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AY Renal > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

What is glomerulonephritis?

A

Immune-mediated disease of the kidneys affecting the glomeruli (with secondary tubulointerstitial changes)

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2
Q

What is glomerulonephritis?

A

Immune-mediated disease of the kidneys affecting the glomeruli (with secondary tubulointerstitial changes)

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3
Q

Pathogenesis of GN

A

antibody mediated depostition of circulating immune complexes in the glomerulus

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4
Q

What is the function of Bowman’s space?

A

Where the filtrate accumulates before entering the proximal tubule

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5
Q

Which cells bind the capillaries together in the glomerulus?

A

Mesangial cells

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6
Q

How is assymptomatic proteinuria defined?

A
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7
Q

How is heavy proteinuria defined?

A

1-3 g/day

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8
Q

How much protein is present in the urine in nephrotic syndrome?

A

> 3g/day

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9
Q

Signs of GN on urine microscopu

A

Squashed dysmorphic red cells

Red cell casts

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10
Q

Features of nephrotic syndrome

A

Proteinuria

Hypoalbuminaemia (

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11
Q

What does nephrotic syndome indicate about the site of injury?

A

Non-roliferativew process at the podocytes

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12
Q

Complications of nephrotic syndrome

A 
Infections 
Renal vein thrombosis 
Pulmonary emboli 
Volume depletion 
Vit D deficiency 
Subclinical hypothyroidism
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13
Q

Features of nephritic syndrome

A 
Acute renal failure 
Oliguri 
Oedema
Hypertension 
Active urinary sediment
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14
Q

What does nephritic syndrome indicate about the sit of injury?

A

Proliferative process on the endothelial side of GBM

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15
Q

What does proliferative and non-proliferative descrbe about GN?

A

Presence or abscence of proliferation of mesangial cells

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16
Q

What does focal or diffuse indicate about GN?

A

50% of glomeruli affected

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17
Q

What des global or segmental indicate about GN?

A

All or part of glomerulus affected?

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18
Q

What is the target BP for patients with GN?

A
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19
Q

What is the role of diuretics in GN?

A

Offload salt & water retention that patients get as a result ofprotein loss

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20
Q

What is the role of statins in GN?

A

To reduce hyperlipidaemia

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21
Q

What immunosupressive agents can be used in the treatment of GN

A 
Corticosteroids
Azathioprine 
Alkylating agents (cyclophosphamide) 
Caclneurin inhibitors (cyclosprorin, tacrolimus) 
Mycophenylate
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22
Q

Whatimmunosupressive agents can be used in the treatment of GN

A 
Corticosteroids
Azathioprine 
Alkylating agents (cyclophosphamide) 
Caclneurin inhibitors (cyclosprorin, tacrolimus) 
Mycophenylate
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23
Q

Pathogenesis of GN

A

antibody mediated depostition of circulating immune complexes in the glomerulus

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24
Q

What is the function of Bowman’s space?

A

Where the filtrate accumulates before entering the proximal tubule

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25
Q

Which cells bind the capillaries together in the glomerulus?

A

Mesangial cells

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26
Q

How is assymptomatic proteinuria defined?

A
How well did you know this?
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27
Q

How is heavy proteinuria defined?

A

1-3 g/day

28
Q

How much protein is present in the urine in nephrotic syndrome?

A

> 3g/day

29
Q

Signs of GN on urine microscopu

A

Squashed dysmorphic red cells

Red cell casts

30
Q

Features of nephrotic syndrome

A

Proteinuria

Hypoalbuminaemia (

31
Q

What does nephrotic syndome indicate about the site of injury?

A

Non-roliferativew process at the podocytes

32
Q

Complications of nephrotic syndrome

A 
Infections 
Renal vein thrombosis 
Pulmonary emboli 
Volume depletion 
Vit D deficiency 
Subclinical hypothyroidism
33
Q

Features of nephritic syndrome

A 
Acute renal failure 
Oliguri 
Oedema
Hypertension 
Active urinary sediment
34
Q

What does nephritic syndrome indicate about the sit of injury?

A

Proliferative process on the endothelial side of GBM

35
Q

What does proliferative and non-proliferative descrbe about GN?

A

Presence or abscence of proliferation of mesangial cells

36
Q

What does focal or diffuse indicate about GN?

A

50% of glomeruli affected

37
Q

What des global or segmental indicate about GN?

A

All or part of glomerulus affected?

38
Q

What is the target BP for patients with GN?

A
39
Q

What is the role of diuretics in GN?

A

Offload salt & water retention that patients get as a result ofprotein loss

40
Q

What is the role of statins in GN?

A

To reduce hyperlipidaemia

41
Q

When should anti-coagulants be given to GN patients?

A

When profoundly ablunminaemic (

42
Q

Whatimmunosupressive agents can be used in the treatment of GN

A 
Corticosteroids
Azathioprine 
Alkylating agents (cyclophosphamide) 
Caclneurin inhibitors (cyclosprorin, tacrolimus) 
Mycophenylate
43
Q

What would indicate complete remission from nephrotic syndrome?

A

Proteinuria

44
Q

What is the commonest form of nephrotic syndrome in childern & young adults?

A

Minimal change

45
Q

Findings of minimal change on biosy

A

Normal on LM & IF with foot process fusion on EM

46
Q

What percentage of minimal change achieves complete remission with oral steroids?

A

94%

47
Q

What is the second line drug for rsistant minimal change?

A

Cyclophosphamide/CSA

48
Q

Dos minimal change cause progressive renal failure?

A

No

49
Q

What is the commonest cause of glomerulonephritis in adults?

A

FSGS

50
Q

What can FSGS be secondary to?

A

HIV
Heroin use
Obesity
Reflux nephropathy

51
Q

Findings of FSGS on renal biopsy

A

LM - minimal Ig/Complement deposition on IF

52
Q

What percentage of patients with FSGS progress to end stage renal failure after 10 years?

A

50%

53
Q

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

A

Membranous GN

54
Q

Secondary causes of membranous GN

A

Infection (Hep B/parasites)
Connective tissue disease (lupus)
Malignancies (carcinoma/lymphoma)
Drugs (gold/penicillamine)

55
Q

Finsings of membranous GN on biopsy

A

Subepithelial immune complex deposition in the basement membrane

56
Q

What percentage of membranious GN progress to end stage renal failure

A

30%

57
Q

Which antibody is present in >70% of primary membranous nephopathy?

A

Anti-PLA2r antibody

58
Q

What is the commonest GN in the wrold?

A

IgA nephropathy

59
Q

Common presentation of IgA nephropathy

A

Macrscopic haematuria after resp/GI infection

60
Q

What is IgA nephropathy associated with?

A

HSP

61
Q

Findings of IgA nephropathy on renal biopsy

A

Mesangial cell proliferation and exapnsion on light microscopy with IgA deposits in mesangium on IF (increased number of cells)

62
Q

What is RPGN associated with on biopsy?

A

Crescents

63
Q

ANCA positive causes of RPGN

A

Wegners (GPA)

MPA

64
Q

ANCA negative causes of RPGN

A

Goodpastures (antiGBM)
Henoch-Scholein Purpura (HSP/IgA)
SLE

65
Q

Treatment of RPGN

A

Prompt strong immunosupression with supportive care

AY Renal (15 decks)

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