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    Divine Intervention Step 2CK Podcasts Notes - Read Only File - Docx (Dragged) 6 (Dragged) 2

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    winston1234
    This document summarizes several types of glomerulonephritis including: 1) ANCA-associated vasculitis which includes microscopic polyangiitis associated with p-ANCA and proteinase 3-associated c-ANCA. 2) IgA nephropathy caused by antibodies against glycosylated IgA deposits leading to inflammation. 3) Lupus nephritis characterized by malar rash, low complement, anti-DNA antibodies and diffuse proliferative glomerulonephritis on biopsy. 4) Post-infectious glomerulonephritis following a streptococcal infection where antibodies cross-react with glomerular antigens activating complement.

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    Divine Intervention Step 2CK Podcasts Notes - Read Only File - Docx (Dragged) 6 (Dragged) 2

    Uploaded by

    winston1234
    167 views1 page
    This document summarizes several types of glomerulonephritis including: 1) ANCA-associated vasculitis which includes microscopic polyangiitis associated with p-ANCA and proteinase 3-associated c-ANCA. 2) IgA nephropathy caused by antibodies against glycosylated IgA deposits leading to inflammation. 3) Lupus nephritis characterized by malar rash, low complement, anti-DNA antibodies and diffuse proliferative glomerulonephritis on biopsy. 4) Post-infectious glomerulonephritis following a streptococcal infection where antibodies cross-react with glomerular antigens activating complement.

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    This document summarizes several types of glomerulonephritis including: 1) ANCA-associated vasculitis which includes microscopic polyangiitis associated with p-ANCA and proteinase 3-associated c-ANCA. 2) IgA nephropathy caused by antibodies against glycosylated IgA deposits leading to inflammation. 3) Lupus nephritis characterized by malar rash, low complement, anti-DNA antibodies and diffuse proliferative glomerulonephritis on biopsy. 4) Post-infectious glomerulonephritis following a streptococcal infection where antibodies cross-react with glomerular antigens activating complement.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    167 views1 page

    Divine Intervention Step 2CK Podcasts Notes - Read Only File - Docx (Dragged) 6 (Dragged) 2

    Uploaded by

    winston1234
    This document summarizes several types of glomerulonephritis including: 1) ANCA-associated vasculitis which includes microscopic polyangiitis associated with p-ANCA and proteinase 3-associated c-ANCA. 2) IgA nephropathy caused by antibodies against glycosylated IgA deposits leading to inflammation. 3) Lupus nephritis characterized by malar rash, low complement, anti-DNA antibodies and diffuse proliferative glomerulonephritis on biopsy. 4) Post-infectious glomerulonephritis following a streptococcal infection where antibodies cross-react with glomerular antigens activating complement.

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    of 1

    ● Path: c-ANCA (Ab-proteinase3)

    ▪ Microscopic polyangiitis: >60Y, fever, hematuria, p-ANCA (Ab-myeloperoxidase)


    ▪ Churg-Strauss/EGPA: asthma/allergies, tons of eosinophils, hematuria, p-ANCA
    ● Dx: crescent-shaped = monocytes leak through GBM into Bowman's space and proliferate
    ▪ Complement levels are normal
    ● Tx: steroids, cyclophosphamide, rituximab
    o IgA nephropathy/synpharyngitic nephropathy
    ● RF: recent URI
    ● Pathophys: Ab against glycosylated-IgA (from N-acetylgalactosamine on bugs) --> deposits in
    mesangium of kidneys --> inflammation
    ● Systemic manifestation = HSP (purpura x abdominal pain x hematuria)
    ● Sx: hematuria
    ● Dx: biopsy, complement levels are normal
    ● Tx: supportive
    o Lupus nephritis
    ● Sx: malar rash, anti-Sm Ab, anti-dsDNA, low complement levels ("full-house pattern")
    ● Subtypes
    ▪ Diffuse proliferative glomerulonephritis
    o Post-infectious glomerulonephritis/PSGN
    ● RF: URI, Strep infection (nephritogenic strains)
    ▪ --> abx for Strep throat do not decrease chance of PSGN
    ● Pathophys: Ab against GAS cross react with antigens in glomerulus --> complement "destroys
    everything in its wake"
    ● Sx: 1-6wks post-URI, hematuria, low complement
    ● Dx: anti-DNAseB, anti-streptolysinO, anti-hyaluronidase, "granular pattern"
    ● C/b: chronic renal failure (kids 1% vs adults 40%)
    o Membranoproliferative glomerulonephritis (MPGN)
    ● RF: lupus, HepB/C
    ● Dx: low C3, "subendothelial tram tracks"
    ● Subtype: dense-deposit disease ("ribbon-shaped" deposits around basement membrane of
    glomerulus, C3 nephritic factor = C3 convertase --> low C3)
    o Alport syndrome
    ● Sx: "can't pee, can't see, can't hear a bee" = cataracts/dislocation of lens, nephritic syndrome,
    sensorineural hearing loss
    ● Path: X-linked dominant mutation in alpha2* chain of Type4 collagen/COL4A5
    ▪ *A comes before G[oodpasture] in the alphabet!
    ▪ (same inheritance as Fragile X syndrome)

    Disease Light microscopy findings

    Minimal change disease Podocyte effacement

    FSGS Podocyte effacement

    PSGN Subepithelial humps, granular

    Membranous nephropathy Subepithelial spike and dome

    Membranoproliferative glomerulonephritis subendothelial tram tracks

    Lupus nephritis wire-loop appearance

    Goodpasture's syndrome/anti-GBM disease Linear pattern of IgG deposition


    344

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