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Renal (Zoe's cards) > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

What is glomerulonephritis?

A

An immune mediated disease affecting the glomerulus with secondary tubulointerstitial damage.

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2
Q

What is the most common process underpinning glomerulonephritis?

A

Autoimmune

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3
Q

What do you get in the urine of there is damage to endothelial or mesanglial cells?

A

Proliferative lesion and red cells in urine.

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4
Q

If there is endothelial damage then what sorts of lesions do you get in the kidney?

A

Proliferative

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5
Q

If the podocytes are damaged what sort of lesions are there?

A

Non proliferative

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6
Q

What substance appears in the urine if there is damage to podocytes?

A

Protein

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7
Q

Is microscopic haematuria more likely to be a problem in the kidney or lower urinary tract?

A

Kidney

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8
Q

Is macroscopic haematuria more likely to be a problem in the kidney or lower urinary tract?

A

Lower urinary tract

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9
Q

What condition do you get if the podocytes are damaged causing massive protein leakage but no decline in renal function?

A

Nephrotic syndrome

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10
Q

What level of protein in the urine counts as nephrotic syndrome?

A

More than 3g per day

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11
Q

On urine microscopy you see non dysmorphic red blood cells. Where is the blood coming from?

A

Lower urinary tract

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12
Q

On urine microscopy you see dysmorphic red blood cells. Where is the blood coming from?

A

Kidney. They are squashed to go through the glomerulus.

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13
Q

What causes frothy urine?

A

Protein

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14
Q

In nephritic syndrome a proliferative or non proliferative process?

A

Proliferative

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15
Q

A patient has oliguria, hypertension and her urine shows RBCs and granular casts

A

Nephritic syndrome

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16
Q

A patient presents with proteinuria, massive pitting oedema and normal renal function

A

Nephrotic syndrome

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17
Q

In nephrotic syndrome a proliferative or non proliferative condition?

A

Non proliferative

18
Q

What could cause acute kidney injury in a patient with nephrotic sydrome?

A

Renal vein thrombosis

19
Q

List some complications of nephrotic sydnrome?

A 
Infections
Renal vein thrombosis
PE
Volume depletion
Vitamin D deficiency
Subclinical hypothyroidism
20
Q

What does proliferative /non proliferative actually mean in glomerulonephritis?

A

Presence or absence of proliferation of mesangial cells.

21
Q

How would you treat glomerulonephritis? (non immunosuppressive)

A 
Anti hypertensives
ACE inhibitors/ARB
Diuretics
Statins
Anticoagulants if nephrotic syndrome
22
Q

What is the target blood pressure for a patient with glomerulonephritis?

A

130/80

23
Q

What is the first line immunosuppressive in glomerulonephritis?

A

Corticosteroids

24
Q

How do you treat patients with nephrotic syndrome?

A 
Fluid restrict
Salt restrict
Diuretics
ACE inhibitors/ARBs
Anticoagulation
25
Q

When would you give a patient with nephrotic syndrome IV albumin?

A

If the become volume depleted ie the water is in the wrong place!

26
Q

What is the most common type of renal disease seen in patients with SLE?

A

Diffuse proliferative glomerulonephritis

27
Q

Which antibody shows a ribbon like pattern on immunofluresence?

A

Anti glomerular basement antibodies

28
Q

What immunosuppressive treatments would you use for treatment of glomerulonephritis?

A 
Steroids
Azathioprine
Cyclophosphamide
Cyclosporin
Mycophenolate
IV immunoglobulin
Monoclonal antibodies
29
Q

What non drug treatment can you use in the treatment of glomerulonephritis?

A

Plasmapharesis

30
Q

List the five main types of glomerulonephritis

A 
Minimal change disease
FSGS
Membranous 
Membranoproliferative
IgA nephropathy
31
Q

What is the commonest cause of nephrotic syndrome in children?

A

Minimal change nephropathy

32
Q

A 9 year old girl presents with proteinuria. Her renal biopsy in normal.

A

Minimal change nephropathy

33
Q

What is the first line treatment for minimal change nephropathy?

A

Oral steroids

34
Q

When would you use cyclophosphamide in the treatment of minimal change nephropathy?

A

If it was unresponsive to steroids/dependant on high doses

35
Q

Does minimal change nephropathy cause progressive renal failure?

A

No

36
Q

What are 4 causes of secondary membranous nephropathy?

A

Infections (parasites/hep B)
Lupus
Malignancy
Drus (Gold)

37
Q

What do you see in the renal biopsy of membranous nephropathy?

A

Subepithelial immune complex deposition in the basement membrane

38
Q

What kidney problem is associated with henoch schonlein purpura?

A

IgA nephropathy

39
Q

You see glomerular crescents on a kidney biopsy. What is the most likely diagnosis?

A

Rapidly progressive glomerulonephritis

40
Q

List three ANCA +ve diseases that cause glomerulonephritis

A

Systemic vasculitis
Wegners granulomatosis
Microscopic polyangiitis

41
Q

List three ANCA negative causes of glomerulonephritis

A

Goodpastures
Henoch Scholein
SLE

Renal (Zoe's cards) (21 decks)

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