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AUBF > 6.1 RENAL DISEASES - GLOMERULAR > Flashcards

6.1 RENAL DISEASES - GLOMERULAR Flashcards

1
Q

What are the primary classifications of renal diseases based on the kidney’s affected areas?

A

Glomerular, tubular, and interstitial

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2
Q

What is the major function of the kidneys?

A

Filtration of the blood to remove waste products.

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3
Q

What is the primary cause of most glomerular disorders?

A

Immunologic disorders

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4
Q

List down all the diseases under glomerular disorders. - Glomerulonephritis

A

Acute poststreptococcal glomerulonephritis (AGN)

Rapidly progressive glomerulonephritis (RPGN)

Goodpasture syndrome

Granulomatosis with polyangiitis (GPA)

Henoch-Schönlein purpura

Membranous glomerulonephritis

Membranoproliferative glomerulonephritis (MPGN)

Immunoglobulin A Nephropathy

Chronic glomerulonephritis

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5
Q

Nephrotic Syndrome diseases

A

Focal Segmental Glomerulosclerosis
Minimal Change Disease

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6
Q

Which immunoglobulin is commonly associated with immune complex deposition in glomerular disorders?

A

Immunoglobulin A (IgA).

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7
Q

What are nonimmunologic causes of glomerular damage?

A

Exposure to chemicals/toxins,
disruption of electrical membrane charges,
deposition of amyloid material, and
thickening of the basement membrane

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8
Q

What is the hallmark urinalysis finding in acute poststreptococcal glomerulonephritis (AGN)?

A

Red blood cell (RBC) casts.

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9
Q

What laboratory test can confirm the streptococcal origin of AGN?

A

Positive anti–group A streptococcal enzyme tests (e.g., ASO and anti-DNase B).

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10
Q

What serious complication is associated with rapidly progressive glomerulonephritis (RPGN)?

A

Renal failure

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11
Q

Which autoimmune disorder produces antiglomerular basement membrane antibodies?

A

Goodpasture syndrome

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12
Q

What key antibody is identified in granulomatosis with polyangiitis (GPA)?

A

Antineutrophilic cytoplasmic antibody (ANCA).

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13
Q

What is the most serious complication of Henoch-Schönlein purpura

A

Renal involvement leading to proteinuria and hematuria

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14
Q

What urinalysis findings are common in membranous glomerulonephritis (MGN)?

A

Microscopic hematuria and elevated urine protein.

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15
Q

Which type of membranoproliferative glomerulonephritis (MPGN) is associated with dense deposits?

A

Type 2.

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16
Q

What is a common symptom of chronic glomerulonephritis (CGN)?

A

Broad casts in the urine

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17
Q

What is the most common cause of glomerulonephritis?

A

Immunoglobulin A (IgA) nephropathy (Berger disease).

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18
Q

What is the hallmark laboratory finding in nephrotic syndrome?

A

Massive proteinuria (>3.5 g/day).

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19
Q

What is the primary protein lost in nephrotic syndrome?

A

Albumin

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20
Q

What cells absorb lipid-containing proteins in nephrotic syndrome, leading to the formation of oval fat bodies?

A

Renal tubular epithelial (RTE) cells.

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21
Q

Which disorder is the most common cause of nephrotic syndrome in children

A

Minimal change disease (MCD).

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22
Q

What type of renal disease affects only certain numbers and areas of glomeruli?

A

Focal segmental glomerulosclerosis (FSGS

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23
Q

Which glomerular disorder is caused by immune complexes formed from nephrogenic group A β-hemolytic streptococcal infections?

A

Acute poststreptococcal glomerulonephritis (AGN)

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24
Q

Which glomerular disorder is a severe form characterized by crescent formations in Bowman space and a poor prognosis?

A

Rapidly progressive glomerulonephritis (RPGN)

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25
Q

Which glomerular disorder involves antiglomerular basement membrane antibodies and often begins with respiratory symptoms?

A

Goodpasture syndrome

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26
Q

Which glomerular disorder is associated with granuloma-producing inflammation in small blood vessels and is diagnosed by detecting ANCA?

A

Granulomatosis with polyangiitis (GPA)

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27
Q

Which glomerular disorder is a systemic disorder following upper respiratory infections and is characterized by purpura and hematuria?

A

Henoch-Schönlein purpura

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28
Q

Which glomerular disorder is caused by thickening of the glomerular basement membrane due to IgG deposits?

