Glomerular disease

Question 1

define nephritic syndrome.

Answer 1

• protein loss of less than 3.5g/L in 24hr
• haematuria - RBC casts in urine
• HTN
• oliguria
• sterile pyuria

NephrItic indicates Inflammation (I I I)

Question 2

What are the broad causes of nephritic syndrome?

Answer 2

• Infection
• autoimmune
• small vessel vasculitis
• Genetic causes

Question 3

What are the infectious causes of nephritic disease?

Answer 3

-Post-Strep glomerular nephritis

Question 4

What are the features for post-strep glomerularnephritis?

Answer 4

• Group A beta-haemolytic streptococcus infection
• 1-2 weeks post throat/tonsil infection
• 3-4 weeks post skin infection
• tea/cola coloured urine
• self limiting in children
• Severe in adults

Question 5

What findings on investigation would suggest post-step glomerular nephritis?

Answer 5

• streptococcus antibodies
• decreased complement 3
• immune complex deposits on microscopy

Question 6

Glomerular nephritis with….

a) sore throat 2 weeks ago?
b) purpuric rash on skin?
c) sinusitis?
d) haemoptysis?

Answer 6

a) post strep
b) IgA nephropathy (HSP) or wegner’s or other vasculitis
c) wegner’s
d) good pasteures or anti GBM GN

Question 7

Tell me about IgA nephropathy?

Answer 7

• IgA deposits in the glomerulus
• microscopic haematuria with intermittent frank haematuria
• can occur during or after:
  - GI infection
  - URTI
  - Strenuous exercise

Question 8

What findings will there be for IgA nephropathy?

Answer 8

• increased serum IgA

- IgA deposits & mesangial proliferation on