glomerular disease

Question 1

2 main types

Answer 1

1. primary - intrinsic

2. secondary - to a systemic disease

Question 2

2 main presentations

Answer 2

1. nephritic
2. nephrotic
   SEE P 278 to compare

Question 3

main causes

Answer 3

GN is typically immune mediated

- also metabolic and hemodynamic

Question 4

clinical features

Answer 4

overall impaired filtration of blood meaning more protein and RBCs get through
- proteinuria and hematuria

Question 5

3 main Dx tests

Answer 5

1. urinalysis
2. bloods tests (renal function)
3. needle biopsy

Question 6

main Tx

Answer 6

depends on disease, but usually steroid and cytotoxic agents

Question 7

5 primary disorders

Answer 7

1. minimal change
2. focal segmental glomerulosclerosis
3. membranous glomerulonephritis
4. IgA nephropathy
5. hereditary nephritis

Question 8

presentation and features of minimal change

Answer 8

• nephrotic syndrome
• most common in children
• no histo abnormalities
• excellent prognosis

Question 9

features of FSGS

Answer 9

25% of cases

• hematuria and HTN common
• fair to ppor prog
• can get remission in 50%

Question 10

features of membranous glomerulonephritis

Answer 10

• presents with nephrotic
• glom. cap walls are thickened
• primary is idiopathic, secondary due to infection
• prog fair to good
• no use to steroids

Question 11

features of IgA nephropathy

Answer 11

most common cause of glom hematuria

• mesangial depostion of IgA and C3
• prog is good
• unsure about steroids

Question 12

feat. of hereditary nephritis

Answer 12

• Alports Syndrome
• X linked
• hematuria, pyuria, proteinuria, high freq. hearing loss
• no effective Tx

Question 13

Causes of secondary

Answer 13

1. diabetic nephropathy most common
2. HTN
3. SLE
4. membranoproliferative
   - hep C
5. post-strep
6. goodpastures
   - proliferative GN, pulm hemmorage, and IgG anti-basement membrane
7. dysproteinemias
8. sickle cell
9. HIV
10. endocardidits