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Renal > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

What is GN?

A

Immune medated disease of the kidneys affecting the glomeruli

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2
Q

What are the 3 aspects of the pathogenesis of GN?

A

Humoral - antibody mediated
Cell mediated
Inflammatory cells, mediators and complement

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3
Q

Damage to endothelial or mesangial cells leads to what kind of lesion in GN?

A

Proliferative lesions and blood in urine - nephritic syndrome

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4
Q

Damage to podocytes leads to what kind of lesion in GN?

A

Non-proliferative lesion and protein in urine - nephrotic syndrome

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5
Q

How does GN present?

A 
Oedema 
Haematuria 
Tired 
HTN 
Nephrotic syndrome - proteinuria 
Nephritic syndrome - haematuria
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6
Q

What level of proteinuria classified as the nephrotic syndrome?

A

> 3g/day

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7
Q

RBCs in the urine from the glomerulus are described as what shaped?

A

Dysmorphic

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8
Q

What 3 investigations are required for biopsy sample in GN?

A

Light microscopy
Electron microscopy
Immunofluorescence

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9
Q

How does cresentic GN form?

A

Cells burst into Bowman’s sapce ad forma cresta round the glomerulus which compresses it and it becomes ischaemic and dies.

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10
Q

What are the main aims of treatment for GN?

A

Reduce degree of proteinuria
Induce remission of nephrotic syndrome
Preserve long term renal function

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11
Q

In general what treatment can be given for GN?

A 
ACEi/ARBs
Diuretcs 
Statins
Steriods 
AZA
Cyclophosphamide
Calcineurin inhibitors - Cyclosporin/Tacrolimus 
Mycophenolate Mofetil (MMF)
Plasmapharesis 
Antibodies
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12
Q

What is the target BP for GN?

A

<120/75 if proteinuria

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13
Q

How is minimal change GN diagnosed?

A

EM: foot process fusion

Normal biopsy, LM and IF

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14
Q

What is the treatment for minimal change GN?

A

Oral steroids

If steroid-resistant/ dependent then biopsy and cyclophosphamide/CSA

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15
Q

Does minimal change GN cause progressive renal failure?

A

No

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16
Q

Is minimal change GN proliferative or non-proliferative lesions?

A

Non-proliferative lesion

17
Q

What is the most common cause of nephrotic syndrome in adults and children?

A

Children - Minimal change GN

Adults - Focal Segmental Glomerulosclerosis

18
Q

What are the secondary causes of focal segmental glomerulosclerosis?

A

HIV
Heroin use
Obesity
Reflux nephropathy

19
Q

Describe focal segmental glomerulosclerosis as seen on biopsy?

A

Minimal Ig deposition on LM

Complement deposition on IF

20
Q

What is the treatment for focal segmental glomerulosclerosis?

A

Prolonged steroids

21
Q

What is the second most common cause of nephrotic syndrome in adults?

A

Membranous nephropathy

22
Q

What can cause secondary membranous nephropathy?

A

Infections - HepB, parasites
CTDs - SLE
Malignancies - carcinomas, lymphomas
Drugs - gold, penicillamine

23
Q

Describe membranous nephropathy as seen on biopsy?

A

Subepithelial immune complex deposition in the basement membrane

24
Q

Does the BM become thicker in membranous nephropathy?

A

Yes

25
Q

What is IgA nephropathy?

A

Abnormality of IgA which gets stuck in the kidneys and causes damage - prolifertive lesion

26
Q

Which can IgA nephropathy cause, AKI or CKD?

A

Both

27
Q

IgA nephropathy on biopsy looks like what?

A

Mesangial cell prolifertion and expansion on light microscopy with IgA deposits in mesangium on IF

28
Q

What treatment is given for IgA nephropathy?

A

ACEi/ARB

Fish oil

29
Q

What is rapidly progressive GN?

A

rapid deterioration in renal function over days/ weeks

a treatable cause of cute renal failure

30
Q

What is RPGN associated with?

A

Systemic disease - pANCA > nANCA

Glomerular cresents on biopsy

31
Q

Is RPGN a proliferative lesion?

A

Yes

32
Q

What is the treatment for RPGN?

A

Steroids - IV Methylprednisolone/ Oral Prednisolone
Immunosuppression - Cyclophosphamide/ MMF/ AZA
Plasmapharesis

Renal (9 decks)

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