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6- Renal Medicine > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

Definition of glomerulonephritis

A

Normally means inflammation of glomeruli
Generally caused by immunologic rxn

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2
Q

Major clinical manifestation of glomerular injury

A

Proteinuria
Hematuria
Decreased GFR
Sodium retention

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3
Q

2 main syndromes by which glomerulonephritis present

A

Nephrotic syndrome
Nephritic syndrome

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4
Q

What is nephrotic syndrome

A

Protein wasting secondary to diffuse glomerular damage with proteinuria >3.5g/day , Hypoalbuminemia and edema

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5
Q

What is nephritic syndrome

A

Set of clinical manifestation with hematuria and at least one the folllowing - oliguria, hypertension, high BUN, decreased GFR

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6
Q

Main causes of primary glomerulonephritis ( immune response to something )

A

Acute glomerulonephritis
Postinfectious glomerunephritis
Post streptococcus glomerulonephritis
Infectious glomerulonephritis
Membranoproliferative glomerulonephritis
Rapidly progressive glomerulonephritis
Idiopathic membranous glomerulonephritis
Immune globulin A IgA nephropathy
Chronic glomerulonephritis
Focal glomerular sclerosis

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7
Q

Types of glomerulonephritis

A

Primary - occur on its own
Secondary - occurs afeter disease like lupus, diabetes, etc

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8
Q

Main cause of secondary glomerulonephritis

A

Good pasture syndrome
Hemolytic uremic syndrome
Polyarteritis
Progressive systemic sclerosis
SLE
Wegeners granulomatosis
Thrombocytopenic purpura
Postpartum renal failures

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9
Q

Main area of glomerulus affected when presents with nephrotic syndrome

A

Podocyte

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10
Q

Type of histological classification leading to glomerulonephritis with nephrotic syndrome

A

Minimal change
Focal segmental glomerulosclerosis
Membranous nephropathy

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11
Q

Main cause of nephrotic syndrome

A

Minimal change disease
Dominant cause of idiopathic nephrotic syndrome in childhood

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12
Q

Pathogenesis of minimal change nephropathy

A

Unknown but might be due to factors causing podocyte injury

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13
Q

Risk factors minimal change

A

Atopy
Drugs NSAIDs
Hematological
Malignancies

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14
Q

Histological presentation of minimal change

A

Fusion of podocytes in electron microscopy

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15
Q

Presentation minimal change

A

Severe nephrotic syndrome

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16
Q

Management minimal change

A

High dose glucocorticoid

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17
Q

Population more at risk of focal segmental glomerulosclerosis

A

West African because carry more apolipoprotein L1 gene variant

18
Q

Histology focal segmental glomerulosclerosis

A

Segmental scar in some glomeruli so need a lot of sample to see it and not mix it with minimal change
Podocytes foot fusion when primary focal segmental glomerulosclerosis

19
Q

Is there immune deposit in focal segmental glomerulosclerosis

A

Yes in the focal scars , and are non specific

20
Q

Causes of secondary focal segmental glomerulosclerosis

A

Healing of previous local injury
HIV infection
Heroin misuse
Morbid obesity
Chronic hypertension

21
Q

Presentation of focal segmental glomerulosclerosis

A

Primary FSGS presents as idiopathic nephrotic syndrome but less responsive to treatment than minimal change, may progress to renal impairment, can recur after transplantation

Secondary FSGS presents with variable proteinuria and outcome

22
Q

Most common cause of nephrotic syndrome in Caucasian adult

A

Membranous nephropathy

23
Q

Pathogenesis Membranous nephropathy

A

Antibodies mostly autoantibodies directed at antigens expressed on podocyte surface including M type phospholipase A2 receptor 1

24
Q

Prognosis of Membranous nephropathy

A

1/3 recover spontaneously
1/3 remainin nephrotic state
1/3 progressive CKD

25
Q

Dx due to glomerulonephritis leading to mild nephritic syndrome

A

IgA nephropathy
Mesangiocapillary glomerulonephritis

26
Q

Main presentation of patient with mild nephritic syndrome

A

Non visible hematuria
Modest proteinuria
Slow progressive course of renal dx

27
Q

Main way of detection of IgA nephropathy

A

During routine exam

28
Q

Type of immune deposits in IgA nephropathy

A

Mesangial IgA and C3

29
Q

Variant of IgA nephropathy common in children

A

Henoch-schonlein purpura

30
Q

What is Henoch-schonlein purpura

A

systemic vasculitis due to infectious trigger

31
Q

Henoch-schonlein purpura tetras symptom

A

Petechiae task on buttock and lower leg
Abdominal pain
Arthralgia
Renal dx with visible or non visible haematuria with or without proteinuria

32
Q

Prognosis of Henoch-schonlein purpura

A

Good with spontaneous resolution

33
Q

Second name of mesangiocapillary glomerulonephritis

A

membranoproliferative glomerulonephritis

34
Q

Renal biopsy findings in membranoproliferative glomerulonephritis

A

Increased mesangial cells
Thickening of glomerular capillary walls

35
Q

Typical presentation of membranoproliferative glomerulonephritis

A

Proteinuria
Haematuria

36
Q

Two main type of membranoproliferative glomerulonephritis

A

Immunoglobulin deposition from deposition of circulating immune complexes or planted antigens

Complement component deposited

37
Q

Associated risk factor to immunoglobulin type of membranoproliferative glomerulonephritis

A

Infection
Autoimmunity
Monoclonal gammopathies

38
Q

Associated risk factors in complement type of membranoproliferative glomerulonephritis

A

Complement gene mutation
C3 nephritic factor
Partial lipodystrophy

39
Q

Diseases leading to rapidly progressive glomerulonephritis

A

Focal necrotising glomerulonephritis
Diffuse proliferative glomerulonephritis
Anti glomerular basement membrane dx

40
Q

Characteristics of rapidly progressive glomerulonephritis

A

Rapid loss o renal function over days to weeks
Hypertension
Oedema
Non visible haematuria
Proteinuria

6- Renal Medicine (8 decks)

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