7/26/2019 Nephritic table USMLE Step 1
1/2
"GPS RIM" "L.A. G.R.I.M.A"
Post-strep GN GoodPasture's Syndrome RPGN "Crescentric" IgA
Nephropathy (Berger's Dz)
LM 1. Hypercellularity 1. Hypercellularity. 1. Hypercellularity.
1. Hypercellularity
2. PMN's 2. +/- Crescents 2. Crescents 2.mesangial cell
proliferation
IF IgG/C3: "Lumpy Bumpy" IgG/C3 IgG/C3 IgA/C3 in mesangium
Granular Smooth & Linear "Crescents" Mesangial depositsEM
Sub- Epithelial
Rupture of the BM ^ mesangial cellularity
Other MCC: Group A Strep/impetig M>F 20-40 rapid progression
to renal Gross Hematuria
M 1,4, 12"Strep Pyogenes" Hemopotysis-->Death failure in
weeks to months Most commonin World (France/Japan)
Complete recovery in 95% Collagen type IV: alpha 3 subunit
crescent=Fibrin+macrophage ex. Young M hematuria, post URTI
2-4wk ag titers=hematuria type II Hypersensitivity &
parietal epithelial cells in (IgA for mucosa protection)
SLE Type IV- looks similar Most develop RPGN bowman's space
assoc. w/Celiac Sprue (IgA- Glidin)
but deposits= everywhere! lungs & Kidney= alpha 3, coll IV
Type 1: anti-glomerular BM ab dermatitis herpetiformis= itchy
^ASO titer= throat 100% C. O pass through Lungs=A IF: linear IgG
&C3 extensor dermititis
DNAse B= skin infection 25% C. O pass through Kidneys=B Type
2:immune complex dx: tx. Gluten free diet. HSP= vasculitis,
1%= rapidly progressing GN B=rapidly progressing crescents
Lupus, HSP, IgA Kid w/ URTI (IgA) and rash on buttock.
"wire loop region "-subendo tx: Steroids + cyclophosphamide Type
3:Pauci immune
diffuse proliferative 1-2 wks, plasmaphoresis immed.
Wegener's/Polyangitiskid: 5-15yrs old IF: no deposits,
circulating
throat=RF, skin=GN c-ANCA or p-ANCA
erysipelas=superficial rash Tx: plasmapheresis, steroids
Nephritic SyndromeHematuria(smoky urine ), HTN,
Oliguria(inflamed), Azotemia(BUN/Creatinine ratio
),Proteinuria(periorbital s
