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Block 4: SD3 Week 11 > Glomerular Disease 2 > Flashcards

Glomerular Disease 2 Flashcards

1
Q

What is Primary glomerulonephritis?

A

When there is inflammation of the tiny filters of the kidney (glomeruli) that originates from pathology in the kidney.

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2
Q

What is Secondary glomerulonephritis?

A

When there is inflammation of the tiny filters of the kidney (glomeruli) that comes about secondary to another pathology.

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3
Q

Examples of primary GN causes?

A

Post streptococcal GN, Crescentic GN, Minimal change disease, membranous GN, IgA nephropathy

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4
Q

Examples of secondary GN causes?

A
  • Hypertension,Diabetes,SLE, Good pastures, amyloidosis, HSP, Wegner’s
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5
Q

Antibody mediated injury to the glomerulus is what type of HSR?

A

Type 2

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6
Q

What type of HSR is circulating immune complex deposition that causes glomerular injury?

A

Type 3

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7
Q

What type of HSR is cytotoxic Ab that cause glomerular injury?

A

Type 3 HSR

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8
Q

What type of HSR are cell mediated immune injuries to the glomerulus?

A

Type 4 HSR

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9
Q

What type of injury is activation of alternative complement pathway leading to glomerular injury?

A

Type 4 HSR.

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10
Q

Be able to recreate and understand this slide.

A

Be able to understand this slide and reproduce it.

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11
Q

What is anti GBM GN?

A

in situ immune complex deposition

Autoimmune diseases, caused by antibodies against
noncollagenous domain (NCI ) of the α chain of collagen type IV

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12
Q

Characteristic damage, deposition pattern, and progression of Anti GBM GN?

A

severe crescentic glomerular damage

Linear pattern of Immune complex deposition

clinical syndrome of rapidly progressive glomerulonephritis- rapidly progressing AFR

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13
Q

Another name for idiopathic membranous GN?

A

Heymann nephritis

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14
Q

What is the cause of Heymann Nephritis?

A

from the reaction of ab with an antigen complex located on the basal surface of visceral epithelial cells - HEYMANN
ANTIGEN

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15
Q

What pattern of deposition can be found in a person with Heymann nephritis?

A

IF (immunofluoresence) - granular pattern - sub epithelial localization

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16
Q

What are the names of the different types of GN that are caused by immune complex deposition?

A

Poststreptococcal GN, membranous GN,MPGN

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17
Q

Describe the factors affecting localization of antigen, antibody, or complexes around parts of the glomerulus.

A

Because the membrane is negatively charged…..

Small Molecules Highly cationic
Sub epithelial

Highly anionic macromolecules- Sub Endothelial

neutral charge - mesangium

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18
Q

In IF is a granular pattern related to membranous GN or Anti GBM?

A

membranous GN

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19
Q

In IF is a linear pattern related to anti GBM disease or membranous GN?

A

anti GBM disease

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20
Q

Linear basement membrane localization of ag, ab, or complexes could be characteristic of what conditions?

A

anti GBM GN / Good pastures

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21
Q

What glomerular pathologies could contain sub endothelial deposits?

A

MPGN type 1 (membranoproliferative GN type1 ) & SLE (also sub epi & mes)

22
Q

Why renal pathology has characteristic sub epithelial humps?

A

post streptococcal GN, membranous (Heymenn nephritis)

23
Q

What type of nephropathy has only mesangial deposits?

A

IgA nephropathy

24
Q

What type of nephropathy has no immune deposits?

A

Minimal change disease, Idiopathic FSGS, Wegner’s granulomatosis, Alports/thin basement membrane disease

25
Q

In what glomerular disease conditions is C3 in blood low?

A

MPGN type II (persitentantly low)
Post streptococcal GN (transiently low)
IgA nephopathy

26
Q

Another name for MPGN type II

A

Dense Deposit Disease

27
Q

Be able to explain this graph and how this leads to low C3 in the blood.

A

Activation of the alternative pathway C3 converts is initiated.

In the body Properidin usually stabilized this pathway so C3 convertase not broken down by I, and H proteins.

In people with C3NeF autoantibody in MPGN Type 2 it will stabilize C3 convertase and more inflammation and damage will occur

C3 constantly being used and therefore less will be in blood.

28
Q

Describe diffuse involvement of glomeruli

A

involving all glomeruli > 50% of them

29
Q

Describe Global involvement histopathology in renal system.

A

entire glomerulus

30
Q

Describe focal involvement in histological slides of glomerulus.

A

affecting few glomeruli < 50%

31
Q

Describe segmental involvement of glomerulus histopathology.

A

inv. only a proportion of a few glomerulus

32
Q

Be able to reproduce the chart.

A

Reproduce chart

33
Q

What is the condition being seen here and what can it be caused by?

A

mesangial proliferative GN

Caused by:
IgA nephropathy

34
Q

What is the condition being seen in this biopsy and what is the cause?

A

Proliferation of endothelial cells, epithelial cells & neutrophilic infiltration

Acute/ Diffuse proliferative GN

Cause:
Post Streptococcal/ post infectious GN

35
Q

Describe what is being seen here.

What is the condition?

A

proliferation of parietal cells of Bowmans capsule

Crescentic GN

36
Q

What inflammatory mediators can be leaked through the BM of one with Crescentic GN?

A

IL-1; TNF; INF-y

37
Q

What is a characteristic feature of membranous GN?

A

thickening of Glomerular BM

38
Q

Thickening of BM proper of the glomerulus may indicate what condition?

A

DM

39
Q

Deposition of what electron dense deposits can lead to Membranous GN?

A

Lupus nephritis, amyloid-amyloidosis, cryoglobulines

40
Q

What is seen in here?

What is the condition and what are the causes?

A

membranous GN

Thickening of the membrane on PAS

idiopathic, Hep B, malignancy Lupus V, DM

41
Q

What causes what is seen in this image?

A

Accumulation of extracellular amorphous substance - end result of various glomerular damage

Hyalinisation (Scelrosis) Diffuse

42
Q

List some Nephrotic syndromes.

A

MCD,
FSGS
Membranous GN
Diabetic nephropathy
Amyloidosis

43
Q

List the Nephritic syndromes

A

Post Strep GN
RPGN (ARF)
Alports
Thin BM Disease

44
Q

Name some mixed or (Nephrotic nephritic conditions)>

A

MPGN
Lupus GN

45
Q

Frank gross/microscopic hematuria/cola colored urine represents what condition?

A

IgA nephropathy

46
Q

What stains should be done upon renal biopsy to determine condition of renal disease?

A

H&E, special Stains- PAS, PASM for Basement membrane changes

47
Q

After renal biopsy what should be done for diagnosis of glomerulonephropathy?

A

IF or EM

48
Q

If there is a lady with GN what should be done?

A

ANA & Anti Ds DNA

49
Q

IF positive diagnosis could be what GN?

A

IgA nephropathy; Good pastures syndrome

50
Q

IF negative GN could be what conditions?

A

Alports; Wegner’s; Minimal change disease; FSGS

51
Q

What auto antibodies should be checked for when trying to determine GN?

A

anti GBM; C-ANCA; C3 nephritic factor

Block 4: SD3 Week 11 (13 decks)

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