Glomerular disease (pathology) Flashcards
proteins bigger than or equal to albumin will not be ……..
filtered
they will stay in the plasma
3 things in the filter barrier
‘3 layered sandwich’ of the glomerular membrane
endothelial cell cytoplasm
basal lamina (connective tissue)
podocyte
podocyte
cells in the bowman’s capsule that wrap around the capillaries of the glomerulus
mesangial cells
tree like cells that support the capillaries
albumin
protein made by the liver
keeps fluid in your bloodstream
primary glomerulonephritis effects the
glomerulus only
secondary glomerulonephritis effects
other parts of the body as well as the glomerulus
glomerulonephritis can be due to increased
immunoglobulins
clog up the filter as they are not usually filtered
glomerulonephritis 4 common presentations
learn these v important
haematuria
heavy proteinuria (nephrotic syndrome)
slowly increasing proteinuria
acute renal failure
haematuria main causes (4)
UTI
urinary tract stone
urinary tract tumour
glomerulonephritis
haematuria investigations:
urine culture
ultrasound (check for stones)
in a renal biopsy - what are you looking for with regards to glomerulonephritis?
immunoglobulin deposition
does the IgA get filtered into urine?
no it gets ‘stuck’ in the mesangium
IgA irritates mesangium and causes them to proliferate - creating more
matrix
can lead to chronic renal failure occasionally
50 year old male
feel unwell and has swollen legs
tests show serum albumin is low
What tests now?
dipstick proteinuria
send to hospital to see nephrologist
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?
nephrotic syndrome
what is membranous glomerulonephritis?
IgG stuck in the membrane
diabetic nephropathy involves the gross excess of ……. …….. forming nodules
mesangial matrix
is creatinine in urine normal?
yes
what does creatinine measure?
renal function
50 year old female
unwell for 3 weeks
cough
serum biochemistry is creatinine of 500 (60 the year before)
what tests?
ultrasound (renal tract lesion)
check clotting
renal biopsy
rapidly rising creatinine is a sign of what?
acute renal failure
ANCA
anti- neutrophil cytoplasmic antibodies
Small artery supplies the glomerulus by an ……. arteriole
you then have an ……. arteriole coming out of the glomerulus
afferent
efferent
