Glomerulonephritis (Smarty PANCE) Questions and
Answers Rated A
What are the characteristics of glomerular other than the treatment of the underlying
disease?- Proteinuria, hematuria infection in most cases. A trial of steroids may be
(microscopic or gross), renal insufficiency, and indicated if renal failure is severe. There is no
HTN. Depending upon the cause, systemic evidence supporting aggressive
symptoms may also be present. immunosuppression.
A 10 y/o is brought to the clinic with her mother What is the prognosis of postinfectious GN?-
for dark urine. The mother mentions that the child Self-limited, with Cr returning to
was complaining of sore throat and cough/cold baseline in <6 weeks in most cases; hematuria
symptoms two ago. The urine shows gross typically resolves within 6 months. 15% of
hematuria without nitrites or leukocytes.- patients with poststreptococcal GN have
Postinfectious (Poststreptococcal) persistent proteinuria at 3 years, 2% at 7–10
glomerulonephritis years. Progression to ESRD is rare, as is
recurrence.
What is the typical clinical presentation of
postinfectious GN?- Presentation variesA 33-year-old man comes to the ED because of
from asymptomatic with only microscopic blood in his urine for 2 days. He has also been
findings on urinalysis to that of a nephritic feeling unwell, with a sore throat, running nose,
syndrome: gross hematuria, HTN, edema, and cough, and fever. Medical history includes three
acute renal failure. Symptoms appear 2–3 weeks episodes of hematuria in the past that have
after streptococcal pharyngitis or other bacterial spontaneously resolved. His temperature is
infection 98.9°F; pulse is 82/min; respirations are 18/min,
and blood pressure is 145/90 mm Hg. PE is
What are the characteristic laboratory findings of normal. Urinalysis shows moderate numbers of
postinfectious GN?- Urine sediment erythrocytes, a few leukocytes, red cell casts,
and a large amount of protein. No bacteria are
reveals dysmorphic RBCs or RBC casts and
cultured. A renal biopsy demonstrates large dark
proteinuria (occasionally nephrotic range); serum
studies are remarkable for mesangial deposits.- IgA nephropathy
hypocomplementemia, positive ASO titer.
What is the typical clinical presentation of IgA
What are the renal biopsy characteristics for LM, nephropathy?- Gross hematuria with or
IF, EM?- LM - Glomerular without proteinuria during viral upper respiratory
hypercellularity, with epithelial and endothelial tract infection or GI illness, persistent microscopic
cell proliferation, and an inflammatory glomerular hematuria, and sometimes associated dull flank
infiltrate composed of neutrophils. Capillary pain, with a 2:1 male predominance, often
lumens are usually obliterated. Crescents may presenting in the second and third decades of life
be present.
IF - Granular deposition of IgG and C3 in the What are the most common conditions with which
glomerular tuft IgA nephropathy is associated?- Liver
EM - Large, irregular, subepithelial "hump"- disease (e.g., alcoholic cirrhosis), inflammatory
shaped deposits bowel disease, celiac sprue, and HIV
What is the appropriate management of What are the characteristic laboratory findings of
postinfectious GN?- No specific therapy IgA nephropathy?- Normal or decreased
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Answers Rated A
What are the characteristics of glomerular other than the treatment of the underlying
disease?- Proteinuria, hematuria infection in most cases. A trial of steroids may be
(microscopic or gross), renal insufficiency, and indicated if renal failure is severe. There is no
HTN. Depending upon the cause, systemic evidence supporting aggressive
symptoms may also be present. immunosuppression.
A 10 y/o is brought to the clinic with her mother What is the prognosis of postinfectious GN?-
for dark urine. The mother mentions that the child Self-limited, with Cr returning to
was complaining of sore throat and cough/cold baseline in <6 weeks in most cases; hematuria
symptoms two ago. The urine shows gross typically resolves within 6 months. 15% of
hematuria without nitrites or leukocytes.- patients with poststreptococcal GN have
Postinfectious (Poststreptococcal) persistent proteinuria at 3 years, 2% at 7–10
glomerulonephritis years. Progression to ESRD is rare, as is
recurrence.
What is the typical clinical presentation of
postinfectious GN?- Presentation variesA 33-year-old man comes to the ED because of
from asymptomatic with only microscopic blood in his urine for 2 days. He has also been
findings on urinalysis to that of a nephritic feeling unwell, with a sore throat, running nose,
syndrome: gross hematuria, HTN, edema, and cough, and fever. Medical history includes three
acute renal failure. Symptoms appear 2–3 weeks episodes of hematuria in the past that have
after streptococcal pharyngitis or other bacterial spontaneously resolved. His temperature is
infection 98.9°F; pulse is 82/min; respirations are 18/min,
and blood pressure is 145/90 mm Hg. PE is
What are the characteristic laboratory findings of normal. Urinalysis shows moderate numbers of
postinfectious GN?- Urine sediment erythrocytes, a few leukocytes, red cell casts,
and a large amount of protein. No bacteria are
reveals dysmorphic RBCs or RBC casts and
cultured. A renal biopsy demonstrates large dark
proteinuria (occasionally nephrotic range); serum
studies are remarkable for mesangial deposits.- IgA nephropathy
hypocomplementemia, positive ASO titer.
What is the typical clinical presentation of IgA
What are the renal biopsy characteristics for LM, nephropathy?- Gross hematuria with or
IF, EM?- LM - Glomerular without proteinuria during viral upper respiratory
hypercellularity, with epithelial and endothelial tract infection or GI illness, persistent microscopic
cell proliferation, and an inflammatory glomerular hematuria, and sometimes associated dull flank
infiltrate composed of neutrophils. Capillary pain, with a 2:1 male predominance, often
lumens are usually obliterated. Crescents may presenting in the second and third decades of life
be present.
IF - Granular deposition of IgG and C3 in the What are the most common conditions with which
glomerular tuft IgA nephropathy is associated?- Liver
EM - Large, irregular, subepithelial "hump"- disease (e.g., alcoholic cirrhosis), inflammatory
shaped deposits bowel disease, celiac sprue, and HIV
What is the appropriate management of What are the characteristic laboratory findings of
postinfectious GN?- No specific therapy IgA nephropathy?- Normal or decreased
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