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FINALS RENAL + UROLOGY > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

what is glomerulonephritis

A

damage to the glomeruli (filtration) of the kidneys

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2
Q

triad of nephrotic syndrome

A

proteinuria (>3g/day) // hypoalbuminaemia (<30g/L) // oedema

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3
Q

how does nephrotic syndrome predispose thrombosis

A

loss of antithrombin III, protein C+S, rise in fibrinogen

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4
Q

how does nephrotic syndrome predispose preclinical hypothyroid

A

loss if thyroxine-binding globulin –> loss of total (not free) thyroxine levels

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5
Q

what conditions are considered nephrotic syndromes

A

minimal change, membranous, focal segmental, amyloid, diabetic nephropathy

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6
Q

who is minimal change disease most common in

A

kids (75% of cases)

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7
Q

causes minimal change disease

A

usually idiopathic - occasionally drugs eg NSAIDs, rifampicin, hodgkins lymphoma, mono

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8
Q

symptoms minimal change disease

A

nephrotic (proteinuria, hypoalbumin, oedema) // normotension

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9
Q

what protein is lost in minimal change disease

A

albumin + transferrin only

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10
Q

biopsy minimal change disease

A

light microsopy = normal // electron = fusion of podocytes + effacement of foot process

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11
Q

prognosis minimal change disease

A

good prognosis, most stop before adulthood //

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12
Q

mx minimal change disease

A

1 = oral steroids // 2 = cyclophosphamide

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13
Q

who usually gets FSGS

A

young adults

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14
Q

causes FSGS

A

idiopathic // IgA nephropathy // HIV // heroin // Alport’s // sickle cell

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15
Q

biopsy FSGS

A

light = sclerosis + hyalinosis (ronseal appearance) // electron = effacement of foot process

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16
Q

mx FSGS

A

steroids +/- Ciclosporin

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17
Q

effect of renal transplant on FSGS

A

high rate recurrence

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18
Q

prognosis FSGS

A

10% resolve spontaneously // 50% ESRF in 10 years

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19
Q

who gets membranous glomerulonephritis

A

most common glomerulonephritis in adults

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20
Q

causes membranous glomerulonephritis

A

idiopathic - phospholipidase A2 antibodies // Heb B, malaria, syphilis // cancer eg prostate, lung, blood // drugs eg gold, penicillamine, NSAID // SLE, thyroid, RA

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21
Q

biopsy membranous glomerulonephritis

A

electron = thickened membrane ‘spike and dome’ // immune complex in basement

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22
Q

mx membranous glomerulonephritis

A

all on ACEi or ARB // immunosuppression eg steroid + cyclophosphamide // maybe anti-coag

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23
Q

prognosis membranous glomerulonephritis

A

3rd commonest cause ESRF

24
Q

good prognostic factors membranous glomerulonephritis

A

female, young, asymptomatic proteinuria

25
complications of nephrotic syndrome(5)
thromboembolism (lost antithrombin III) eg PE or renal // hyperlipidaemia --> stroke // CKD // infection (Ig loss) // hypocalcaemia
26
symptoms nephritic syndrome
haematuria, + hypertension!!! // protein, oliguria
27
conditions nephritic syndrome
IgA, rapidly progressing, anti-GBM, ANCA vasculitis, HSP, alport's
28
most common cause glomerulonephritis worldwilde
IgA nephropathy (nephritic) aka bergers
29
symptoms IgA nephropathy
macrosopic haematuria in young people 1-2 days after URTI // males // proteinuria or renal failure rare
30
assoc conditions IgA nephropathy
alcoholic cirrhosis, coeliac, HSP
31
pathology IgA nephropathy
deposit IgA immune complex in mesangial // overlap with HSP
32
biopsy IgA nephropathy
immunofluorescence IgA + C3
33
good prognsis IgA nephropathy
frank haematuria
34
bad prognosis IgA nephropathy
male, proteinurea, hypertension, smoking, hyperlipidaemia
35
prognosis IgA nephropathy
25% --> ESRF
36
what is rapidly progressive glomerulonephritis
rapid loss of renal function + epithelial crescents
37
what can cause rapidly progressive glomerulonephritis
Goodpastures // ANCA+ eg MPA and GPA // SLE //
38
symptoms rapidly progressive glomerulonephritis
nephritic: haematuria + red cell casts, hypertension, oliguria, proteins
39
mx rapidly progressive glomerulonephritis
steroids + immunosuppression eg Cyclophosphamide, azathioprine
40
what is anti-glomerular basement membrane (anti-GBM) disease aka Goodpastures
small vessel vasculitis --> pulm haemorrhage + rapid glomerulonephritis
41
what type of hypersensitivity is ant-GBM and what immune cells are involed
type II // antibodies to collagen IV
42
RF anti-GBM
young males, 20-30 or 60-70 // HLA DR2 (SLE, narcolepsy)
43
symptoms anti-GBM
pulm haemorrhage // AKI + nephritis --> haematuria + proteinurea
44
biopsy + bloods anti-GBM
biopsy = IgG in basement membrane // bloods = raised transfer factor
45
mx anti-GBM
plasma exchange // steroids // cyclophospamide
46
RF pulm haemorrhage in anti-GBM
smoking // LRTI // pulmonary oedema // inhaled hydrocarbons // young males
47
symptoms Membranoproliferative glomerulonephritis
proteinurea, haematuria, mixed picture
48
most common type Membranoproliferative glomerulonephritis
type 1
49
causes Membranoproliferative glomerulonephritis
cryoglobulinaemia, hep C
50
biopsy type 1 Membranoproliferative glomerulonephritis
electron = subendothelial + mesangial immune deposits --> tram track
51
biopsy Membranoproliferative glomerulonephritis type 2
low C3, C3b nephritic factor // intramembranous immune complexes
52
symptoms Membranoproliferative glomerulonephritis type 2
no subcut fat on their face
53
cause type 3 Membranoproliferative glomerulonephritis
hep B + C
54
mx Membranoproliferative glomerulonephritis
steroids
55
what causes Post-streptococcal glomerulonephritis
srep pyogenes --> 1-2 weeks --> immune complex deposits in glomeruli
56
symptoms Post-streptococcal glomerulonephritis
malaise // visiable haematuria // proteinuria // hypertension // oligouria
57
bloods Post-streptococcal glomerulonephritis
low C3 // raised anti-strep O

FINALS RENAL + UROLOGY (16 decks)

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