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Urinary system > Glomerular pathology > Flashcards

Glomerular pathology Flashcards

1
Q

What is meant by nephrotic syndrome?

A

Collection of symptoms due to glomerular damage

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2
Q

What part of the glomerulus is damaged in nephrotic syndrome?

A

Podocytes

Glomerular basement membrane

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3
Q

What are the symptoms of nephrotic syndrome?

A

Proteinuria

Low blood albumin levels

Oedema

High blood lipids

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4
Q

What are the groups of causes of nephrotic syndrome?

A

Primary causes

Secondary causes

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5
Q

What is meant by primary causes of nephrotic syndrome?

A

Damage is limited to the kidney glomerulus

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6
Q

What is meant by secondary causes of nephrotic syndrome?

A

Damage to multiple parts of body

including kidney glomerulus

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7
Q

What are some examples of primary causes of nephrotic syndrome?

A

Minimal change glomerulonephritis

Focal segmental glomerusclerosis

Membranous glomerulonephritis

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8
Q

What are some examples of secondary causes of nephrotic syndrome?

A

Diabetes mellitus

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9
Q

What is meant by minimal change glomerulonephritis?

A

Inflammation of the glomerulus

but changes to glomerulus cannot be seen on light microscope

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10
Q

What are the effects on the glomerulus of minimal change glomerulonephritis?

A

Loss of podocyte foot process, filtration slits

Loss of negative charges in glomerular basement membrane

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11
Q

How does minimal change glomerulonephritis give nephrotic syndrome?

A

Larger gaps in glomerular capillary membrane, loss of negative charges that repel
proteins are filtered out of glomerulus into Bowman’s capsule
this is mainly albumin
reduced oncotic pressure of blood
loss of albumin for lipids to bind to in the blood

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12
Q

Does minimal change glomerulonephritis usually give kidney failure? Why?

A

No

because glomerulus can still filter blood, normal GFR

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13
Q

How is minimal change glomerulonephritis treated?

A

Steroids to reduce inflammation of glomerulus

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14
Q

What age group is minimal change glomerulonephritis most common in?

A

Children

Adolescents

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15
Q

How does minimal change glomerulonephritis relate to focal segmental glomerulosclerosis?

A

Minimal change glomerulonephritis eventually develops into focal segmental glomerulosclerosis

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16
Q

What is meant by focal segmental glomerulosclerosis?

A

Focal meaning some glomeruli are affected
segmental meaning parts of glomeruli are affected
glomerulosclerosis meaning fibrous scarring of glomerulus

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17
Q

What are the effects on the glomerulus of focal segmental glomerulosclerosis?

A

Glomerulus is damaged beyond regeneration
fibrous scarring of glomerulus
blocks glomerulus

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18
Q

Does focal segmental glomerulosclerosis usually give kidney failure? Why?

A

Yes
because it blocks part of the glomerulus
reduced filtration of blood at glomerulus, reduced GFR

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19
Q

How does focal segmental glomerulosclerosis respond to steroids?

A

Less of a response to steroids

because fibrous scarring is irreversible unlike inflammation

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20
Q

What age group is focal segmental glomerulosclerosis most common in?

A

Adults

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21
Q

Which primary cause is the most common cause of nephrotic syndrome in adults?

A

Membranous glomerulonephritis

22
Q

What is meant by membranous glomeronephritis?

A

Inflammation of the glomerular basement membrane

23
Q

What are the causes of membranous glomerulonephritis?

A

Autoimmune conditions

Infection

24
Q

What is the effect on the glomerulus of membranous glomerulonephritis?

A

Immune complexes deposit in glomerular basement membrane
it becomes inflamed
thickening of glomerular basement membrane
but with holes in it

25
Q

What particular antibody is part of the immune complexes in membranous glomerulonephritis?

A

IgG

26
Q

How do the immune complexes reach the glomerular basement membrane?

A

Antigen is on podocyte
or antigen is filtered out of the glomerulus into Bowman’s capsule, binds to podocyte

IgG is filtered from glomerulus into Bowman’s capsule
binds to antigen

27
Q

What is the prognosis of membranous glomerulonephritis?

A

Third of patients recover

Third of patients stay the same

Third of patients develop acute kidney injury

28
Q

What is nephritic syndrome?

A

Collection of symptoms due to glomerular inflammation

29
Q

What are the signs and symptoms of nephritic syndrome?

A

Haematuria

Decreased GFR

Maybe proteinuria…

30
Q

What are the some of the causes of nephritic syndrome?

A

IgA nepropathy

Goodpasture syndrome

Vasculitis

Hereditary nephropathies

31
Q

What is the most common type of glomerulonephritis?

A

IgA nephropathy

32
Q

What is the effect of IgA nephropathy on the glomerulus?

A

IgA deposits in the mesangium
gives mesangial hyperplasia and increased matrix
damage to glomerular capillaries
leak blood

33
Q

How does IgA reach the mesangium?

A

In glomerular capillaries

diffuses out to adjacent mesangium

34
Q

What is a non-renal symptom of IgA nephropathy? Why?

A

Mucosal infections
IgA deposition in mesangium reduces IgA in mucosa
less protection against bacterial invasions

35
Q

What is meant by hereditary nephropathy?

A

Diseases of the nephrons that are inherited from parents to children

36
Q

What are some examples of hereditary nephropathies?

A

Alport syndrome

Thin GBM disease/benign familial haematuria

37
Q

What is meant by thin GBM disease/benign familial haematuria?

A

Abnormal thinning of glomerular basement membrane
gives haematuria
but have normal kidney function

38
Q

What is the inheritance pattern of Alport syndrome?

A

X-linked recessive

39
Q

What gene is affected by Alport syndrome?

A

Gene for type 4 collagen

40
Q

What protein is affected by Alport syndrome?

A

Type 4 collagen

41
Q

What is the effect on the nephron of Alport syndrome?

A

Abnormal glomerular basement membrane

gives glomerulonephritis, haematuria

42
Q

What are the non-renal signs and symptoms of Alport syndrome?

A

Hearing loss

Eye problems

43
Q

What is the cause of Goodpasture syndrome?

A

Autoantibodies against type 4 collagen on glomerular basement membrane of nephron
gives glomerulonephritis

44
Q

What autoantibody is involved in Goodpasture syndrome?

A

IgG

45
Q

What are the signs and symtpoms of Goodpasture syndrome?

A

Acute but severe nephritic syndrome

Pulmonary haemorrhage due to type 4 collagen also being present in alveoli

46
Q

How is Goodpasture syndrome treated?

A

Immunosuppression

Plasmaphoresis

47
Q

What is plasmaphoresis?

A

Process of removing the plasma which contains autoantibodies

replaced with IV fluid

48
Q

What is meant by vasculitis?

A

Inflammation of blood vessels

48
Q

What is the cause of vasculitis?

A

Anti neutrophil cytoplasmic antibody
activates neutrophils
which are active against blood vessels

50
Q

What does a glomerulus affected by vasculitis look like under the microscope?

A

Segmental necrosis

inflammatory cells surrounding it

Urinary system (25 decks)

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