Glomerulonephritis Flashcards

1
Q

What is glomerulonephritis (GN)?

A

An autoimmune condition that targets the glomerulus

Mediated by antibodies

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2
Q

Why do patients, in general, present with haematuria and proteinuria?

Link to damage to the glomerules

A

Haematuria -> damage to the endothelial/mesangium cells (proliferative)

Proteinuria -> damage to the podocytes/basement membrane (non-proliferative)

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3
Q

What are the 2 important drugs used in HTN management in patients with GN?

What is the other drug used to manage?

A
  • Statin - reduce hypercholestremia (present in nephrotic syndrome)
  • ACEi - help to reduce proteinuria (can induce AKI but important for management of chronic kidney conditions)

Steroids

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4
Q

What is the buzzword on renal biopsy for rapidly progressive glomerulonephritis?

A

Crescentic glomerulonephritis

think of the moon quickly changing

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5
Q

RBC analysis on haematuria is rarely used now but why are dysmorphic RBC a sign of glomerular dysfunction as opposed to the blood being from a bleed further down the urinary system?

A

Dysmorphic RBC -> squeezed through the glomeruli

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6
Q

What does proteinuria do to the blood?

A

Causes hypoalbuminaemia (albumin is the main protein found in the blood)

Causes hypercholestermia

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7
Q

How much protein needs to be found in the blood before it is defined as nephrotic syndrome?

A

3g/day

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8
Q

In nephrotic syndrome the patient is often urinating normally so why do they get such significant oedema?

A

Significant protein loss reduces BP -> body retains H20 and Na+ to try increase BP

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9
Q

How does glomerulonephritis present?

A

Proteinuria and microscopic haematuria

~Nephritic and nephrotic syndrome
- more commonly nephrotic syndrome

HTN

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10
Q

If steroids aren’t tolerated or aren’t sufficient what other drug may be offered?

A

Monoclonal antibodies

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11
Q

What is the most common cause of NEPHROTIC SYNDROME to affect children?

If a child presents with nephrotic syndrome what should be done immediately?

A

Minimal change disease

Give steroids - assume it is minimal change

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12
Q

What is the most common cause of NEPHROTIC SYNDROME in adults?

A

Focal segmental glomerulosclerosis

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13
Q

What is IgA nephropathy also known as?

What is seen on histology?

A

Berger’s disease

  • most common cause of PRIMARY GN

IgA deposits and glomerular mesangial proliferation

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14
Q

A patient presents to clinic with haemoptysis and acute renal failure. You suspect this could be a condition assoc. with antibodies. What antibodies would you be looking for?

A

Suspect Goodpasture’s or Granulomatosis with polyangiitis

Goodpastures - anti-GBM
GPA - cANCA +ve

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15
Q

Are patients with post streptococcal glomerulonephritis most likely to present with nephrotic or nephritic syndrome?

A

Nephritic

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16
Q

The most common type of GN overall on histology shows ‘IgG and complement deposits on the basement membrane”.

What is this condition?

A

Membranous glomerulonephritis

17
Q

How may the urine appear if there is high concentrations of protein in it?

18
Q

What 3 things does nephrotic syndrome predispose a patient to?

A

HTN
High cholesterol
Thrombosis

19
Q

Vasculitis can cause glomerulonephritis. What are the two types which can cause and their associated antibodies?

A

GPA = cANCA

Microscopic polyangittis - pANCA

20
Q

How will GPA/sarcoidosis appear on renal biopsy?

A

Granulomas

21
Q

What Ig is associated with Goodpastures?

A

Linear IgG on immunofluorescence

22
Q

What presents with ‘spikes on silver stain’?

A

Membranous glomerulonephritis

23
Q

IgA neuropathy most commonly occurs in kids and young males following what?

A

URTI

GI viral infection

24
Q

What appears as tram tracks on silver staining?

A

Membranoproliferative

25
What kind of GN NEEDS electron microscopy for diagnosis?
Membranous
26
What are the two types of GN that are associated with sore throats? Which one will present at the same time as throat symptoms and which one will present after?
IgA nephropathy - present at same time as sore throat | Post-streptococcal GN - present several days/weeks after