases show podocyte effacement, however, patients with _________, present with hematuria and hypertension whereas patients with ________ do not
What is FSGS, minimal change disease
Primary amyloidosis is most commonly associated with _______ (disease) whereas secondary amyloidosis is associated with chronic inflammatory states such as _________ (name any 1)
What is multiple myeloma; chronic infection, RA, IBD, malignancy
This disease is the most common cause of nephrotic syndrome in non-diabetic adults
What is membranous nephropathy?
What is immunoglobulin light chain
Hypogammaglobulinemia causes patients with nephrotic syndrome to be more susceptible to infections by __________ and ___________
What are:
-staphylococcus
-pneumococcus (streptococcus pneumoniae)
________ has the worst prognosis of the primary nephrotic syndromes and over 50% develop ______ within 10 years of diagnosis
What is FSGS, ESRD
_______ are used to treat diabetic nephropathy because they _______ GFR by blocking the action of _________ which preferentially constricts ________ arterioles to ________ GFR
What is ACE inhibitors, decrease, angiotensin II, efferent, increase