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Nephrology > Glomerular Disease > Flashcards

Glomerular Disease Flashcards

1
Q

What is nephrotic syndrome?

A

Presence of Protein in the urine >3.5g/day

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2
Q

How does nephrotic syndrome occur?

A

Increased permeability of serum protein through the damaged basement membrane

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3
Q

What are three common causes of primary nephrotic syndrome?

A

Minimal Change Disease
Focal segmental glomerulosclerosis
Membranous Nephropathy

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4
Q

What is Minimal change disease:

  • Epidemiology
  • Presentation
  • Management
A
  • Children 1-8 years
  • Follows recent viral illness, facial oedema
  • Tx with Fluid rest and corticosteroid
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5
Q

What is Focal segmental glomerulonsclerosis:

  • Pathology
  • Presentation
  • Management
A
  • Primary = no identifiable cause and Secondary = injury to podocytes due to viruses and toxins.
    Presents - HTN, oedema, frothy urine
    Mx - Furosemide, statins and BP control with ACE Symptomatic + coritcosteroids.
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6
Q

What is Membranous Nephropathy :

  • Definition
  • Causes
  • Presentation
  • Management
A

Chronic immune mediated glomerular disease of the BM
Primary is idiopathic and secondary can be due to:
- NSAIDS, Malignancy, Infection (Hep B and Syph), AI

Presents HTN and oedema
Mx - ACE, Furosemide, Low Na+ and Steroids

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7
Q

What are secondary causes of nephrotic syndrome?

A 
DM and amyloidosis 
Drugs: Lithium, RA 
Malignancy 
Pre-eclampsia 
Infection: HIV, Hep B and Malaria
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8
Q

What are complications of nephrotic syndrome?

A

Increase in clotting factors
Increased risk of Strep infection
Hyperlipidemia - Increased production by liver to increase oncotic pressure

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9
Q

What is nephritic syndrome?

A

Large pores in podocytes allowing blood and protein leakage

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10
Q

What are 3 primary causes of nephritic syndrome?

A

IgA nephropathy
Post-infectious glomerulonephritis
Rapidly progressive glomerulonephritis

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11
Q

What is post infectious glomerulonephritis:

  • Pathophysiology
  • Presentation and epidemiology
  • Management and Diagnosis
A

Microbial antigens bind to glomerular basement membrane and activate compliment. Immune complex deposition results in glomerular damamge

Presents weeks after a streptococcal infection e.g. URTI or Impetigo
Common in 5-15 YO

Diagnosed with hypocomplimentemia and treatment is supportive

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12
Q

What is IgA nephropathy:

  • Pathophysiology
  • Presentation and epidemiology
  • Management
A

Renal IgA deposits

Occurs 1-2 days post URTI and occurs in teens- late thirties
ACE and ARB mx

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13
Q

What is Rapidly Progressive Glomerulonephritis?

A

Acute nephritic syndrome with progression to renal failure within weeks - months . There is formation of crescents as a part of a necrotising histological response

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14
Q

How does Rapidly Progressive Glomerulonephritis present?

A

Fatigue, weakness, fever, nausea and haematuria

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15
Q

What conditions can cause Rapidly Progressive Glomerulonephritis?

A

Wegeners
Goodpastures
SLE

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16
Q

What is the management of Rapidly Progressive Glomerulonephritis?

A

Corticosteroids and Cyclophamide

17
Q

What is Good pastures syndrome?

A

AI Autoantibodies against type IV collagen present in the kidneys and lungs. Present as pulmonary haemorrhage (Haemoptysis) anaemia and haematuria).

18
Q

What is presentation of Nephritic syndrome in general?

A 
Azotaemia - high nitrogen 
Oliguria 
Haematuria 
Proteinuria 
HTN
19
Q

What are secondary causes of nephritic syndrome?

A

Membranoproliferative glomerulonephritis and Henoch-schloen purpura

20
Q

What is Henoch-schloen purpura and how does it present?

A

Systemic vasculitis. IgA deposition in the skin and kidney

Presents with arthralgia, haematuria, purpuric rash and abdominal pain

21
Q

What can cause Membranoproliferative glomerulonephritis?

A

SLE

HEP B/C

22
Q

What is granulomatosis with polyangiitis?

A

Characterised by ELK involvement - ENT, Lungs and Kidneys. cANCA - positive RPGN

23
Q

What are typical features of granulomatosis with polyangiitis?

A

Haemoptysis
Haematuria
Otitis, Epistaxis and sinusitis
Conjunctivitis and episcleritits

24
Q

What is management of asymptomatic patients or patients with no organ damage with granulomatosis with polyangiitis?

A

Methotrexate

25
Q

What is management of symptomatic patients with granulomatosis with polyangiitis?

A

Cyclophosphamide and adjunct prednisolone

26
Q

What are examples of mixed nephrotic and nephritic syndrome?

A

Alport Syndrome

Membranoproliferative glomerulonephritis

27
Q

What is alport syndrome?

A

X linked dominant

Type IV collagen defect which affects the eyes, ears and kidney basement membrane

28
Q

What is the presentation of Alport Syndrome?

A

Protein and haematuria
Sensioneural deafness
Lens abnormalities

29
Q

What is management of Alport syndrome?

A

ACE to control HTN and slow disease progression

Nephrology (3 decks)

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