Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

What?

A

Immune mediated disease of kidneys affecting glomeruli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types?

A 
Idiopathic GN 
Minimal change nephropathy 
FSGS 
Membranous nephropathy 
IgA nephropathy 
RPGN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathogenesis?

A

Humoral (antibody mediated)
Cell- mediated (T cells)
Inflammatory cells, mediators and complements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does damage to endothelial or mesangial cells lead to?

A

Proliferative lesions and red cells in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does damage to podocytes lead to?

A

Non- proliferative lesion and protein in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes atrophy?

A

Podocyte damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Microalbuminuria?

A

30- 300mg albuminuria/ day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Asymptomatic proteinuria?

A

<1g/ day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Heavy proteinuria?

A

1-3g/ day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nephrotic syndrome proteinuria?

A

> 3g proteinuria/ day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clinical presentations of glomerulonephritis?

A 
Haematuria
Proteinuria
Urine microscopy - RBC 
Red cell casts
Impaired renal function
Hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nephrotic syndrome?

A

Heavy proteinuria
Hypoalbuminaemia
Fluid retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Nephritic syndrome?

A 
Haematuria
Proteinuria
Fall in GFR
Salt and water retention
Hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Rapidly progressive glomeurlonephritis?

A

Rapid loss of renal function

ESRD within weeks/ months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chronic glomerulonephritis?

A

Much slower deterioration in renal function

Haematuria, proteinuria, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Investigations?

A 
Urine dipstick and microscopy
Urine protein quantification
GFR
FBC, ESR, CRP
Biochemistry
Glucose
Serum immunoglobulins, serum and urine protein electrophoresis 
Serum complement 
Autoantibodies 
HBsAg
Radiology 
RENAL BIOPSY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Urine dipstick and microscopy?

A

Haematuria and/ or proteinuria

Red cell casts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Urine protein quantification?

A

24 hour urine sample or protein: creatinine ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Biochemistry?

A 
Renal function
Electrolytes
Liver function
Low serum albumin in nephrotic syndrome
High potassium, low bicarbonate and high phosphate in renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Autoantibodies?

A

ANA
Anti- dsDNA
ANCA
Antiglomerular basement membrane antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Nephritic syndrome (2)?

A 
Acute renal failure
Oliguria
Oedema/ fluid retention
Hypertension
Haematuria
Proteinuria <3g/ 24 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Nephrotic syndrome?

A 
Proteinuria > 3 g/day (mostly albumin, also globulins) 
Can be frothy urine 
Hypoalbuminaemia (<30) 
Oedema
Serum albumin <25g/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Renal function in nephrotic syndrome?

A

Usually normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Most common cause of nephrotic syndrome in children?

A

Minimal change disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What process is indicated in nephrotic syndrome and where is affected?

A

Non- proliferative process

Affects podocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Complications of nephrotic syndrome?

A 
Infections
Renal vein thrombosis
Pulmonary emboli
Volume depletion 
Vit D deficiency
Subclinical hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Histological classifications in GN?

A

Proliferative/ non- proliferative
Focal/ diffuse
Global/ segmental
Crescentic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Treatment of nephrotic patients?

A 
Fluid restriction 
Salt restriction
Diuretics
ACEI/ ARB
Anticoagulation
IV albumin (if volume deplete)
Immunosuppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the aim of treatment in nephrotic patients?

A 
Induce sustained remission
Complete remission (proteinuria <300mg/ day)
Partial remission (proteinuria <3g/ day)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Main types of idiopathic GN ?

A 
Minimal change
FSGS
Membranous
Membranoproliferative
IgA nephropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the commonest cause of nephrotic syndrome in children?

A

Minimal change nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Who gets minimal change nephropathy?

A

Children 2- 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Renal biopsy on light microscopy and immunofluorescence in minimal change nephropathy?

A

Normal

Negative IF

34
Q

Electron microscopy in minimal change nephropathy?

A

Widespread fusion of epithelial cell foot processes on outside of glomerular basement membrane

35
Q

Clinical features of minimal change nephropathy?

A 
Nephrotic syndrome with selective proteinuria
normal renal function
Normal BP
Normal complement
Inc risk of infections
36
Q

What is minimal change nephropathy associated with?

A

Atopy in children - HLA- DR7 positive

37
Q

Treatment for minimal change nephropathy?

A

Oral steroids (prednisolone)

38
Q

Second line drugs in minimal change nephropathy?

A

Cyclophosphamide/ CSA or ciclosporin

39
Q

Does minimal change nephropathy cause progressive renal failure

A

No my breh

40
Q

FSGS?

A

Focal segmental glomerulosclerosis

41
Q

What is the commonest cause of nephrotic syndrome in adults?

A

FSGS

42
Q

Renal biopsy in FSGS?

