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Renal > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

what are the most common causes of glomerular diseases

A

diabetic nephropathy, glomerulonephritis, amyloid/ light chain nephropathy, transplant glomerulopathy

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2
Q

what are the 2 ways that GN resents

A

chronic GN- commonest and Acute GN- treatable cause of acute renal failure

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3
Q

what is glomerulonephritis

A

AN immune mediated disease of kidneys feeding glomeruli

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4
Q

how does GN come about?

A

Humoral (antibody-mediated), cell mediated T cells, inflammatory cells, mediators na compliments

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5
Q

what are the foot processes held together by?

A

protein bridging

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6
Q

is the cell surface negative or positively chargeD?

A

negatively

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7
Q

what type of lesion occurs on endothelial surface?

A

proliferative

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8
Q

what type of lesion occurs on the endothelial podocytes

A

non proliferative

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9
Q

how does GN present?

A

haematuria- asymptomatic or symptomatic (painless haematuria)

Proteinuria- microalbuminuria (30-300mg/ day), nephrotic syndrome >3g/ day

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10
Q

how do we pick up proteinuria and haematuria

A

urinalysis

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11
Q

why do we use light microscopy

A

to assess red blood cells- dysmprhic, red cell casts- lots of cells stuck in tubule

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12
Q

what is nephritic syndrome

A

acute renal failure, hypertension, oedema, oliguria, active urinary sediment- RBCs and granular casts

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13
Q

what presents with nephrotic syndrome

A

proteinuria, hypoalbuminaemia

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14
Q

is nephrotic syndrom a proliferative or non proliferative porcess

A

non- proliferative

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15
Q

what are complications of nephrotic syndrome?

A

infection, renal vein thrombosis, pulmonary emboli, volume depletion- overuse of diuretics, bit D deficiency and subclinical hypothyroidism

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16
Q

What is the aetiology of most causes of GN

A

idiopathic

17
Q

what are secondary causes of GN

A

infections drugs, systemic diseases- good pastures, lupus, HSP

18
Q

How do we assess GN via investigations

A

renal biopsy

light microscopy- immunofluorescence

19
Q

how do you treat GN

A 
Anti-hypertensives (130/80) 
ACEi/ ARBs - reduce proteinuria
Diuretics- reduce oedema
Statins- hyperlipidaemia 
Warfarin/ LMWH
20
Q

how dos ou treat GN immunosuppressively

A

Corticosteroids, Azathioprine, Mycophenalite Mofetil
Plasmophoresis- high antibody volume, high ra[id resolution of vasculitis
Antibodies- IV immunoglobulin

21
Q

how do we treat patients wth nephrotic syndrome

A

fluid restriction, reduce salt, diuretics- reduce water, ACEi, Anticoagulation

22
Q

what is the commonest cause of nephrotic syndrome in children

A

minimal change nephropathy

23
Q

how do you treat minimal change disease

A

steroids- cyclophosphamide

24
Q

what is the commonest cause of nephrotic syndrome in adults

A

Focal segmental glomerulosclerosis

25
Q

what can cause FSGS

A

HIV, heroin, diabetes, obesity, reflux

26
Q

What would be seen on renal biopsy in FSGS

A

minimal Ig complement deposition on IF

27
Q

how do you treat FSGS

A

prolonged steroids

28
Q

what percentage of people with FSGS progress to end stage renal failure

A

50%

29
Q

what is the second most common cause of nephrotic syndrome in adults

A

membranous nephropathy

30
Q

what are second degree causes of membranous nephropathy

A

infections- Hep B, connective tissue disease (lupus), malignancies, drugs (gold, penicllamine)

31
Q

what is the primary cause of membranous nephropathy

A

Anti PLA2r antibody

32
Q

what is the commonest GN in the world

A

IgA nephropathy

33
Q

what is IgA associated with

A

Hence Schonlein Purpura

34
Q

how do you treat IgA nephropathy

A

BP control, ACE inhibitors, ARBs and fish oil

35
Q

is rapidly progressive goomerulonepheitis treatable

A

yes

36
Q

what is sen on biopsy with rapidly progressive glomerulonephritis

A

crescent sign

Renal (18 decks)

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