Glomerular disease (pathology)

Question 1

proteins bigger than or equal to albumin will not be ……..

Answer 1

filtered

they will stay in the plasma

Question 2

3 things in the filter barrier

‘3 layered sandwich’ of the glomerular membrane

Answer 2

endothelial cell cytoplasm

basal lamina (connective tissue)

podocyte

Question 3

podocyte

Answer 3

cells in the bowman’s capsule that wrap around the capillaries of the glomerulus

Question 4

mesangial cells

Answer 4

tree like cells that support the capillaries

Question 5

albumin

Answer 5

protein made by the liver

keeps fluid in your bloodstream

Question 6

primary glomerulonephritis effects the

Answer 6

glomerulus only

Question 7

secondary glomerulonephritis effects

Answer 7

other parts of the body as well as the glomerulus

Question 8

glomerulonephritis can be due to increased

Answer 8

immunoglobulins

clog up the filter as they are not usually filtered

Question 9

glomerulonephritis 4 common presentations

learn these v important

Answer 9

haematuria

heavy proteinuria (nephrotic syndrome)

slowly increasing proteinuria

acute renal failure

Question 10

haematuria main causes (4)

Answer 10

UTI

urinary tract stone

urinary tract tumour

glomerulonephritis

Question 11

haematuria investigations:

Answer 11

urine culture

ultrasound (check for stones)

Question 12

in a renal biopsy - what are you looking for with regards to glomerulonephritis?

Answer 12

immunoglobulin deposition

Question 13

does the IgA get filtered into urine?

Answer 13

no it gets ‘stuck’ in the mesangium

Question 14

IgA irritates mesangium and causes them to proliferate - creating more

Answer 14

matrix

can lead to chronic renal failure occasionally

Question 15

50 year old male
feel unwell and has swollen legs
tests show serum albumin is low

What tests now?

Answer 15

dipstick proteinuria

send to hospital to see nephrologist

Question 16

50 year old male
feel unwell and has swollen legs
tests show serum albumin is low

nephrologist measures protein (albumin) in his urine (a very heavy loss).

What is the clinical diagnosis?

Answer 16

nephrotic syndrome

Question 17

what is membranous glomerulonephritis?

Answer 17

IgG stuck in the membrane

Question 18

diabetic nephropathy involves the gross excess of ……. …….. forming nodules

Answer 18

mesangial matrix

Question 19

is creatinine in urine normal?

Answer 19

yes

Question 20

what does creatinine measure?

Answer 20

renal function

Question 21

50 year old female
unwell for 3 weeks
cough

serum biochemistry is creatinine of 500 (60 the year before)

what tests?

Answer 21

ultrasound (renal tract lesion)

check clotting

renal biopsy

Question 22

rapidly rising creatinine is a sign of what?

Answer 22

acute renal failure

Question 23

ANCA

Answer 23

anti- neutrophil cytoplasmic antibodies

Question 24

Small artery supplies the glomerulus by an ……. arteriole

you then have an ……. arteriole coming out of the glomerulus

Answer 24

afferent

efferent