A

Membranous glomerulonephritis

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29
Q

Which glomerular disorder involves both thickening and cellular proliferation in the glomerular basement membrane?

A

Membranoproliferative glomerulonephritis (MPGN)

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30
Q

Which glomerular disorder represents the advanced stage of many glomerular diseases and leads to chronic renal failure?

A

Chronic glomerulonephritis

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31
Q

What changes can immune system mediators cause in the glomerular membrane?

A

Cellular infiltration,
proliferation,
thickening of the glomerular basement membrane, and
complement-mediated capillary damage.

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32
Q

Can glomerulonephritis progress to other disorders?

A

Yes, it can progress from
rapidly progressive glomerulonephritis to
chronic glomerulonephritis,
nephrotic syndrome, and eventually
renal failure.

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33
Q

What triggers acute poststreptococcal glomerulonephritis (AGN)?

A

Respiratory infections caused by certain strains of

group A β-hemolytic streptococci with M protein in their cell wall.

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34
Q

What are the clinical symptoms of AGN?

A

Fever,
edema (especially around the eyes),
fatigue,
nausea,
hypertension,
oliguria,
proteinuria, and
hematuria.

35
Q

What are the primary urinalysis findings in AGN?

A

Marked hematuria,
proteinuria,
oliguria,
RBC casts,
dysmorphic RBCs,
hyaline and granular casts,
and WBCs.

36
Q

What laboratory tests confirm the streptococcal origin of AGN?

A

Positive anti-streptococcal enzyme tests, such as antistreptolysin O (ASO) and anti-DNase B.

37
Q

What distinguishes rapidly progressive glomerulonephritis (RPGN)?

A

It is a severe form of glomerular disease with a poor prognosis, often leading to renal failure.

38
Q

What initiates RPGN?

A

Deposition of immune complexes in the glomerulus, often from systemic disorders like

systemic lupus erythematosus (SLE).

39
Q

What causes crescent formations in RPGN?

A

Damage by macrophages to capillary walls releases cells and plasma into Bowman space

forming crescents of macrophages, fibroblasts, and fibrin.

40
Q

What are key laboratory findings in RPGN as the disease progresses?

A

Markedly elevated protein levels,
low glomerular filtration rates (GFR),
increased fibrin degradation products,
and cryoglobulins.

41
Q

What triggers Goodpasture syndrome?

A

Cytotoxic autoantibodies

against glomerular and alveolar basement membranes, often following viral respiratory infections.

42
Q

What is the primary urinalysis finding in Goodpasture syndrome?

A

Proteinuria,
hematuria, and
RBC casts.

43
Q

Identify the glomerular disorder characterized by granuloma formation in small blood vessels and the presence of ANCA.

A

Granulomatosis with Polyangiitis (GPA)

44
Q

What are the two patterns of ANCA detected in GPA testing?

A

Perinuclear pattern (p-ANCA) and cytoplasmic pattern (c-ANCA).

45
Q

What are the primary urinalysis findings in GPA?

A

Hematuria,
proteinuria,
RBC casts, and
elevated serum creatinine and
BUN.

46
Q

Identify the glomerular disorder primarily affecting children and characterized by purpura and renal involvement

A

Henoch-Schönlein Purpura

47
Q

What are the primary symptoms of Henoch-Schönlein purpura?

A

Raised red skin patches,
respiratory and gastrointestinal symptoms, hematuria, and
proteinuria.

48
Q

Raised red skin patches, respiratory and gastrointestinal symptoms, hematuria, and proteinuria.

A

Complete recovery in over 50% of cases, though some progress to severe glomerulonephritis and renal failure.

49
Q

Identify the glomerular disorder with pronounced thickening of the basement membrane due to IgG immune complexes.

A

Membranous Glomerulonephritis (MGN)

50
Q

What disorders are associated with membranous glomerulonephritis?

A

Systemic lupus erythematosus (SLE),
Sjögren syndrome,
secondary syphilis,
hepatitis B, and
malignancies.

51
Q

What are the laboratory findings in membranous glomerulonephritis?

A

Microscopic hematuria,
elevated protein excretion, and
rare RBC casts.

52
Q

Identify the glomerular disorder with cellular proliferation in the glomerulus and capillary wall thickening.

A

Membranoproliferative Glomerulonephritis (MPGN)

53
Q

What are the three types of MPGN?

