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nephrology and urology > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

nephrotic syndrome criteria

A

peripheral oedema
massive proteinuria > 3g/24hrs
serum albumin < 25g/L hypoalbuminaemia
Hypercholesterolaemia

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2
Q

nephritic syndrome criteria

A

haematuria. cola coloured urine
oliguria
proteinuria <3g/24hr
normal albumin or slightly raised
fluid retention
hypertension
abrupt onset

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3
Q

frothy urine is a sign of what

A

proteinuria, nephrotic syndrome

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4
Q

frothy urine is a sign of what

A

proteinuria, nephrotic syndrome

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5
Q

minimal change disease signs

A

common in children
sudden oedema
proteinuria

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6
Q

tests for minimal change disease

A

creatinine
eGFR
cholesterol
albumin
haemoglobin

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7
Q

treatment minimal change

A

prednisolone high dose
slow taper over 6 months
2/3 relapse, steroids
diuretics and thromboprophylaxis if necessary

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8
Q

focal and segmental glomerulonephritis

A

syndrome with multiple causes
steroid resistant
nephrotic
tests- urine PCR, albumin, creatinine, GFR
treat with steroid trial (resistant)
cyclosporin, cyclophosphamide, ritixumab
diuretics, renal transplant or plasma exchange

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9
Q

commonest cause of nephrotic syndrome in adults and commonest type of glomerulonephritis overall

A

membranous nephropathy

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10
Q

cause of membranous nephropathy

A

secondary : malignancy, SLE, rheumatoid arthritis, NSAIDs, penicillamine

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11
Q

membranous nephropathy signs

A

histology shows IgG and complement deposits on the basement membrane
PLA2R positive in 70% of cases
THSD7A in around 2%

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12
Q

membranous nephropathy treatment

A

immunesuppression if symptomatic, rising proteinuria or decrease renal function
cyclophosphamide and steroids (alternate months)
ritixumab
or just cyclophosphamide if severe

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13
Q

Crescenteric glomerulonephritis types

A

ANCA associated- microscopic polyangiitis, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis
Anti GBM- anti GBM nephritis or goodpastures sydnrome
IgA vasculitis
post infection glomerulonephritis
SLE

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14
Q

what is anti GBM disease/ good pastures syndrome

A

anti GBM antibodies attack glomerulus and pulmonary basement membranes. cause glomerulonephritis and pulmonary haemorrhage. shows anti GBM antibodies in serum and biopsy, 10-20% of crescenteric glomerulonephritis. can lead to rapidly progressive glomerulonephritis

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15
Q

treating good pastures syndrome

A

aggressive immunesupression
steroids
plasma exchange
cyclophosphamide

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16
Q

presentation good pasture syndrome

A

nephritis or nephritis and lung haemorrhage, haemoptysis

17
Q

IgA nephropathy (bergers disease)

A

most common cause of primary glomerulonephritis Histology shows “IgA deposits and glomerular mesangial proliferation”.

18
Q

signs for IgA nephropathy

A

microscopic haematuria
proetinuria
nephrotic syndrome
hypertension

19
Q

managament for IgA nephropathy

A

usually self limiting
ACE i
kidney disease progresses then transplant

20
Q

post infectious glomerulonephritis signs

A

10-12 days post streptococcal infection
so throat or skin infection signs
haematuria
high BP
low complement
creatinine

21
Q

post strep glomerulonephritis treatment

A

antibiotics if necessary
loop diuretics- furosemide for oedema
anti hypertensives

22
Q

granulomatosis with polyangiitis (wegener’s)

A

form of vasculitis which affects kidneys, nose and lungs
shows ANCA antineutrophil cytoplasmic antibodies
fatal if left untreated

23
Q

what causes nephritic state

A

attack on endothelium causes a spillage of RBCs so haematuria

24
Q

what causes nephrotic state

A

ill and shrunk podocytes cause spillage of protein so proteinuria

25
Q

usual treatment of glomerulonephritis in general is

A

immunosuppression eg steroids and blood pressure control by RAAS eg ACEi

26
Q

causes of nephritic syndrome

A

SHARP AIM
SLE
henoch schonlein purpura
anti GBM
rapidly progressive GN
post strep GN
alports syndrome
IgA nephropathy
membranoproliferative GN

27
Q

what requires a renal biopsy

A

proteinuria of more than 1g in 24 hrs
combo of proteinuria and haematuria
nephrotic syndrome in adults

28
Q

when should you avoid a renal biopsy

A

PKD due to fear of infection or haemorrhage
uncontrolled hypertension

29
Q

what is the most common viral cause of FSGS

A

HIV

also bergers, sickle cell

30
Q

what is the most common viral cause of membranous GN

A

Hep B

nephrology and urology (17 decks)

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