Glomerular Disease Flashcards
What is the difference between non- proliferative and proliferative glomerulonephritis?
Proliferative is congested due to excessive numbers of cells in glomeruli.
Non-proliferative is not congested
What are the different types of proliferative glomerulonephritis?
Diffuse proliferative
Focal proliferative
Focal necrotising (crescentic)
Membrane-proliferative
What is the microbiological cause of diffuse glomerulonephritis?
Lancefield group A streptococci
What is the treatment for post-infective glomerulonephritis?
Antibiotics for infection
Loop diuretics for oedema
Vasodilator drugs for hypertension
Possibly immunosuppression in severe cases
What is the presentation of acute nephritis?
Fluid retention with oedema Normal serum albumin Little proteinuria Hypertension Renal impairment
What is the main presentation of IgA nephropathy?
Macroscopic haematuria
What causes focal proliferative nephritis?
Mesangial IgA disease
What is the treatment for IgA nephropathy?
Ace inhibitors and other hypotensives
What are the 3 main settings under which focal narcotising glomerulonephritis can occur?
Presence of anti-glomerular basement membrane antibodies
Associated with systemic vasculitis
Complication of other types of glomerulonephritis
How is good pastures disease diagnosed?
Anti-GBM antibodies in serum and kidney
What is the management of good pastures disease?
Plasma exchange and immunosuppression
How is crescentic glomerulonephritis managed?
Immunosuppression (prednisolone)
What are the different types of non proliferative glomerulonephritis?
Minimal change disease
Focal glomerulonephritis
Membranous nephropathy
What do all types of non proliferative glomerulonephritis cause?
Nephrotic syndrome
What is the clinical triad of nephrotic syndrome?
Pitting oedema
Proteinuria
Hypoalbuminaemia
What is the definition of nephrotic syndrome?
Severe oedema caused by hypoalbuminia due to loss of protein in the urine
What are the additional features of nephrotic syndrome?
Hyperlipidaemia
Hypercoaguable state
Increased risk of infection, especially pneumococcus
What is the differential diagnosis for nephrotic syndrome?
Congestive heart failure
Hepatic disease
How is oedema treatment within nephrotic syndrome?
Fluid and sodium restriction
Normal to high protein diet
Loop diuretics
Infusion of albumin with loop diuretics for resistant oedema
What prophylaxis is given against complications in nephrotic syndrome?
Penicillin V
Heparin
What is minimal change nephrotic syndrome?
Sudden onset of oedema accompanies by complete loss of protein with steroids
What is the treatment for minimal change nephrotic syndrome?
Prednisolone
What are the complications of steroid responsive nephrotic syndrome?
Bacterial infection, especially with pneumococcus
Thrombosis
What are the clinical features of focal gloemrulosclerosis?
Severe nephrotic syndrome
Disabling symptoms
What is the treatment for focal glomerulosclerosis?
Initial trial of steroids
Cyclophosphamide or cyclosporin if steroids fail
What is the treatment for membranous nephropathy?
Control nephrotic symptoms
Immunosuppression (prednisolone and chrorambucil alternating for 6 months)
