Glomerular Disease

Question 1

how much protein should be in urine normally?

Question 2

how to test for protein in urine?

Answer 2

24 hour urine collection usually
spot protein-creatinine ratio
dipstick

Question 3

how much RBCs should be in urine?

Answer 3

zero

Question 4

blood in urine can look like 1 of 2 ways? where is it from?

Answer 4

dismorphic: glomerular
normal: non-glomerular

Question 5

3 ways to looks at a renal biopsy?

Answer 5

light (H&E)
EM
Immunohistochem.immunofluoroscopy

Question 6

glomeruli are affected in one of 4 ways geographically:

Answer 6

diffuse vs. focal (# of glomeruli in kidney as whole)

global vs segmental (of individual glomeruli)

Question 7

5 symptoms of nephrotic syndrome?

Answer 7

proteinuria
oedema
decreased albumin
increase lipids
increased coagulation

Question 8

4 symptoms of nephritic syndrome

Answer 8

haematuria
hypertension
incerased creatinine
oedema

Question 9

2 main diseases what cause haematuria?

Answer 9

IgA nephropathy: most common

Post-infectious glomerulonephritis (immune complexes)

Question 10

treatment for IgA nephropathy?

Answer 10

BP control

Question 11

3 main conditions that cause proteinuria?

Answer 11

membranous
minimal change disease
focal segmental glomerulosclerosis

Question 12

who gets membranous nephropathy? rule of 1/3s?

Answer 12

adults:
1/3 spontaneous recover
1/3 partial remit
1/3 progressive to ESKD

Question 13

how to treat membranous nephropathy?

Answer 13

steroids, cyclophosphamide/cyclosporin

Question 14

who gets minimal change disease? how to treat?

Answer 14

kids

treat with steroids

Question 15

2 common causes of secondary focal segmental glomerulosclerosis?

Answer 15

HIV and obesity

Question 16

what happens in focal segmental glomerulosclerosis??

Answer 16

progressive scarring of glomerulous to ESKD

Question 17

who gets focal segmental glomerulosclerosis??

Answer 17

younger ppl in 20s

Question 18

what condition has both proteinuria and haematuria?

Answer 18

membrano-proliferative

Question 19

membrano-proliferative glomerulonephritis is linked to what diseases?

Answer 19

Hep B, C

Question 20

3 systemic causes of glomerulonephritis?

Answer 20

Lupus
Diabetes
Amyloidosis

Question 21

2 important not to be missed rapidly progressive glomerulonephritises?

Answer 21

Wegner’s

Goodpasture’s

Question 22

3 classes of rapidly progressive glomerulonephritises?

Answer 22

ANCA
Anti-Glomerular Basement Membrane disease (collagen type 4)
Immune complexes

Question 23

Wegner’s is what ANCA?

Answer 23

cANCA (cytoplasmic)

Question 24

Goodpasture’s affects what?

Answer 24

kidneys and lungs with anti-basement membrane antbodies

Question 25

what disease of rapidly progressive glomerulonephritises caused by immune complexes?

Answer 25

lupus

Question 26

important side effects of cyclophosphamide?

Answer 26

infertility
infections
TCC
nausea
hair loss

Question 27

4 things that glomerulonephritis associated with?

Answer 27

proteinuria
haematuria
hypertension
impaired renal function (increase creatinine)