Glomerular Diseases Flashcards
Diseases that damage glomeruli are varied and include what types of disorders?
Immunologic, metabolic, and hereditary disorders.
T/F) Systemic disorders are technically secondary glomerular diseases.
True because they initially and principally involve other organs.
Define glomerulonephritides (plural) or glomerulonephritis.
Nephrotic conditions characterized by damage to and inflammation of the glomeruli. Causes are varied and include immunologic, metabolic, and hereditary disorders.
What four distinct morphologic changes of glomeruli occur during glomerular disease?
Cellular proliferation, leukocytic infiltration, glomerular basement membrane thickening, and hyalinization with sclerosis.
Define cellular proliferation.
An increased number of endothelial cells (capillary endothelium), mesangial cells, and epithelial cells.
Define leukocytic infiltration.
Leukocytes, particularly neutrophils and macrophages, can readily infiltrate glomeruli; may also be accompanied by cellular proliferation.
Define glomerular basement membrane thickening.
Any process that results in enlargement of the basement membrane.
Glomerular basement membrane thickening is commonly from the result of what?
The deposition of precipitated proteins (e.g. immune complexes, fibrin).
Define glomeruli hyalinization.
The accumulation of a homogeneous, eosinophilic extracellular material in the glomeruli.
What is the primary mode of glomerular injury?
Immune-mediated processes; circulating Ag/Ab complexes and complexes that result from Ag/Ab reactions within the glomerulus.
Circulating immune complexes are created in response to ___ or ___ antigens.
Circulating immune complexes are created in response to endogenous or exogenous antigens.
What becomes entrapped within the glomeruli and bind complement and causing glomerular damage?
Immune complexes.
Glomerular injury does not result from the immune complexes but rather from the ___ ___ and ___ substances that they induce.
Glomerular injury does not result from the immune complexes but rather from the chemical mediators and toxic substances that they induce.
What are the clinical features that indicate glomerular damage?
Hematuria, proteinuria, oliguria, azotemia, edema, and hypertension.
What is an example of nephritic syndrome?
Acute poststreptococcal glomerulonephritis.
Glomerular disease that manifest the nephritic or nephrotic syndrome have the potential to develop what?
Chronic renal failure.
Define the group of clinical features indicative of nephrotic syndrome.
Increased permeability of the glomeruli to the passage of plasma proteins, most notably albumin; nephrotic syndrome is characterized by heavy proteinuria (3.5 g/day or more).
Why is albumin the predominant protein lost during nephrotic syndrome?
Because of Albumin’s high plasma concentration.
What would you expect to see on a patient’s physical and chemical exam with acute glomerulonephritis?
Protein: mild
Blood: positive (degree variable)
What would you expect to see on a patient’s microscopic exam with acute glomerulonephritis?
↑ RBCs, often dysmorphic
↑ WBCs
↑ RTE cells
↑Casts: RBC, granular, WBC, renal cell casts
What would you expect to see on a patient’s physical and chemical exam with chronic glomerulonephritis?
Protein: heavy
Blood: positive (usually small)
S.G.: low and fixed
What would you expect to see on a patient’s microscopic exam with chronic glomerulonephritis?
↑ RBCs
↑ WBCs
↑ Casts: all types, particularly granular, waxy, and broad.
↑ Renal epithelial cells
What would you expect to see on a patient’s physical and chemical exam with nephrotic syndrome?
Protein: severe
Blood: positive (usually small)
What would you expect to see on a patient’s microscopic exam with nephrotic syndrome?
Lipiduria: oval fat bodies, free fat bodies
↑ Casts: all types, particularly fatty, waxy, and renal cell casts
↑ Renal epithelial cells
↑ RBCs