A

Type 1: Subendothelial cellular proliferation.
Type 2: Dense deposits in the basement membrane.
Type 3: Combined subepithelial and subendothelial deposits.

54
Q

What are the typical urinalysis findings in MPGN?

A

Hematuria,
proteinuria, and
decreased serum complement levels.

55
Q

Identify the glomerular disorder characterized by progressive damage leading to end-stage renal disease.

A

Chronic Glomerulonephritis (CGN)

56
Q

What are the symptoms of chronic glomerulonephritis?

A

Fatigue,
anemia,
hypertension,
edema, and
oliguria.

57
Q

What are the key laboratory findings in CGN?

A

Hematuria,
proteinuria,
glucosuria, and the
presence of broad casts.

58
Q

What is another name for Minimal Change Disease (MCD)?

A

Lipid nephrosis or nil disease

59
Q

What is the primary structural damage seen in Minimal Change Disease?

A

Damage to podocytes and the shield of negativity

60
Q

What is the percentage of Minimal Change Disease cases in nephrotic syndrome in children versus adults?

A

85% to 95% in children; 10% to 15% in adults

61
Q

What are the primary clinical symptoms of Minimal Change Disease?

A

Edema,
heavy proteinuria,
transient hematuria,
normal BUN and creatinine levels

62
Q

What factors have been associated with the etiology of Minimal Change Disease?

A

Allergic reactions,
recent immunization, and
possession of the human leukocyte antigen B12 (HLA-B12)

63
Q

What is the proposed pathogenesis of Minimal Change Disease?

A

A T-cell disorder releasing cytokines that injure the glomerular epithelial foot processes

64
Q

How does Minimal Change Disease typically respond to treatment?

A

Responds well to corticosteroids

65
Q

What is the prognosis for Minimal Change Disease?

A

Generally good, with frequent complete remissions

66
Q

What is the defining feature of nephrotic syndrome in terms of proteinuria?

A

Massive proteinuria (greater than 3.5 g/day)

67
Q

What are the primary biochemical abnormalities associated with nephrotic syndrome?

A

Low serum albumin,
high serum lipids, and
pronounced edema

68
Q

What circulatory disruption can lead to nephrotic syndrome?

A

Systemic shock decreasing blood flow and pressure to the kidneys

69
Q

What types of damage increase glomerular permeability in nephrotic syndrome?

A

Damage to the shield of negativity and podocytes

70
Q

Which protein is primarily depleted in nephrotic syndrome?

A

Albumin

71
Q

What compensatory response in the liver occurs due to hypoalbuminemia in nephrotic syndrome?

A

Increased lipid production

72
Q

How does hypoalbuminemia contribute to edema in nephrotic syndrome?

A

Decreased oncotic pressure causes fluid loss into interstitial spaces, compounded by sodium retention

73
Q

What complications arise from immunoglobulin and coagulation factor depletion in nephrotic syndrome?

A

Increased risk of infection and coagulation disorders

74
Q

What are common urinalysis findings in nephrotic syndrome?

A

Marked proteinuria,
urinary fat droplets (lipiduria),
oval fat bodies,
epithelial/fatty/waxy casts, and
microscopic hematuria

75
Q

What produces oval fat bodies in nephrotic syndrome?

A

Absorption of lipid-containing proteins by renal tubular epithelial cells followed by cellular sloughing

76
Q

What is a possible progression of nephrotic syndrome if untreated?

A

Chronic renal failure

77
Q

What distinguishes FSGS from other glomerular diseases?

A

It affects only certain areas and numbers of glomeruli while others remain normal

78
Q

It affects only certain areas and numbers of glomeruli while others remain normal

A

Focal Segmental Glomerulosclerosis (FSGS)

79
Q

What are the primary causes of FSGS?

A

Primary (idiopathic) glomerular disease or secondary to other diseases or drug abuse

80
Q

Which substances or conditions are commonly associated with secondary FSGS?

A

Heroin abuse,
analgesics,
HIV, and
hepatitis viruses

81
Q

What immune deposits are often found in FSGS?

A

Immunoglobulin M (IgM) and C3

82
Q

What are the consistent urinalysis findings in FSGS?

A

Moderate to heavy proteinuria and microscopic hematuria

83
Q

What symptoms of FSGS overlap with nephrotic syndrome and minimal change disease?

A

Similar symptoms due to podocyte damage

AUBF (22 decks)

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