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Ch. 5 - Nephrology > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q
A
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2
Q

Define glomerulonephritis.

A

Inflammation of the glomeruli causing injury, leading to either nephritic (protein <3.5g/day) or nephrotic (>3.5g/day)

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3
Q

How is Nephritic Syndrome characterized compared to nephrotic syndrome?

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4
Q

What is the difference between segmental and global glomerular involvement?

A

Segmental: Part of the glomerulus is affected.
Global: The entire glomerulus is affected.

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5
Q

What is the difference between crescentic and proliferative glomerulonephritis?

A

Crescentic: Increased cells in Bowman’s capsule.
Proliferative: Increased cells in the glomerulus.

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6
Q

What is the difference between focal and diffuse glomerulonephritis?

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7
Q

What are the common cause of glomerular injury?

A

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).

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8
Q

How does glomerular injury affect filtration?

A

It leads to disruption of the basement membrane, disrupting filtration.

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9
Q

How is nephritic syndrome classified based on immunofluorescence findings? (list)

A

linear
immune complex (granular) - low c3/c4 or normal c3/c4
pauci immune

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10
Q

What does a linear immunofluorescence pattern in nephritic syndrome indicate?

A

Continuous staining along the basement membrane, typically seen in Anti-GBM disease (Goodpasture’s syndrome)

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11
Q

What are examples of nephritic diseases with low C3/C4 levels?

A

Slowly Progressive: Membranoproliferative glomerulonephritis (mesangiocapillary) and Cryoglobulinemic glomerulonephritis.
Rapidly Progressive: SLE nephritis and Post-streptococcal glomerulonephritis

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12
Q

What are examples of nephritic diseases with normal C3/C4 levels?

A

IgA nephropathy (Berger’s disease).
IgA vasculitis (Henoch-Schönlein purpura)

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13
Q

What does Pauci-immune nephritic syndrome indicate?

A

Minimal or no immune complex staining, associated with ANCA-positive diseases

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14
Q

What are examples of ANCA-associated conditions in Pauci-immune nephritic syndrome?

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15
Q

What are the nephritic symptoms in GN?

A

Hematuria: Coca-cola colored urine.
Oliguria: Reduced urine output.
Blurred Vision: From hypertension.
Fever: Often from infectious causes

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16
Q

What are the nephrotic symptoms in GN?

A

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

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17
Q

What are the uremic symptoms in GN?

A

can be due to other waste products (not only urea)

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18
Q

What are 2 common underlying disease which may cause nephrotic/ nephritic syndrome or GN? What are their common clinical features.

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19
Q

What are all the symptoms of GN?

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20
Q

What are the nephritic signs in GN?

A

HTN

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21
Q

What are the nephrotic signs in GN?

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22
Q

What signs of underlying disease would you be looking for in a patient with GN?

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23
Q

What type of GN has a mixed nephrotic - nephritic picture or can present as either or?

A
24
Q

What are all the signs of GN?

A
25
Q

List some ddx for GN

A
26
Q

What would you find on urinalysis of GN?

A
27
Q

How would you investigate for GN?

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28
Q

What is the role of dendritic cells and macrophages in the immune system?

A

Dendritic cells and macrophages detect antigens, acting as antigen-presenting cells (APCs)

29
Q

What do antigen-presenting cells (APCs) do after detecting an antigen?

A

They present the antigen to CD4+ T cells

30
Q

How do T cells contribute to antibody production?

A

T cells activate B cells, prompting them to differentiate into plasma cells

31
Q

What are the key functions of antibodies?

A
32
Q

What is the function of plasma cells in the immune system?

A
33
Q

What is the main feature of rapidly progressive glomerulonephritis (RPGN)

A

RPGN is characterized by the proliferation of parietal epithelial cells and macrophages in Bowman’s capsule.

34
Q

What is the effect of Anti-GBM in GN?

A

Anti-GBM antibodies target Type IV collagen in the glomerular basement membrane, producing a continuous linear pattern on biopsy

35
Q

How is Anti-GBM disease treated?

A
36
Q

What clinical features are a/w Churg-Strauss Syndrome?

A
37
Q

Which ANCA subtype is associated with Granulomatosis with Polyangiitis?

A
38
Q

What ANCA type is associated with Microscopic Polyangiitis?

A
39
Q

WHat are the antibodies involved in SLE nephritis? What are the other symptoms of SLE?

A
40
Q

How is Post-Streptococcal Glomerulonephritis (GN) diagnosed?

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41
Q

Describe the structure of the large glomeruli.

A
42
Q

What is the mesangial cells of the glomerulus and what is its function

A
43
Q

What does biopsy of membranoproliferative GN or mesangiocapillary GN show?

A
44
Q

What are the RFs for nephrotic membranoproliferative GN.

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45
Q

What is the treatment of mesangiocapillary or membranoproliferative GN?

A
46
Q

What are the types of cryoglobulinemia? How is it diagnosed?

A
47
Q

Why is C3/C4 normal in IgA nephropathy?

A
48
Q

How does IgA nephropathy typically present?

A
49
Q

What does biopsy of IgA nephropathy show? How is it treated?

A
50
Q

What are common clinical features of IgA vasculitis? How is it treated?

A
51
Q

What is the pharmacological treatment of slowly progressive GN?

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52
Q

What is the pharmacological treatment of rapidly progressive GN?

A
53
Q

What are the indications for a kidney biopsy in a non-transplanted patient?

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54
Q

What are the indications for a kidney biopsy in a transplanted patient?

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55
Q

What are the contraindications for a kidney biopsy?

A
56
Q

What are the complications for a kidney biopsy?

A

Ch. 5 - Nephrology (5 decks)

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