A

Light microscopy - minimal Ig/

Complement deposition on

43
Q

What may FSGS be associated with?

A

Haematuria
Hypertension
Impaired renal function

44
Q

Treatment of FSGS?

A

4 months high dose prednisolone

If unsuccessful -> addition of cyclophosphamide or ciclosporin

45
Q

How many with FSGS progress to ESRF?

A

50%

46
Q

Collapsing glomerulopathy?

A

Associated with HIV

47
Q

2nd commonest cause of nephrotic syndrome in adults?

A

Membranous nephropathy

48
Q

what occurs in membranous nephropathy?

A

Widespread thickening of glomerular basement membrane

49
Q

Who is more at risk of getting membranous nephropathy?

A

Men

50
Q

What may membranous nephropathy present with?

A

Protineuria or nephritic syndrome, hypertension

51
Q

2nd degree causes of membranous nephropathy?

A

Infections (hep B/ parasites)
Connective TD (SLE)
Malignancies (carcinoma/ lymphoma)
Drugs (gold/ penicillamine)

52
Q

Renal biopsy in membranous nephropathy?

A

Subepithelial immune complex deposition in basement membrane

53
Q

What may the idiopathic form of membranous nephropathy respond to?

A

Alternate months of corticosteroids with chlorambucil or cyclophosphamide, or to ciclosporin

54
Q

Appearance of membranous nephropathy?

A

Thick membranes
Sub- epithelial immune deposits
Silver stain -> spikes

55
Q

Membranoproliferative/ mesangiocapillary glomerulonephritis (MCGN)?

A

Proliferation of mesangial cells, inc in mesangial matrix and thickening of glomerular basement membrane

56
Q

How may MCGN present?

A

Nephritic or nephrotic syndrome in young adults or children

57
Q

What is MCGN associated with?

A

Low levels of C3

58
Q

Appearance of MCGN?

A

Big lobulated hyper cellular glomeruli with thick membranes

Tram tracks

59
Q

How many with MCGN develop ESRD?

A

~50%

60
Q

Treatment of MCGN?

A

Nephrotic its with corticosteroids (no proven benefit)

61
Q

What is IgA nephropathy?

A

Asymptomatic microhaematuria +/- non- nephrotic range proteinuria
Genetically abnormal IgA

62
Q

Cause of IgA nephropathy?

A

Genetic
Acquired defect e.g. coeliac
Post infectious

63
Q

Who gets IgA nephropathy?

A

Post infection

64
Q

Is IgA nephropathy nephritic or nephrotic?

A

Nephritic

65
Q

Appearance of IgA nephropathy?

A

IgA deposition in mesangium

66
Q

Presentation of IgA nephropathy?

A

Macroscopic Haematuria after resp/ GI infection

67
Q

What is IgA nephropathy associated with?

A

Henoch-Schonlein Purpura (HSP) (arthritis/colitis/ purpuric skin rash)

68
Q

Renal biopsy in IgA nephropathy?

A

Mesangial cell proliferation and expansion on light microscopy with IgA deposits in mesangium on IF

69
Q

Kidneys in IgA nephropathy?

A

AKI/ CKD

70
Q

How many with IgA nephropathy progress to ESRF?

A

~25%

71
Q

Treatment for IgA nephropathy?

A

BP control/ ACEI or ARB/ fish oil

72
Q

Rapidly progressive glomerulonephritis? (RPGN)

A

Treatable cause of renal failure
Rapid deterioration in renal function over days/ weeks
Active urinary sediment (RBC, RBC and granular casts)

73
Q

What may RPGN be part of?

A

Systemic disease

74
Q

What is RPGN associated with?

A

Glomerular crescents on biopsy

75
Q

Treatment for RPGN?

A

Prompt immunosuppression
Steroids (IV methylprednisolone/ oral prednisolone)
Cytotoxics (cyclophosphamide/ mycophenalate/ azathioprine)
Plasmapharesis

76
Q

Good pastures syndrome?

A

Due to antibodies directed against alpha 3 chain of type IV collagen

77
Q

What is type IV collagen a structural component of?

A

Glomerular basement membrane

78
Q

What do 50% patients with good pastures have?

A

Pulmonary haemorrhage

79
Q

Presentation of good pastures?

A

Rapidly progressive glomerulonephritis

Usually leading to renal failure if untreated

80
Q

Treatment of Goodpastures?

A

Prednisolone
Cyclophoshphamide
Plasma exchange

81
Q

Salt losing nephropathy?

A

Renal loss of sodium
Leads to hyponatraemia and ECV loss
Sometimes after UTI

82
Q

Acute tubulointerstitial nephritis?

A

Patient started on new drug
Symptoms of fever, rash, urine abnormalities
Prednisolone

Renal (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions