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Urinary System > 16) Glomerular Pathology > Flashcards

16) Glomerular Pathology Flashcards

1
Q

What components of the renal cortex can become diseased?

A

Glomerulus
Tubules (childhood and rare)
Interstitial
Vascular

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2
Q

Why may the whole nephron be affected by damage to glomerulus?

A

Vascular structures of glomerulus and nephron are all one complex, so damage to one can cause damage to other

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3
Q

What is nephrotic syndrome?

A

Loss of protein (>3.5g/day) particularly albumin leading to oedema (low oncotic pressure)

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4
Q

What is nephritic syndrome?

A

Blockage or inflammation of glomerulus causing glomeruli to burst and haematuria

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5
Q

What are some sites of glomerular injury?

A

Podocytes
GBM
Sub-endothelial
Mesangial

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6
Q

Why does immune complex deposition causes injury?

A

Activates complement and causes cell injury

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7
Q

What is minimal change glomerulonephritis?

A

Loss of podocyte foot processes so wider filtration slits, allowing proteinuria and oedema

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8
Q

Who are more likely to get minimal change glomerulonephritis?

A

Children or adolescents (mid 20s)

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9
Q

What causes minimal change glomerulonephritis and what treatment does it respond to?

A

Unknown circulating factor damaging podocytes

Steroids

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10
Q

What is focal segemental glomerulosclerosis?

A

Unknown circulating factor damaging podocytes and causing glomerulosclerosis

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11
Q

Who does focal segemental glomerulosclerosis affect and what can it progress to?

A

Affects adults and progresses to renal failure

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12
Q

What is membranous glomerulonephritis?

A

Immune complex deposits in sub-epithelial space which bind to antigen/receptor on podocytes

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13
Q

What causes membranous glomerulonephritis?

A

Probably autoimmune

May be secondary to malignancy of immune system e.g. lymphoma

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14
Q

What is seen microscopically in membranous glomerulonephritis?

A

Capillary loop thick

BM thick and abnormal

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15
Q

What are the outcomes of membranous glomerulonephritis?

A

1/3 get better
1/3 stay same
1/3 renal failure

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16
Q

What microscopic changes occur to kidney in diabetes?

A

Microvascular injuries damage glomerulus
Mesangial sclerosis -> nodules
BM thickening

17
Q

What can diabetes cause, in terms of kidneys?

A

Progressive proteinuria

Progressive renal failure

18
Q

What is IgA nephropathy?

A

Deposition of IgA immune complexes in the mesangium causing local inflammation

19
Q

How does IgA nephropathy present?

A

Visible/invisible haematuria

May have proteinuria and progress to renal failure

20
Q

Why is IgA nephropathy related to mucosal infections?

A

These infections activate IgA which can then become deposited in the glomerulus

21
Q

How does IgA nephropathy present microscopically?

A

Glomerulus becomes cellular due to proliferation of mesangial cells and matrix
May scar

22
Q

Why does the IgA immune complex deposit in mesangium?

A

No basement membrane between mesangium and glomerulus

23
Q

What are two hereditary nephropathies?

A

Thin GBM nephropathy - thin GBM, isolated haematuria

Alport Syndrome

24
Q

Describe Alport Syndrome:

A

X linked, abnormal collagen IV
Associated with deafness
Abnormally split GBM

25
Q

What is Goodpasture Syndrome?

A

Acute onset of severe nephritic syndrome due to autoantibody to collagen IV
May affect alveolar membranes as well

26
Q

How do you treat Goodpasture Syndrome?

A

Immunosuppression and plasmapheresis

27
Q

How does Goodpasture Syndrome present microscopically?

A

IgG deposition and many inflammatory cells

28
Q

What is vasculitis?

A

Group of disorders that destroy blood vessels by inflammation. Associated with anti-neutrophil cytoplasmic antibody (ANCA), which activates neutrophils so they attack endothelium

29
Q

How does vasculitis affect the glomerulus?

A

Punches holes in glomerulus through endothelium and BM causing segmental necrosis
See crescent of inflammatory cells

Urinary System (10 decks)

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