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Renal > 2: Nephritic Syndrome > Flashcards

2: Nephritic Syndrome Flashcards

1
Q

What is glomerulonephritis

A

Immume-mediated damage to the glomerulus causing inflammation and damage that enables protein and blood to pass into the urine

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2
Q

What are the two types of glomerulonephritis

A

Nephritic syndrome

Nephrotic syndrome

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3
Q

How does nephritic syndrome present

A
  • Haematuria
  • Oedema
  • RBC casts in urine
  • Oliguria
  • HTN
  • Proteinuria <3.5g/day
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4
Q

What is a mnemonic to remember causes of nephritic syndrome

A

PIGARMS

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5
Q

What are the causes of nephritic syndrome

A

Post-streptococcal glomerulonephritis

IgA neprhopathy

Good-pastures, Granulomatous with polyangitis

Alport’s syndrome

Rapidly progressive glomerolonephritis

Membroproliferative glomerulonephritis

SLE

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6
Q

What is post-streptococcal glomerulonephritis

A

Occurs following infection with Group A streptococcus

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7
Q

What age does post-streptococcal glomerulonephritis affect

A

Children: 3-12 years-old

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8
Q

What time frame after infection does post-streptococcal glomerulonephritis occur

A

1-2 Weeks

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9
Q

Name two streptococcal infections that can lead to post-streptococcal glomerulonephritis

A
  • Pharyngitis

- Impetigo

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10
Q

What are the symptoms of post-streptococcal glomerulonephritis

A
  • Coca-cola urine (haematuria)
  • Proteinuria (>3.5g/day)
  • Oliguria
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11
Q

What investigations can be ordered in post-streptococcal glomerulonephritis

A

Antistreptolysin O titre (ASOT)

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12
Q

Explain prognosis of post-streptococcal glomerulonephritis

A

Self-resolving in one month

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13
Q

What is IgA neprhopathy also known as

A

Berger disease

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14
Q

What is the most common cause of nephropathy worldwide

A

IgA nephropathy

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15
Q

What is the stereotype for Bergers disease

A

Young male, presents with episodes of recurrent haematuria following recurrent URTIs

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16
Q

How does Bergers disease present

A

1-2 days after URTI with macroscopic haematuria

NO proteinuria

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17
Q

What is a way to remember time frame that IgA neprhopathy is 1-2 days and post-streptococcal is 1-2W

A

A comes before S

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18
Q

What blood-test can be ordered in IgA nephropathy to confirm diagnosis

A

Raised total serum IgA

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19
Q

What is a good prognostic factor in IgA nephropathy

A

Frank Haematuria

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20
Q

What are poor prognostic factors in IgA nephropathy

A 
Male
Smoker
HTN
Hyperlipidaemia 
ACEi
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21
Q

What is anti-GBM disease also known as

A

Goodpasture’s syndrome

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22
Q

When should good pasture’s be suspected

A

Haemoptysis and haematuria

23
Q

What age does goodpasture’s tend to occur

A

20-30 or 60-70 years-old

24
Q

What gene is goodpasture’s associated with

A

HLADR2

25
Q

What environmental factors increase risk of good pastures

A

Smoking
Infection
Oxidative-stress
Hydocarbon-based solvent

26
Q

How does goodpasture’s present clinically

A

Haemoptysis and haematuria

27
Q

Do lung or kidney symptoms start first in good pastures

A

Lung symptoms occur before kidney symptoms

28
Q

What type of collagen are autoantibodies raised to in good pasture’s syndrome

A

Collagen type IV

29
Q

What happens when autoantibodies bind to collagen type IV

A

Activate the complement system

30
Q

How is good pastures syndrome managed

A
  • Plasmapheresis
  • Glucocorticoids
  • Cyclophosphamide
31
Q

What can good pastures syndrome lead to

A
  • Rapidly progressive glomerulonephritis
32
Q

What is alports syndrome

A

Genetic condition

33
Q

What is the inheritance pattern of Alport syndrome

A

X Linked Dominance

34
Q

Given Alport syndrome is an x-linked dominant condition, which gender are affected more

A

Males

35
Q

What age does Alport Syndrome tend to occur

A

Haematuria may be present during infancy, however severe symptoms manifest during adolescence

36
Q

Outline the clinical presentation of Alport Syndrome

A
  • Intermittent gross haemaruia
  • ESRD: as glomerular damage progresses causes decrease in GFR
  • SNHL
  • Eye involvement
37
Q

What collagen is defective in Alport syndrome

A

IV Collagen

38
Q

What is the confirmatory test for Alport syndrome

A

Skin Biopsy - absence of type IV collagen a5 chain fibres

39
Q

What will be seen on skin biopsy in Alport Syndrome

A

Absence of type IV collagen a5 chain fibres

40
Q

What ocular deficit may be seen in Alport Syndrome

A

Anterior lenticonus

Perimacular flecks

41
Q

Explain management of Alport Syndrome

A
  • ACEi
  • Hearing aids
  • Surgery for anterior lenticonus

RRT = only definitive management

42
Q

What is rapidly progressive glomerulonephritis also known as

A

Cresenteric glomerulonephritis

43
Q

What is rapidly progressive glomerulonephritis

A

Inflammatory disease causing rapid destruction of glomeruli leading to ESRD

44
Q

What is type I RPGN

A

anti-GBM mediated

45
Q

What is type II RPGN

A

Due to immune complex deposition

46
Q

Give examples of immune complex mediated type II RGPN

A
  • SLE
  • Post-streptococcal glomerulonephritis
  • IgA neprhopathy
47
Q

What is type 3 RPGN

A

Pauci-immune

48
Q

What is pauci immune

A

No immune complex deposition

49
Q

What are two types of type 3 RPGN

A
  • Granulomatosis with polyangitis

- Eosinophillis granulomatosis with polyangitis

50
Q

What antibody is present in granulomatosis with polyangitiis

A

C-ANCA

51
Q

What antibody is present in eosinophillic granulomatosis with polyangitis

A

P-ANCA

52
Q

How does rapidly progressive glomerulonephritis present

A

Nephritis syndrome: haematuria, oliguria, oedema

53
Q

What will be seen on light-microscopy in rapidly progressive glomerulonephritis

A

Cresenteric cells

54
Q

How is cresenteric glomerulonephritis treated

A
  • Anticoagulants
  • Glucocorticoids
  • Cyclophosphamide
  • RRT

Renal (15 decks)

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