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Year 2 Urinary (JK) > Glomerular disease pathology > Flashcards

Glomerular disease pathology Flashcards

1
Q

What is a podocyte?

A

glomerular epithelial cell with foot processes

cells in bowmans capsule that wrap around capillaries of the glomerulus

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2
Q

What proteins are not filtered at the glomerulus?

A

bigger or equal to albumin + ig

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3
Q

3 parts of filter barrier membrane at glomerulus

A

endothelial cell cytoplasm
basal lamina
podocyte

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4
Q

What are mesangial cells?

A

“tree-like” group of cells which support capillaries

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5
Q

What is found in the efferent arteriole?

A

blood cells, some fluid, albumin+larger proteins and antibodies

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6
Q

What is glomerulonephritis?

A

disease of the glomerulus which can be inflammatory or non inflammatory

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7
Q

Difference between primary and secondary glomerulonephritis

A

primary - only affects glomerulus

secondary - other parts of body affected eg SLE

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8
Q

Aetiology of glomerulonephritis

A

Ig deposition stuck in filter

can be no Ig deposition eg diabetic glomerular disease

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9
Q

4 common presentations/signs of glomerulonephritis

A

haematuria
heavy proteinuria (nephrotic syndrome)
slowly increasing proteinuria
acute renal failure - rising creatinine

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10
Q

4 causes of haematuria

A

UTI
Urinary tract stone
urinary tract tumour
glomerulonephritis - rare

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11
Q

What should always be checked before a renal biopsy?

A

clotting screen

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12
Q

What happens in mesangial proliferative glomerulonephritis?

A

IgA deposition in mesangial cells causing proliferation which leads to increased matrix production

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13
Q

prognosis of mesangial proliferative glomerulonephritis

A

most resolve and self limiting

small % - chronic renal failure due to continued deposition of matrix

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14
Q

If serum albumin is low but urine albumin high what does this suggest?

A

leaky glomerular filter

membranous glomerulonephritis

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15
Q

What immunoglobulin is related to membranous glomerulonephritis?

A

IgG

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16
Q

What happens to the glomerular basement membrane in membranous glomerulonephritis ?

A

thickened

spikes of new basement membrane matrix

17
Q

What does the IgG do in membranous glomerulonephritis ?

A

not filtered and lodges between basal lamina and podicyte

activates complement to punch holes in filter - leaky

18
Q

Consequence of IgG activating complement

A

albumin now in urine - nephrotic syndrome

19
Q

Prognosis of membranous glomerulonephritis

A

1/4 - chronic renal failure in 10 years

can have underlying malignancy

20
Q

What happens in diabetic nephropathy?

A

small, compressed capillary lumen due to increased mesangial matrix
reduced blood flow - atherosclerosis
thickened capillary wall leaks albumin

21
Q

What are the nodules of mesangial matrix in diabetic nephropathy called?

A

Kimmelsteil - Wilson lesion

22
Q

What Ig is present in diabetic nephropathy?

A

none

23
Q

What 2 factors means inevitable decline in diabetic nephropathy?

A

continued poor glycaemic control

established diabetic nephropathy

24
Q

What does rapidly rising creatinine signify?

A

acute renal failure

25
Q

What is crescentic glomerular nephritis?

A

cellular proliferation and influx of macrophages causing a crescent tuft and crushed glomerulus leading to inflammation and scarring

26
Q

What is granulomatosis with polyangitis?

A

a form of vasculitis which affects vessels in kidneys, nose and lungs

27
Q

What is ANCA?

A

antibody indicating vasculitis

28
Q

Is ANCA deposited in the kidney?

A

no

29
Q

What are ANCA antibodies directed towards?

A

enzymes in primary granules of neutrophils

30
Q

What do ANCA antibodies lead to?

A

produce tissue damage via interactions with primed neutrophils and endothelial cells

31
Q

Prognosis of granulomatosis with polyangitis

A

fatal - 6 months if untreated

75% remission with cyclophosphamide

Year 2 Urinary (JK) (26 decks)

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