glomerular disease pathology Flashcards

1
Q

What aspect of the arterioles prevents large blood pressures reaching the delicate blood vessels in the glomerulus

A

They contain smooth muscle in their walls

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2
Q

What is the glomerulus

A

A bag of capillaries sitting in between two arterioles

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3
Q

What is a podocyte

A

glomerular epithelial cell

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4
Q

What cells always lines capillaries

A

endothelial cells

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5
Q

How does blood enter the glomerulus

A

The afferent arteriole

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6
Q

What proteins are not filtered by the glomerulus

A

All proteins equal to or larger than albumin will not be filtered

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7
Q

What are the 3 layers of the glomerular membrane

A

Endothelium
Basal lamina
Podocyte foot processes

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8
Q

What are mesangial cells

A

‘Tree like’ group of cells which support capillaries

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9
Q

Where do the unfiltered substances go

A

Some fluid, albumin and larger proteins exit the through the efferent arteriole

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10
Q

Where does the efferent arteriole carry blood to

A

capillaries which are around the tubule

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11
Q

What is glomerulonephritis

A

Disease of the kidneys

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12
Q

What are the two categories of glomerulonephritis

A

Immunoglobulin deposition nephritis or non immunoglobulin nephritis

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13
Q

What are the 4 common presentations for glomerulonephritis

A

Haematuria
Heavy proteinuria
Slowly increasing proteinuria
Acute renal failure

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14
Q

What are the main causes of haematuria

A

UTI - most common cause
Urinary tract stone (calculi)
Urinary tract tumour
Glomeluonephritis can cause haematuria but it is less common then the other options

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15
Q

What can deposits of IgA cause

A

Increased IgA deposits causes increased proliferation of mesangial cells

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16
Q

Is IgA removed by the glomerulus

A

It is not known but is is a important part of the cause of the disease

17
Q

Does IgA get filtered in the urine

A

No, the IgA is stuck within the mesangium

18
Q

What is the prognosis for IgA nephropathy

A

Usually self limiting but some go onto develop chronic renal failure

19
Q

Why is albumin measured when glomerular abnormalities are expected

A

Albumin is slightly bigger than the glomerular basement membrane can filter so when there is an issue at the glomerular basement membrane, albumin is the first substance to be excreted

20
Q

How does IgG cause glomerulonephritis

A

It is too big to be filtered and deposits itself between basal lamina and podocyte

IgG then activates compliment 3 which punches holes into the filter - leaky filter allows proteins into the urine which leads to nephrotic syndrome

21
Q

What is the prognosis of mebranous glomerulonephritis

A

25% develop chronic renal failure within 10 years

22
Q

What happens in diabetic nephropathy

A

Thickened, narrowed arterioles which reduces blood flow to glomerulus

Increased mesangial matrix which compresses capillaries

Thickened capillary wall which is leaking albumin

Adhesions to bowmans capsule are the glomerulus attempt to stop major leakage of protein (albumin) into the urine

23
Q

What is the kimmelsteil-Wilson lesion which is seen in diabetic nephropathy

A

A very big excess of mesangial matrich which produces nodules

24
Q

What is rapidly rising creatinine a sign of

A

Acute renal failure

25
Q

What are anti-neutrophil cytoplasmic antibodies(ANCA)

A

Antibodies which are directed against proteinase 3 and myeloperoxidase which both are present as primary granl

26
Q

How do antibodies cause tissue damage

A

Interactions with primed neutrophils

27
Q
A