Glomerulonephritis

Question 1

def

Answer 1

glomerular injury which causes inflammation (commonly immune mediated) in the glomerular capillaries and glomerular basement membrane

Question 2

epidemiology

Answer 2

3rd most common cause of end-stage renal disease in the UK, after diabetes and HTN
most common cause worldwide of ESRD

Question 3

aetiology

Answer 3

very commonly idiopathic

infection: (GABHS such as strep pyogenes, respiratory + GI infections, hep B+C, endocarditis, HIV)
inflammation: SLE, RA
malignancy: lung and colorectal cancer

Question 4

what drugs can cause glomerulonephritis

Answer 4

penicillamine (RA)

NSAIDs

Question 5

risk factors

Answer 5

GABHS (strep pyogenes)
respiratory + GI infections (IgA nephropathy)
hep B/C
SLE/ RA

Question 6

history

Answer 6

non-specific symptoms such as nausea, malaise, fever

frequent urination with little urine when going
blood may be seen in the urine
swelling of ankles

Question 7

examination

Answer 7

microscopic haematuria is common
oedema
HTN

Question 8

investigations

Answer 8

1 bloods
-normocytic normochromic anaemia (systemic diseases which cause GN)
-elevated creatinine (severe GN/renal failure)
-elevated LFTs (hep B/C)
-hypoalbuminaemia (nephrotic syndrome)
2 urine
-for proteinuria
3 USS
-small kidneys

Question 9

a 35y/o with no PMH presents with cola coloured urine. No pain or fever associated with the bleed but has had a sore throat for the past 3 days. O/E there is a non-blanching purpuric rash over both his legs

Answer 9

Glomerulonephritis

Question 10

a 42y/o man with history of HIV infection presents with generalised swelling progressive for the past week. HIV was diagnosed a year ago and he has been non-compliant with the medical therapy. No orthopnea, abdominal pain, nausea and blood in urine. He has non-pitting oedema from the lower extremities to the mid-abdomen

Answer 10

Glomerulonephritis