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renal + urology > glomerular disease > Flashcards

glomerular disease Flashcards

1
Q

what is glomerulonephritis

A

inflammation of the glomeruli in the kidneys

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2
Q

what is nephritis

A

inflammation of the kidneys

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3
Q

5 clinical features of nephritic syndrome

A

haematuria
proteinuria (,3g, +/++ on urinalysis)
oliguria
hypertension
fluid retention

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4
Q

what is oliguria

A

reduced urine output

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5
Q

mnemonic to remember the causes of nephritic syndrome

A

SHARP AIM
SLE
HSP
Anti-GBM disease
RPGN
Post-infectious GN, eg. streptococcal, infective endocarditis
Alport syndrome
IgA nephropathy
MPGN

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6
Q

pathophysiology of nephritic syndrome

A

damage to the glomerular capillary wall - leading to haematuria and reduced kidney function

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7
Q

pathophysiology of nephrotic syndrome

A

loss of the glomerular basement membrane’s charge and size selectivity resulting in massive proteinuria

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8
Q

what is nephritic syndrome

A

signs and symptoms that occur due to renal inflammation (particularly glomerulonephritis)

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9
Q

what is the most common cause of nephrotic syndrome in children

A

minimal change disease

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10
Q

what is the most common cause of nephrotic syndrome in older patients

A

membranous nephropathy

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11
Q

classic presentation of a patient with nephrotic syndrome

A

major proteinuria, hypoalbuminaemia, peripheral oedema

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12
Q

clinical sign of major proteinuria

A

frothy urine

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13
Q

classic oedema seen in nephrotic syndrome

A

periorbital

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14
Q

conservative management of nephrotic syndrome

A

fluid restriction and reduced salt intake

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15
Q

medical management of nephrotic syndrome

A

corticosteroids
+ thiazide for oedema

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16
Q

name some complications of nephrotic syndrome

A

infection - loss of immunoglobulins in urine
reduced vit D
subclinical hypothyroidism (loss of thyroid binding globulin)

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17
Q

what is rapidly progressive glomerulonephritis

A

acute and severe development of renal impairment

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18
Q

what is the most common subtype of rapidly progressive glomerulonephritis

A

pauci-immune complex glomerulonephritis

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19
Q

histology of rapidly progressive glomerulonephritis

A

glomerular crescents

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20
Q

what are glomerular crescents and why do they occur

A

proliferation of epithelial cells in bowmans space - due to injury of the glomerular capillary wall causing rupture of the glomerular basement membrane

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21
Q

clinical presentation of rapidly progressive glomerulonephritis

A

rapid deterioration (duh)
severe nephritic syndrome

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22
Q

name some ANCA negative causes of rapidly progressive glomerulonephritis

A

goodpastures, HSP, SLE

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23
Q

what is the definitive diagnostic test for rapidly progressive GN

A

renal biopsy

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24
Q

mainstay of treatment for rapidly progressive GN

A

immunosuppression
prednisolone or cytotoxics e.g. azathioprine or cyclophosphamide

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25
clinical presentation of minimal change disease
nephrotic syndrome !!! proteinuria, facial oedema, no real renal impairment fatigue, weight gain (fluid retention)
26
what is usually needed for a diagnosis of minimal change disease and what is a positive result
electron microscopy - diffuse podocyte effacement (fused or flattened)
27
first line management of minimal change disease
prednisolone
28
what is focal segmental glomerulosclerosis associated with
obesity, HIV, sickle cell, PWID, reflux
29
clinical presentation of focal segmental glomerulosclerosis
nephrotic syndrome
30
focal segmental glomerulosclerosis on microscopy
light microscopy: areas of sclerosis electron microscopy: diffuse podocyte foot process effacement
31
medical management of focal segmental glomerulosclerosis
prolonged glucocorticoid steroids
32
what antibody is present in most patients with primary membranous nephropathy
anti-PLA2r
33
clinical presentation of membranous nephropathy
nephrotic syndrome
34
light microscopy of membranous nephropathy
thickened basement membrane, spike and dome pattern on a silver stain
35
electron microscopy of membranous nephropathy
immune complex deposits in the basement membrane
36
blood marker for membranous nephropathy
anti-phospholipase A2 antibodies
37
what drug is used to induce remission of membranous nephropathy
rituximab
38
what is another name for membranoproliferative GM
mesangiocapillary GN
39
double contour of basement membrane on biopsy
membranoproliferative GN
40
what are the 2 primary mechanism of membranoproliferative GN
immune complex deposition and activation of complement complement dysregulation leading to persistent activation of alternate pathway
41
what is the most common form of GN worldwide
IgA nephropathy
42
histology of IgA nephropathy
IgA deposits and mesangial proliferation
43
what is the role of mesangial cells and where are they found in the kidney
centre of the glomerulus and help support the capillaries
44
who usually presents with IgA nephropathy
patients under 30
45
what can commonly precede IgA nephropathy
infection e.g. URTI
46
what is associated with IgA nephropathy
HSP
47
classic presentation of IgA nephropathy
recurrent haematuria following 12-72hrs of an URTI or GI infection
48
first line investigation for IgA nephropathy
urinalysis and MC&S
49
what is MC&S investigation
microscopy, culture and sensitivities
50
management of IgA nephritis
salt restriction treat proteinuria with an ACE or ARB management of HTN
51
what is another name for alports syndrome
hereditary nephritis
52
what is alports syndrome
genetic condition causing disorder of type 4 collagen matrix
53
inheritance in alports syndrome
X-linked
54
classic presentation of alports
microscopic haematuria + hearing loss in early years
55
what kind of hearing loss is seen in alports syndrome
sensorineural
56
diagnostic investigation for alports syndrome and positive result
renal biopsy - variable thickness of the glomerular basement membrane
57
what is HSP
IgA mediated small vessel vasculitis
58
who usually presents with HSP
children
59
what commonly precedes HSP
viral URTI
60
classic presentation of HSP
tetrad of: rash, arthritis, abdo pain, renal impairment
61
management of HSP
supportive: fluids, analgesia and rest
62
name 2 ways in which HSP is monitored
urinalysis and BP monitoring
63
what causes anderson fabrys disease
deficiency of ⍺-galactosidase A
64
inheritance seen in anderson fabrys disease
X-linked
65
dermatological symptom associated with anderson fabrys disease
angiokeratomas on groin, buttocks and lower trunk
66
management of anderson fabrys disease
fabryzyme
67
linear deposition of IgG in basement membrane
goodpastures disease

renal + urology (13 decks)

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