Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Inflammation block > An intro to glomerular diseases > Flashcards

An intro to glomerular diseases Flashcards

1
Q

What is glomerulonephritis

A

-Glomerular inflammation
-Generally caused by immunological mediated injury to the glomeruli
-Pathogenic mechanism: deposition of circulating or in situ formation of immune; deposition of antiglomerular basement membrane abs
(These mechanisms activate secondary mechanisms that lead to the glomerular damage &inflammation)
-Pattern of injury and the clinical presentation will depend on the ‘target’ of the immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How can we classify glomerulonephritis

A
  1. ) PRIMARY eg membranous

2. ) SECONDARY- as part of a generalized disease eg SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How may someone with glomerular disease present?

A
  • hypertension
  • incidental finding of proteinuria
  • incidental finding of microscopic haematuria
  • Nephrotic syndrome
  • Progressive renal impairment
  • Acute kidney injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is nephrotic syndrome

A

A collection of symptoms due to kidney damage

  • hyperlipidaemia
  • Oedema( children=periorbital; adults=peripheral)
  • Hypoalbuminuaemia
  • Heavy proteinuria>3.5g per day
  • If you have 3+ protein on urine dipstick and someone with oedema, it’s almost always going to be nephrotic syndrome
  • A leak of protein through your kidney cos the podocyte pores(these usually hang onto protein) get disrupted and the protein leaks through into the urine freely
  • Basically an increase in protein leak associated with oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What may be a consequence or renal artery stenosis

A

renal hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why would you consider checking complements if a pt presents to you with incidental hypertension

A

To check for SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why would you consider checking ANCA if a pt presents to you with incidental hypertension

A

To check for vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is IgA nephropathy?

A
  • aka Berger’s disease
  • occurs when IgA lodges in your kidney
  • Results in local inflammation that, over time, may hamper your kidneys’ ability to filter wastes from your blood
  • Could cause and incidental finding of hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some causes of secondary hypertension

A
  • endocrine causes

- renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some non-glomerular causes of microscopic haematuria ?

A
  • Bladder tumours
  • Renal stones
  • Renal tumors
  • BPH
  • UTI
  • Renal injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some of the primary glomerular causes of microscopic haematuria

A
  • IgA nephropathy
  • Alports
  • Thin basement membrane disease
  • Post infectious GN
  • Membranoproliferative GN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some of the secondary glomerular causes of microscopic haematuria

A
  • Henoch Scorlein Purpura (IgA vasculitis)
  • SLE
  • HUS
  • ANCA
  • Sickle nephropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Outline the pathogenesis of IgA nephropathy

A

-Glomerular deposition of IgA causing inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Outline the clinical presentation of IgA nephropathy

A

Variable clinical presentation

  • Microscopic haematuria
  • Hypertension
  • Slowly progressive renal impairment
  • Rapidly progressive renal impairment
  • Nephrotic range proteinuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What lab tests may be useful for IgA nephropathy

A
  • Raised serum IgA

- Renal biopsy shows mesangial proliferation with IgA deposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can we manage IgA nephropathy?

A
  • Control of BP

- Immunosuppression may be useful

17
Q

Outline the characteristics of Henoch Schonlein Purpura

A
  • Inflammation of the small blood vessels esp in kidneys,skin and gut
  • Most common in young children
  • IgA deposition in the kidney in a similar pattern to IgA nephropathy
  • Associated with a leucocytoclasic vasculitic rash
  • Variable prognosis, some fully recover with resolution of the rash and renal findings, others progress to ESKD
18
Q

Define leucocytoclasic

A

‘To be destroyed by WBCs’

-eg IgA vasculitis; the small vessels are destroyed by IgA antibodies

19
Q

What are the primary causes of nephrotic syndrome?

A
  • Membranous nephropathy
  • FSGS(focal segmental glomerulosclerosis)
  • MCGN (Mesangiocapillary glomerulonephritis)
  • Minimal change disease
20
Q

What are the secondary causes of nephrotic syndrome?

A
  • Diabetic nephropathy
  • SLE
  • Amyloidosis
  • Malignancy
  • Drugs
21
Q

What are the possible complications of nephrotic syndrome?

A
  • Protein malnutrition
  • Hypovolaemia
  • AKI (esp older pts with min change disease)
  • VTE
  • Infections
22
Q

Describe the management of nephrotic syndrome

A
  • Diuretics
  • ACE
  • Anticoagulation
  • Statin
  • Renal biopsy (in children minimal change disease is common so steroids are given before the biopsy)
23
Q

What is the most common cause of nephrotic syndrome in children?

A

Minimal change disease (90%)

24
Q

What are the most common causes of nephrotic syndrome in adults

A 
FSGS(35%)
Membranous nephropathy(33%)
25
What is minimal change disease?
- Sudden onset oedema especially in children - Normal light microscopy - Foot process effacement of podocytes on EM
26
Outline the causes of minimal change disease
- Ideopathic(majority), esp kids - NSAIDs - Lithium,pellicinamine,pamidronate, sulfazalizine,immunizations - Paraneoplastic (Hodgkins lymphoma) - Infections (syphillis, TB, mycoplasma, Hep C) - Allergy
27
What is FSGS
- Focal segmental glomerulosclerosis - This is a lesion, not a disease - A lot of cases have nephrotic syndrome with it - Light microscopy shows focal and segmental areas of mesangial collapse and sclerosis - Very common in blacks
28
What are the possible causes of FSGS?
-Idiopathic-usually presents with nephrotic syndrome Secondary (non-nephrotic proteinuria, hypertension, microscopic haematuria and renal insufficiency more common presentations) - HIV infection(collapsing) - Reflux nephropathy - Massive obesity - Scaring from previous insult eg IgA, vasculitis, Lupus - Heroin
29
What is membranous nephropathy
- Most common cause of primary nephrotic syndrome in adults - Basement membrane thickening, little or no cellular expansion - Electron dense deposits in the GBM (represent immune deposits) - Ideopathic-antiPLA2 ab associated - Secondary- hepB, autoimmune diseases (inc SLE), thyroiditis, carcinomas, gold,penicillamine,captopril, NSAIDs
30
Define exsanguination
severe loss of blood
31
How can we treat hyperkalaemia ?
- Calcium gluconate to protect your heart & prevent him getting arrhythmias - Insulin will drive K into cells (but you're not removing the K you're just moving it into a different compartment, so you then need to think about removing the K excess) - Dextrose to replace loss fluids & provide carbs for the body - It is the extracellular K that's dangerous and can cause arrhythmias
32
Outline ANCA positive vasculitis
- Granulomatosis with polyangitis (GPA) - Microscopic polyangitis - Rapidly progressive GN with crescent formation - ANCA= anti neutrophil cytoplasmic abs and these have been shown to be pathogenic
33
What is anti GBM disease
- Auto antibodies to the glomerular basement membrane causing a rapidly progressive glomerular nephritis with crescent formation - Previously known as good pastures syndrome - Associated with anti GBM abs and alveolar basement membrane abs - Can cause absolute anuria with pulmonary haemorrhage (or only AKI or pulmonary haemorrhage)
34
How can the colour of the urine on a urine dipstick be useful?
- Visible haematuria - Frothy suggests proteinuria - Cloudy may suggest infection - Coca cola colour suggests rhabdomyolysis
35
Why may the urine specific gravity be useful in a urine dipstick?
1. ) high= increased conc of solutes in the urine eg glucose in diabetes or dehydration 2. ) If low can suggest GN or diabetes insipidus (but non-specific and not greatly helpful)
36
What blood tests may be useful in suspected glomerular disease?
- Blood cultures - U&E, LFT, Bone profile - Virology - RF - C3 &C4 - ANCA - Anti GBM - Myeloma screen (Igs,Electrophoresis & urine Bence-Jonce proteins)
37
What is rheumatoid factor?
-Antibodies directed against the Fc portion of IgG (usually IgM)
38
What are the different ways gomerular disease can present in
1. ) Acute vs chronic 2. ) Idiopathic vs secondary 3. ) Incidental finding vs acute presentation 4. ) Nephrotic (proteinuria) vs nephritic (haematuria)

Inflammation block (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions