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302- metabolic and renal > glomerularmephritis > Flashcards

glomerularmephritis Flashcards

1
Q

what are clinical consequences of glomerular nephritis?

A

depending on where the inflammation is… - protein in urine - blood in urine - abc in urine - casts failure of the filtration membrane-> leads to AKI which may lead to further scarring and CKD

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2
Q

presentation of nephrotic syndrome

A

Preserved renal function Proteinuria > 3g/day, Spot UPCR or ACR >300mg/mmol or > 180mg/mmol decreased serum albumin – normal 40 Decreased total protein normal 65

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3
Q

presentation of nephritic syndrome

A

Impaired renal function (rapid or chronic) Proteinuria, haematuria, leucosuria

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4
Q

what are general presentations of GN?

A

Presentation Symptoms Systemic, flu like symptoms Rash Arthralgia Swelling

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5
Q

what examinations would you do for suspected GN?

A

Examination Skin CVS, Oedema Chest abdomen Urine Analysis

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6
Q

Draw a table to cmpare the urine dip nephrotic vs nephritic syndrome

A
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7
Q

which blood tests would you preform when suspecting GN?

A

serum albumin

protein

renal function

autoimmune screen

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8
Q

what checks are done for a renal biopsy?

A
  • ligh microscopy

immuno-histology

electron microscopy

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9
Q

what are the nephrotic diseases

A
  • minimal change disease
  • mebranous nephropathy
  • focal segmental sclerosis
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10
Q

what are associations of minimal change disease?

A

–NSAIDS

–Lithium/Gold

–Allergy

–Hodgkins

NORMALLY HAPENS IN CHILDREN

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11
Q

what are treatments for minimal change disease?

A

–steroids, Calcineurin Inhibitors (tacrolimus)

•50% relapse

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12
Q

what is the typical presentation of minimal change disease?

A

–Frothy urine, oedema

–Low albumin

–Preserved function

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13
Q

what changes do you see when you take a minimal change disease biopsy?

A

LM- normal

Immune assay- normal

electron microscopy- effacemnt of podocyte foot processes

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14
Q

what are autoimmune causes of membranous nephropathy?

A

•Lupus,

sjorgrens,

Rh Arthritis,

ank spond,

post transplant

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15
Q

what are infections that can cause membranous nephropathy?

A

•Hep B, Hep C

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16
Q

what are drugs that cause membranous nephropaty?

A

•Mercury,

Captopril,

Gold,

penicillamine

17
Q

which nephrotic disease is associatedd with paraneoplasms?

A

membranous nephropathy

18
Q

what are the biospy changes seen in membranous nehrotic syndrome?

A

LM- capilliary and glomerular basement membrane thickening due to immune complex deposition

also can see irregulr expansions from glomerular basement when stained with glomerular methenamine

immunofluresence- granular complexes made of igG and C3

EM- flattening of podocytes and spike dome pattern

19
Q

what is the treatment for membranous?

A

–Underlying cause

–Steroids, CNIs, BP

20
Q

which type of nephritic disease results in deposition of IGA in the glomeruli?

A

mesangial proliferative GN

Ig A deposition can be a result of the following;

–Malaria

–Typhoid

–IgA nephropathy

21
Q

what can mesangial proliferative GN present as?

A

•Presentation variable

–Haematuria

–AKI, CKD, hypertensive crisis

22
Q

what is the disease is associated with IgA nephropathy?

A

IGA normally forms in resp and GI infections so the nephropathy is accompanied by resp or GI infection

23
Q
A
24
Q

what are the causes of diffuse proliferative glomerulonephritis?

A

endocarditis

post strep GN

25
Q

what is th pathophysiology of diffuse proliferative glomerular nephritis

A

IGg

IgM

C3

depositon along glomerular basement membrane and mesangium

26
Q

what are the causes of FSGS?

A

•Causes

–Primary

•idopathic

–Secondary

  • Familial – reoccurs after transplantation
  • Virus – HIV
  • Drugs – Heroin, pamidronate
  • Obesity, hypertension, atheroemboli, sickle cell anaemia
27
Q

what is the treatemnt of fsgs?

A

•Treatment

–Primary and familial

•Immunosuppression and BP

–Secondary underlying cause

28
Q

what are treatment options for proliferative crescentic GN?

A
  • Strict BP control
  • ACE inhibitors for proteinuria >1g/day
  • Immunosuppression

–steroids

–cyclophosphamide

–Azathioprine

–mycophenolate mofetil,

–Rituximab

29
Q

what are causes/ associatons of crecentric GN?

A

•ANCA–associated is related to small vessel vasculitis

–granulomatosis with polyangiitis (GPA), Wegener granulomatosis

–microscopic polyangitis (MPA) Churg Strauss

  • GBM Disease ( Goodpasteurs)
  • Aggressive IgA nephropathy
30
Q

what is another word for rapidly progressive glomerulonephritis?

A

proliferative crescentic GN

302- metabolic and renal (8 decks)

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