Show:
Serum Protein Electrophoresis
Multiple Myeloma
Tx for MM + NS
Nephrotic Syndrome
Renal Review
100
Mechanism for SPEP

What is proteins moving across electrical current, stopping at different places based on size and charge?

100

Evidence of bone destruction found on CT/X-ray in MM.

What is 'Punched-out' lytic lesions?
100

Possible tx options for hypercalcemia found in NS.

IV hydration

Loop diuretics

100

Thickened basement membrane with double contour resembling 'Tram-tracks' on LM.

What is Membranous Proliferative Glomerularnephritis?
100

Most common cause of Nephrotic Syndrome in adults.

What is Focal Segmental Glomerular Sclerosis?

200
Risk for increased infection is caused by this finding on SPEP. (Found in all nephrotic syndromes except MCD)

What is gammaglobulin lost?

200

Pathophysiology, in one sentence, of Multiple Myeloma.

Monoclonal proliferation of plasma cells that orginates in bone marrow?

200

At least 2 nephrotoxic agents patients with NS should avoid.

What is NSAIDs, Thiazide Loop Diuretics, contrast agents?

200

Pathogenesis includes non-soluble filbrillary aggregates of misfolded proteins, often light chains, cause pressure induced 'necrosis.'

What is Amyloidosis?

200

Most common Nephrotic Syndrome in pediatrics.

What is Minimal Change Disease?

300

This specific type of protein, the most common cause of myeloma kidney damage, is produced in excess and appears as a "monoclonal spike" in electrophoresis.

What are light chains (or Bence-Jones proteins)?

300

MM contribution to nephrotic syndrome.

What is overproduction and deposition of monoclonal free light chains within kidney filtration units, glomeruli?

300

Nephrotic syndrome is defined by a daily urinary protein excretion greater than 3.5 grams, but also requires this specific finding regarding serum albumin levels.

What is hypoalbuminuria?

300

1-75% cases commonly due to Antiphospholipase A2-R antibody (PLASR)

What is Membranous Nephropathy?

300

Most common cause of Nephritic Syndrome worldwide.

What is IgA Nephropathy?

400

Of the 4 peaks found on a serum protein electrophoresis, which one changes in a patient with nephrotic syndrome. 

What is the gamma region?


This is the peak found on the far right. The significant elevation in this region is caused by excess of monoclonal immunoglobulins.
400

Clinical presentations of MM (4)

C- HyperCalcemia

R- Renal failure

A- Anemia

B- Bone pain/lesions

400

The one nephrotic syndrome that responds very well to treatment when the others don't.

What is Minimal Change Disease, responds well to steriods?

400

Systemic non-enzymatic glycation of tissues.

What is Diabetic Nephropathy?

400

Types of Nephritic Syndrome.

What is, 

Infection-associated Glomerulonephritis

Rapidly Proliferative Glomerulonephritis

IgA Nephropathy

Alports Syndrome

500

What is the mechanism causing the 'M' peak on SPEP in a patient with multiple myeloma?

What is identical 'M' proteins (same size, charge) = migration to same location?

500

Two kidney pathologies MM is associated with.

Amyloidosis and Type 2 RTA (Fanconi Syndrome)

500

At least 2 supportive care for Nephrotic Syndrome.

What is 

Hydration

Avoiding Nephrotic toxic agents (NSAIDS, certain chemotherapies)

Hypercalcemia management

Blood clot prevention

Dialysis

500

Injury, death and detachment of podocytes followed by focal and segmental fibrosis. 

What is Focal Segmental Glomerular Sclerosis?

500

3 different types of Rapidly Progressive Glomerulonephritis.

What is, 

Type I: Anti-GBM ('Goodpastures' if lung involved)

Type II: Immune complex mediated

Type III: Pauci Immune (Lupus)