This Is Why We Can’t Have Nice Things (Like Albumin)
Chronic use of this common class of painkillers has been associated with secondary membranous nephropathy.
What are NSAIDs?
The loss of plasma proteins, particulary albumin, reduces this type of pressure, leading to edema.
What is oncotic pressure?
This lifestyle recommendation helps reduce edema from nephrotic syndrome and should be paired with diuretics.
What is dietary sodium restriction?
In nephrotic syndrome, a classic urine finding is proteinuria exceeding this amount per day.
What is 3.5 grams per day?
This kidney cell type is damaged in membranous nephropathy, leading to proteinuria.
What is a podocyte?
This systemic autoimmune disease can cause secondary membranous nephropathy and is known for "full-house" immunofluorescence.
What is systemic lupus erythematosus (SLE)?
The defining defect in nephrotic syndrome involves increased permeability of this structure.
What is the glomerular filtration barrier?
50 extra points if you can name the three components of it.
These two drug classes reduce intraglomerular pressure and proteinuria, making them key in nephrotic syndrome management.
What are ACE inhibitors or ARBs?
This is the normal range for albumin and its change in nephrotic syndrome.
What is 3.5–5.5 g/dL and decreased?
In membranous nephropathy, immunofluorescence shows granular subepithelial deposits of these two proteins.
What are IgG and C3?
50 extra points if you can choose the correct immunofluorescence photo.
This autoimmune target found on podocytes is responsible for most cases of primary membranous nephropathy.
What is PLA2R (phospholipase A2 receptor)?
Complement activation plays a role in membranous nephropathy pathogenesis, particularly this complex that damages podocytes.
What is C5b-9 (or MAC)?
50 extra points if you can name the specific immunoglobulin subtype that activates it.
Patients with nephrotic syndrome are at increased risk of this vascular complication, which may require anticoagulation.
What is a thromboembolism (or DVT/PE)?
This is the normal level for total cholesterol and its change in nephrotic syndrome.
What is <200 and increased?
This special stain helps visualize the thickened basement membrane and the characteristic spike formations.
What is a Jones silver stain (or silver methenamine stain)?
50 extra points if you can point them out in the photo.
Exposure to this heavy metal has been reported to cause secondary membranous nephropathy in rare cases.
What is gold?
50 extra points if you can tell me what disease it was once used to treat.
In this type of proteinuria caused by damage to the glomerular basement membrane, all types of protein of any size can be found in the urine.
What is nonselective?
Patients with nephrotic syndrome have a higher risk for this, for which they should receive preventive vaccination.
What is Streptococcus pneumoniae infection?
This is the normal range for serum sodium and its change in nephrotic syndrome.
What is 136–146 mEq/L and decreased/normal?
This descriptive term refers to the appearance of subepithelial immune complex deposits and the intervening matrix of basement membrane between them.
What is "spike and dome"?
50 extra points if you can point them out in the photo.
These infections (two viral, one bacterial, and two parasitic) are associated with secondary membranous nephropathy.
What are hepatitis B, hepatitis C, syphilis, schistosomiasis, malaria?
In nephrotic syndrome, loss of this property of the glomerular basement membrane contributes selective proteinuria, in which only small to medium sized proteins can be found in the urine (primarily albumin).
What is negative charge/anionic charge/charge selectivity?
50 extra points if you can tell me a glomerular disease with this.
This drug class can be used to prevent a complication of nephrotic syndrome caused by liver overproduction of a certain molecule to compensate for hypoalbuminemia.
What are statins?
This is the normal level of D-dimer and its likely change in nephrotic syndrome.
What is ≤250 ng/mL and increased?
Lack of this feature on light microscopy can help differentiate membranous nephropathy from membranoproliferative glomerulonephritis.
What is hypercellularity?
50 extra points if you can choose the correct light microscopy photo.