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2 - CPR (renal) > Glomerular Injury/Disease Pathogenesis > Flashcards

Glomerular Injury/Disease Pathogenesis Flashcards

1
Q

What defines a Primary Glomerulopathy?

A

ONLY the kidney is involved

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2
Q

List 4 responses that the glomerulus tissue can have in response to injury

A
  • Hypercellularity
  • Basement membrane thickening
  • Hyalinosis
  • Sclerosis
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3
Q

List 4 responses that the glomerulus tissue can have in response to injury

A
  • Hypercellularity
  • Basement membrane thickening
  • Hyalinosis
  • Sclerosis
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4
Q

Hypercellularity of the glomerulus tissue can result from a few different things. It can result from proliferation of what type of cells?

A

Mesangial/endothelial cell proliferation

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5
Q

Hypercellularity of the glomerulus tissue can result from a few different things. It can result from infiltration of?

A

Leukocyte infiltration

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6
Q

If Hypercellularity of the glomerulus tissue is due to mesangial/endothelial cell proliferation AND leukocyte infiltration, what is that called?

A

Endocapillary proliferation

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7
Q

Hypercellularity of the glomerulus tissue can result from a few different things. What specific structures can form and and what are they made of that may cause hypercellularity?

A

Formation of Crescents

= Epithelial cells + leukocytes

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8
Q

Crescents are made of what things?

A

Epithelial cells + leukocytes

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9
Q

What 2 glomerulus tissue responses to injury can cause/result in capillary wall injuries?

A

Hyalinosis and Sclerosis

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10
Q

Homogenous eosinophilic material

A

Hyalinosis

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11
Q

What proteins make up hyalinosis?

A

Plasma proteins

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12
Q

Extracellular collagenous matrix deposition

A

Sclerosis

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13
Q

There are many different clinical manifestations of Glomerular Diseases. List some of them (5)

A
  • Nephritic or Nephrotic syndrome
  • Rapidly Progressive Glomerulonephritis
  • CKD
  • Urinary abnormalities (hematuria/proteinuria)
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14
Q

There are many different clinical manifestations of Glomerular Diseases. List some of them (5)

A
  • Nephritic or Nephrotic Syndromes
  • Rapidly Progressive Glomerulonephritis
  • CKD
  • Urinary abnormalities (hematuria/proteinuria)
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15
Q

Glomerular Injury is usually ____ mediated

A

Immune mediated

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16
Q

What is the most common Glomerular Injury pathogenesis?

A

In situ formation of immune complexes

- Antibodies react with intrinsic or planted tissue in glomerulus

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17
Q

Glomeruluar injury caused by in situ formation of immune complexes involves?

A

Antibodies that react with intrinsic tissue antigens or planted antigens in the glomerulus

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18
Q

Diseases that are caused by In situ formation of immune complexes show what type of immunofluorescence?

A

Granular

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19
Q

Diseases that are caused by antibodies against components of the GBM show what type of immunofluorescence?

A

Diffuse Linear

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20
Q

Diseases that are caused by circulating immune complexes are trapped how in the glomeruli?

A

Antigen-Antibody complexes get trapped due to the glomeruli hemodynamics
– not because they are reacting with intrinsic tissue

21
Q

Diffuse linear immunofluorescence pattern suggests that the antibodies are against?

A

GBM

22
Q

Granular immunofluorescence suggests that the antibodies are against?

A

Intrinsic tissue antigens or planted antigens

– in situ formation of complexes

23
Q

ALL immune complex depositions in the glomeruli cause what to occur?

A

Local inflammatory reaction that produces an injury

24
Q

What main inflammatory reactants do immune complex deposition glomerular diseases activate?

A

Complement
Neutrophils
Macrophages

25
Q

What main inflammatory reactants do T-cell mediated Glomerular injuries activate?

A

Macrophages
T cells
Mesangial cells
Platelets

26
Q

What specific things can cause the injury to the glomerulus?

A

Oxidants, cytokines, chemokines
Proteases
Nitric oxide, Eicosanoids

27
Q

Immune Complex deposition that causes glomerular injury involves what type of deposits?

A

Electron dense deposits made of immune complexes

28
Q

Electron dense deposits between the endothelial cells and the GBM are considered?

A

Subendothlelial

29
Q

Electron dense deposits between the outer surface of the GBM and the podocytes are considered?

A

Subepithelial

30
Q

Electron dense deposits can also occur in the?

A

Mesangium

31
Q

Glomerular injury can also occur due to epithelial cell injury. This involves injury to?

A

Podocytes

32
Q

What occurs with podocyte injuries?

A

Effacement of foot processes, vacuolization, retraction and cell detachment

33
Q

What are 2 examples of diseases that specifically cause podocyte injury?

A

Focal Segmental Glomerulosclerosis

Diabetic Nephropathy

34
Q

With Glomerular injuries, what will it progress to once the GFR is < 30-50% of normal?

A

ESRD

35
Q

What are the 2 histologic manifestations of ESRD?

A

Glomerulosclerosis

Tubular injury/interstitial fibrosis

36
Q

What are 2 Hereditary Nephritis’s?

A

Alport Syndrome

Thin Basement Membrane Nephropathy

37
Q

What are 2 Hereditary Nephritis’s?

A

Alport Syndrome

Thin Basement Membrane Nephropathy

38
Q

Hereditary Nephritis diseases have mutations in?

A

Collagen type IV

39
Q

Alport Syndrome is inherited how?

A

X-linked

40
Q

What are the symptoms of Alport syndrome?

A
  • Hematuria that progresses to renal failure

- Nerve Deafness and Eye disorders

41
Q

Hematuria, nerve deafness and eye disorders suggests what hereditary nephritis?

A

Alport Syndrome

42
Q

How does Alport Syndrome’s GBM look?

A

Basket weave appearance

– alternating thin and thick areas

43
Q

What is a sign of Alport Syndrome?

A

Alpha 3,4,5 collagen antibodies all fail to stain

44
Q

Thin Basement Membrane Nephropathy is inherited how?

A

Autosomally

45
Q

What are the symptoms of Thin Basement Membrane Nephropathy?

A

Asymptomatic hematuria

46
Q

How does Thin Basement Membrane Nephropathy GBM look?

A

Thin

47
Q

Benign Familial Hematuria is also known as?

A

Thin Basement Membrane Nephropathy

48
Q

Asymptomatic hematuria suggests what hereditary nephritis?

A

Thin Basement Membrane Nephropathy

2 - CPR (renal) (27 decks)

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