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renal > glomerulonephritis > Flashcards

glomerulonephritis Flashcards

1
Q

glomerulus

A

capillary network in the renal corpuscle that filters blood across capillary walls to Bowman’s capsule

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2
Q

nephritic syndrome

A 
active glomerular inflammation with the presence of:
RBCs and RBC casts
protein in urine <3.5 
HTN 
decline in kidney function
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3
Q

nephritic syndrome urinalysis findings

A

hematuria
acanthocytes
RBC casts
Proteinuria <3.5g/day

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4
Q

what are acanthocytes? why do they form?

A

dysmorphic RBC that looks like Mickey Mouse

form because of osmotic stress in the tubules

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5
Q

what does the presence of dysmorphic RBCs in urine mean?

A

indicate glomerular bleeding due to damage of the basement membrane

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6
Q

nephritic syndrome general pathophys

A

inflammatory response in glomeruli leads to basement membrane damage
=leakage of proteins and RBCs through porous membrane and decreased GFR

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7
Q

ANCA

A

anti-neutrophil cytoplasmic antibodies

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8
Q

what would make ANCA positive on blood work?

A

glomerulonephritis due to vasculitis

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9
Q

C-ANCA

A

autoantibody against proteinase 3

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10
Q

P-ANCA

A

autoantibody again myeloperoxidase

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11
Q

what is RPGN

A

rapidly progressive glomerulonephritis

  • rapidly declining kidney function due to rapid destruction of glomeruli
  • will rapidly progress to end stage renal disease
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12
Q

glomerular disease can either present as ____ or ____

A

nephritic or nephrotic syndrome

“itis” of the glomerulus

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13
Q

podocytes

A

cells that form the epithelial layer of Bowmans capsule, they have foot processes to help with filtration

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14
Q

most important initial test to diagnose glomerular disease

A

urinalysis

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15
Q

in the glomerulus blood enters via the ____ and exits via the ______

A

afferent arteriole

efferent arteriole

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16
Q

disease that shows crescent formation on biopsy

A

RPGN

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17
Q

what causes crescent formation

A

fibrin and plasma protein depositions cause Bowmans capsule to collapse and look like a crescent

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18
Q

gold standard to definitively diagnose glomerular disease

A

kidney biopsy

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19
Q

most common cause of acute glomerulonephritis

A

IgA nephropathy (Berger disease)

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20
Q

IgA nephropathy (Berger disease) commonly affects who

A

young males

21
Q

IgA nephropathy (Berger disease) is triggered by

A

URI or GI infection (mucosal infections)

22
Q

IgA nephropathy (Berger disease) pathophys

A

increased number of defective IgA antibodies are made and form immune complexes that are deposited in the glomerulus and lead to inflammation

23
Q

post infectious GN is most common after___

A

10-14 days post group A Streptococcus infection

skin or pharyngeal strep

24
Q

IgA nephropathy diagnosis

A

kidney biopsy showing IgA mesangial deposits on immunostaining

25
Q

poststreptococcal diagnosis

A

kidney biopsy showing granular sub epithelial immune complex depositions of IgG, IgM, C3 along the GBM

“starry sky” appearance

26
Q

Membranoproliferative GN (MPGN) usually occurs due to

A

SLE, HCV, HBV forming immune complexes that damage glomeruli

27
Q

type 1 Membranoproliferative GN (MPGN) what is it and what does it show on kidney biopsy?

A

immunoglobulin mediated MPGN

sub endothelial IgG immune complexes on GBM

28
Q

Type II Membranoproliferative GN (MPGN) what is it and what does it show on kidney biopsy?

A

Complement-mediated MPGN

intra-membranous C3 deposits on GBM

29
Q

immune complex GN that presents as a mixed nephritic-nephrotic picture

A

MPGN, lupus nephritis too

30
Q

mutation in gene encoding type IV collagen

A

Alport Syndrome

31
Q

X-linked dominant autosomal recessive immune complex GN

A

alport syndrome

32
Q

MPGN has ____ C3 serum levels and ____ C4

A

low

normal

33
Q

3 main categories of RPGN

A

Immune Complex GN
Pauci-immune GN
Goodpasture’s (AntiGBM disease)

34
Q

lupus nephritis pathophys

A

immune complexes deposit in glomeruli and cause damage

very dangerous and can lead to death in lupus pts

35
Q

anti-GBM antibody disease (Goodpasture syndrome) pathophys

A

A type of RPGN that forms autoantibodies directly against collagen type IV in the GBM of the kidney and lung alveoli

36
Q

presents with AGN and hemoptysis

A

goodpasture syndrome

37
Q

IgA nephropathy/proteinuria treatment

A

ACE inhibitors +/- corticosteroids

38
Q

lupus nephritis treatment

A

immunosuppression with cyclophosphamide

+/- corticosteroids

39
Q

anti-GBM treatment (Goodpasture)

A

plasmapheresis

40
Q

renal biopsy findings for Goodpasture

A

IgG deposits in GBM (also in lungs)

41
Q

types of Pauci immune GN

A

Granulomatosis with polyangiitis
Microscopic Polyangiitis
Churg-Strauss

42
Q

Pauci-immune GN features

A

no immune complexes deposited

+ ANCA antibodies

43
Q

has a + P-ANCA

A

microscopic polyangiitis

P like puny, like microscopic

44
Q

has a positive C-ANCA

A

granulomatosis with polyangiitis
(Wegener’s)
(C like cheesy granuloma)

45
Q

what makes a nephritic/nephrotic picture?

A

hematuria and proteinuria >3.5 g / day

46
Q

Alport has ___ C3 and ___ C4

A

normal normal

47
Q

Anti-GBM has ___ C3 and ___ C4

A

normal

normal

48
Q

lupus nephritis has ___ C3 and ___ C4

A

low

low

49
Q

acute presentation, often have pulmonary renal syndrome

A

RPGN pts

renal (17 decks)

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