FN: Nephritic Syndrome/Acute GN

Question 1

Description

Answer 1

Haematuria (macro/micro) + red cell casts
Proteinuria - oedema (esp. periorbital)
Hypertension
Oliguria and progressive renal impairment

Question 2

Causes

Answer 2

1. Proliferative/post-streptococcal

2. Cresentic/RPGN

Question 3

Proliferative/Post-strep features

Answer 3

1. young child develops malaise and nephritic syndrome with smoky urine 1-2 wks after sore throat or skin infection
2. Raised ASOT
3. reduced CS

Question 4

Proliferative/Post-strep biopsy

Answer 4

IgG and Cs deposition

Question 5

Proliferative/Post-strep Rx

Answer 5

supportive

Question 6

Proliferative/Post-strep prognosis

Answer 6

95% of children fully revocer

Minority develop RPGN

Question 7

Cresentic/RPGN description

Answer 7

Most aggressive GN whcih can - ESRF in days

Question 8

Cresentic/RPGN classification

Answer 8

Type 1: Anti-GBM (Good pastures)
Type 2: Immune complex deopsition
Type 3: Pauci Immune

Question 9

Cresentic/RPGN type 1

Answer 9

Ab to NC domain on collagen 4
HAematuria and haemoptysis
CXR show infiltrates

Question 10

Cresentic/RPGN type 1 Rx

Answer 10

Plasmapheresis and immunosuppression

Question 11

Cresentic/RPGN Type 2

Answer 11

Complication of any immune complex deposition –>

1. Bergers
2. Post0strep
3. Endocarditis
4. SLE

Question 12

Cresentic/RPGN Type 3

Answer 12

cANCA: Wegners
pANCA: microscopic polyangitis, Churg strauss
Even if ANCA +ve may still be idiopathy i.e. no features of systemic vasculitis