Glomerulonephritis Flashcards
Define glomerulonephritis.
Inflammation of the glomeruli causing injury, leading to either nephritic (protein <3.5g/day) or nephrotic (>3.5g/day)
How is Nephritic Syndrome characterized compared to nephrotic syndrome?
What is the difference between segmental and global glomerular involvement?
Segmental: Part of the glomerulus is affected.
Global: The entire glomerulus is affected.
What is the difference between crescentic and proliferative glomerulonephritis?
Crescentic: Increased cells in Bowman’s capsule.
Proliferative: Increased cells in the glomerulus.
What is the difference between focal and diffuse glomerulonephritis?
What are the common cause of glomerular injury?
It is most commonly immune-mediated but can also result from infections or non-inflammatory causes.
E.g. - Strep infections, SLE, DM, Alport’s syndrome, and IgA nephropathy (Berger’s disease).
How does glomerular injury affect filtration?
It leads to disruption of the basement membrane, disrupting filtration.
How is nephritic syndrome classified based on immunofluorescence findings? (list)
linear
immune complex (granular) - low c3/c4 or normal c3/c4
pauci immune
What does a linear immunofluorescence pattern in nephritic syndrome indicate?
Continuous staining along the basement membrane, typically seen in Anti-GBM disease (Goodpasture’s syndrome)
What are examples of nephritic diseases with low C3/C4 levels?
Slowly Progressive: Membranoproliferative glomerulonephritis (mesangiocapillary) and Cryoglobulinemic glomerulonephritis.
Rapidly Progressive: SLE nephritis and Post-streptococcal glomerulonephritis
What are examples of nephritic diseases with normal C3/C4 levels?
IgA nephropathy (Berger’s disease).
IgA vasculitis (Henoch-Schönlein purpura)
What does Pauci-immune nephritic syndrome indicate?
Minimal or no immune complex staining, associated with ANCA-positive diseases
What are examples of ANCA-associated conditions in Pauci-immune nephritic syndrome?
What are the nephritic symptoms in GN?
Hematuria: Coca-cola colored urine.
Oliguria: Reduced urine output.
Blurred Vision: From hypertension.
Fever: Often from infectious causes
What are the nephrotic symptoms in GN?
Frothy urine (proteinuria).
Edema (facial, periorbital, lower limbs).
Weight gain due to fluid retention.
Orthopnea/PND (hydrothorax).
Uremic symptoms like pruritis (uremic frost on skin), and brain encephalopathy (confusion, seizures, asterixis)
REDUCED URINE OUTPUT
What are the uremic symptoms in GN?
can be due to other waste products (not only urea)
What are 2 common underlying disease which may cause nephrotic/ nephritic syndrome or GN? What are their common clinical features.
What are all the symptoms of GN?
What are the nephritic signs in GN?
HTN
What are the nephrotic signs in GN?
What signs of underlying disease would you be looking for in a patient with GN?
What type of GN has a mixed nephrotic - nephritic picture or can present as either or?
What are all the signs of GN?
List some ddx for GN
What would you find on urinalysis of GN?
How would you investigate for GN?
What is the role of dendritic cells and macrophages in the immune system?
Dendritic cells and macrophages detect antigens, acting as antigen-presenting cells (APCs)
What do antigen-presenting cells (APCs) do after detecting an antigen?
They present the antigen to CD4+ T cells
How do T cells contribute to antibody production?
T cells activate B cells, prompting them to differentiate into plasma cells
What are the key functions of antibodies?
What is the function of plasma cells in the immune system?
What is the main feature of rapidly progressive glomerulonephritis (RPGN)
RPGN is characterized by the proliferation of parietal epithelial cells and macrophages in Bowman’s capsule.
What is the effect of Anti-GBM in GN?
Anti-GBM antibodies target Type IV collagen in the glomerular basement membrane, producing a continuous linear pattern on biopsy
How is Anti-GBM disease treated?
What clinical features are a/w Churg-Strauss Syndrome?
Which ANCA subtype is associated with Granulomatosis with Polyangiitis?
What ANCA type is associated with Microscopic Polyangiitis?
WHat are the antibodies involved in SLE nephritis? What are the other symptoms of SLE?
How is Post-Streptococcal Glomerulonephritis (GN) diagnosed?
Describe the structure of the large glomeruli.
What is the mesangial cells of the glomerulus and what is its function
What does biopsy of membranoproliferative GN or mesangiocapillary GN show?
What are the RFs for nephrotic membranoproliferative GN.
What is the treatment of mesangiocapillary or membranoproliferative GN?
What are the types of cryoglobulinemia? How is it diagnosed?
Why is C3/C4 normal in IgA nephropathy?
How does IgA nephropathy typically present?
What does biopsy of IgA nephropathy show? How is it treated?
What are common clinical features of IgA vasculitis? How is it treated?
What is the pharmacological treatment of slowly progressive GN?
What is the pharmacological treatment of rapidly progressive GN?
What are the indications for a kidney biopsy in a non-transplanted patient?
What are the indications for a kidney biopsy in a transplanted patient?
What are the contraindications for a kidney biopsy?
What are the complications for a kidney biopsy?
