Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal SB > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

what is the renal parenchyma

A

the kidney itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the two main presentations of GN

A

Chronic GN is 2nd commonest cause of End Stage Renal Failure (after diabetes). More common than acute.

Acute GN is an important treatable cause of Acute Renal Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

definition of GN

A

Immune-mediated disease of the kidneys affecting the glomeruli

(with secondary tubulointerstitial damage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how can GN happen

A

Humoral (antibody-mediated)

Cell-mediated (T-cells)

Inflammatory cells, mediators and complements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the charges of the glomerular cell membrane

A

negatively charged

allows it to have a size and charge selective barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what happens to the barrier in GM

A

disruption of the barrier leading to haematuria and/or proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what determines how GM presents

A

site and type of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does Damage to endothelial or mesangial cells lead to

A

a proliferative lesion and red cells in urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does damage to podocytes lead to

A

non-proliferative lesion and protein in urine (no RBC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is GN diagnosis

A

Clinical presentation
Blood tests
Examination of urine
Kidney biopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how can urine be analysed

A

Urinalysis - haematuria, proteinuria
Urine microsopy - RBC (dysmorphic), RBC & granular casts, lipiduria
Urine Protein: Creatinine Ratio / 24 hour urine - quantify proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how can GN present

A 
Haematuria (micro or macroscopic)
Proteinuria 
Impaired renal function (AKI or CKD/ ESRD)
Hypertension
Nephrotic syndrome
Nephritis syndrome
Nephrotic-Nephritic Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how can proteinuria be defined

A 
Microalbuminuria (30-300mg albuminuria/day)
Asymptomatic proteinuria ( 3 g/day)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is features of nephritic syndrome

A 
Acute Renal Failure
Oliguria
Oedema/ Fluid retention
Hypertension
Active urinary sediment
RBC’s, RBC & Granular Casts

Indicative of a proliferative process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is features of nephrotic syndrome

A

Proteinuria > 3 g/day (mostly albumin, also globulins)

Hypoalbuminaemia (

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

nephrotic syndrome complications

A

Infections
Renal vein thrombosis
Pulmonary emboli
Volume depletion (overaggressive use of diuretics) - may lead to ARF (pre-renal)

Vit D deficiency
Subclinical hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

classifications of GN

A

Primary - idiopathic (majority)

Secondary - caused by eg. infections or drugs eg. malignancies part of systemic disease
eg. ANCA - associated systemic vasculitis, lupus, Goodpastures, HSP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how is GN described in terms of histology

A

Proliferative or non-proliferative
Focal/Diffuse
Global/Segmental
Crescentic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the aims of GN treatment

A

Reduce degree of proteinuria
Induce remission of nephrotic syndrome
Preserve longterm renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the two categories of treatment of GN

A

Immunosuppressive

Non-immunosuppressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Non-immunosuppressive Tx of GN

A

Goal to lower BP:

- Anti-hypertensives (target BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Immunosuppressive Tx of GN

A

Corticosteroids (Prednisolone po/MethylPred IV)

Azathioprine

23
Q

Tx of nephrotic syndrome

A

Fluid restriction
Salt restriction
Diuretics
ACE Inhibitors/ ARBs

IV Albumin (only if volume deplete)

24
Q

what is needed after initial treatment of nephrotic syndrome

A

immunosuppression to induce remission

- normally steroids

25
Q

what is the definition of complete and partial remission

A

complete remission (proteinuria

26
Q

what are the main primary idiopathic causes of GN

A

Minimal change
FSGS (focal segmental glomerulosclerosis)
Membranous
Membranoproliferative
IgA nephropathy e.g. Henoch-Schönlein purpura (HSP)

27
Q

what is the commonest cause of nephrotic syndrome in children and why is it

A

minimal change nephropathy

Normal renal biopsy on LM & IF with foot process fusion on EM.

28
Q

Tx of minimal change nephropathy

A

Oral steroids - 94% remission

Steroid resistant
Tx with cyclophosphamide/CSA

29
Q

does minimal change nephropathy cause progressive renal failure

A

NO

30
Q

what is the commonest cause of nephrotic syndrome in adults

A

FSGS - FOCAL SEGMENTAL GLOMERULOSCLEROSIS

31
Q

FSCS can be primary or secondary - what are secondary causes of FSCS

A

HIV/Heroin use/Obesity/ Reflux nephropathy

32
Q

how does FSCS appear on renal biopsy

A

light microscopy with minimal Ig/ Complement deposition on IF

33
Q

Tx of FSCS

A

Prolonged Steroids - remission 60%

2nd line - Cyclophosphamide or Ciclosporin

34
Q

prognosis of FSCS

A

50% progress to end stage renal failure (ESRF) after 10 years

35
Q

what is membranous nephropathy

A

2nd commonest cause of nephrotic syndrome in adults

Can be primary or secondary

36
Q

what are secondary causes of membranous nephropathy

A

infections (hepatitis B/ parasites)
connective tissue diseases (lupus)
malignancies (carcinomas/ lymphoma)
drugs (gold/penicillamine)

37
Q

what is seen on renal biopsy of membranous nephropathy

A

subepithelial immune complex deposition in the basement membrane

38
Q

Tx of membranous nephropathy

A

Steroids + Cyclophosphamide (Alkylating agents)

Consider B cell monoclonal Ab e.g. rituximab

39
Q

prognosis of membranous nephropathy

A

30% progress to end stage renal failure in 10 years

40
Q

what antibody is seen in the majority of MN cases

A

Anti PLA2r antibody

41
Q

what is the commonest GN in the world

A

IgA nephropathy

42
Q

what is IgA nephropathy associated with

A

Henoch-Schonlein Purpura (HSP) (arthritis/colitis/ purpuric skin rash)

43
Q

what is the range of symptoms IgA nephropathy can cause

A

Asymptomatic microhaematuria ± non-nephrotic range proteinuria

Macroscopic haematuria after resp/GI infection

AKI/ CKD

44
Q

what is seen on renal biopsy of IgA nephropathy

A

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

45
Q

Tx of IgA nephropathy

A

BP control/ ACE inhibitors & ARBs/ Fish oil

46
Q

what is RPGN

A

Rapidly progressive glomerulonephritis

  • treatable cause of Acute renal failure
  • causes rapid deterioration in renal function over days/weeks
47
Q

what is RPGN associated with on renal biopsy

A

Glomerular crescents

48
Q

what are the two categories of RPGN

A

ANCA-positive

ANCA-negative

49
Q

what are the ANCA-positive conditions

A

Systemic Vasculitis
Wegener’s granulomatosis
(Granulomatosis with polyangiitis)
Microscopic polyangiitis

50
Q

what are the ANCA-negative conditions

A

Goodpasture’s disease-Anti-GBM
Henoch Scholein Purpura HSP/IgA
SLE

51
Q

how is ANCA detected

A

by indirect immunofluorecence

52
Q

what is antibody in GoodPasture’s syndrome

A

Anti-GBM

53
Q

Tx of RPGN

A

Prompt Immunosuppression with supportive care

  • Steroids (IV Methylprednisolone / Oral Prednisolone)
  • Cytotoxics (Cyclophosphamide/ Mycophenolate/ Azathioprine
  • Rituximab

Renal SB (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions