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Year 2 Urinary (JK) > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

4 features of GN

A

haematuria
proteinuria
renal insufficiency
hypertension

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2
Q

Haematuria in GN

A

persistent microscopic

dysmorphic RBC on microscopy

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3
Q

Proteinuria in GN

A

persistent, proteinuria >1gram/mmol creatinine

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4
Q

Values of hypertension

A

> 140/80mmHg

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5
Q

How is renal insufficiency described?

A

rising creatinine
mild or severe
slow or rapid deterioration
nephritic>nephrotic

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6
Q

Nephritic state

A

hypertension, renal impairment, haematuria, dysmorphic RBC, cellular casts, active urine sediment

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7
Q

Nephrotic syndrome

A 
oedema 
proteinuria 
hypoalbuminaemia 
hyperlipidaemia 
primary or secondary glomerular disease
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8
Q

Differential diagnosis of nephrotic syndrome

A

congestive heart failure - JVP raised, normal albumin, minimal proteinuria
hepatic disease - no proteinuria, LFT abnormal

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9
Q

Aetiology of GN

A

autoimmune, infection, malignancy, drugs, others

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10
Q

2 types of GN

A

proliferative and non-proliferative

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11
Q

proliferative GN

A

excessive numbers of cells in glomeruli

Include infiltrating leucocytes

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12
Q

Non-proliferative GN

A

Glomeruli look normal or have areas of scarring

normal numbers of cells

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13
Q

Diffuse GN

A

> 50% glomeruli affected

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14
Q

Focal GN

A

<50% glomeruli affected

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15
Q

Global GN

A

All of the glomeruli are affected

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16
Q

Segmental GN

A

part of the glomerulus is affected

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17
Q

4 types of proliferative GN

A

Diffuse proliferative = post infective nephritis
focal proliferative = mesangial IgA
focal necrotising crescentic nephritis
membrano-proliferative nephritis

18
Q

What is the usual cause of post infective GN?

A

10-21 days after throat or skin streptococcal infection

19
Q

Causative organisms of post strep GN

A

Lancefield group A strep

20
Q

Presentation of post infective GN

A

dark urine - haematuria

10-21 days after infection

21
Q

Treatment of post strep GN

A

antibiotics?
diuretics eg furosemide
vasodilator drug for hypertension eg amlodipine

22
Q

IgA nephropathy

A

IgA deposition in mesangium and mesangial proliferation is the most common cause of GN worldwide

23
Q

Presentation of IgA nephropathy

A

Microscopic haematuria and proteinuria
nephrotic syndrome
IgA crescentic GN

24
Q

3 broad causes of crescentic GN

A

ANCA eg polyangiitis
Anti GBM nephritis
other eg vasculitis, SLE

25
Q

Presentation findings of ANCA crescentic GN

A

ANCA +ve

rash, proteinuria, haematuria, high creatinine

26
Q

Treatments of ANCA crescentic GN

A

high dose steroids
plasma exchange
cyclophosphamide

27
Q

What does anti-GBM crescentic GN present as?

A

nephritis

nephritis and lung haemorrhage

28
Q

Diagnosis of anti GBM GN

A

Anti GBM antibodies in serum AND kidney

29
Q

Treatments of anti GBM GN

A

aggressive immunosuppressions

steroid, cyclophosphamide, plasma exchange

30
Q

Crescentic GN management

A

immunosuppression

  • CCS
  • plasma exchange
  • cytotoxic eg cyclophosphamide
  • B cell therapy eg Rituximab
  • complement inhibitors
31
Q

3 types of non proliferative GN

A

minimal change disease
focal and segmental GN
membranous nephropathy

32
Q

Treatments of nephrotic syndrome

A

loop diuretics and salt restriction for oedema
renin-angiotensin-aldosterone blockade for hypertension
reduce thrombosis risk eg warfarin or heparin
reduce risk of infection - pneumococcal vaccine
treat dyslipidaemia - statins

33
Q

Minimal change nephrotic syndrome description

A

commonest form In children
rapid oedema
complete loss of proteinuria with steroids
2/3 patients relapse

34
Q

Treatment of minimal change nephropathy

A 
Prednisolone (first relapse aswell)
- cyclophosphamide
- ciclosporin 
- Tacrolimus 
- Rituximab 
And general nephrotic syndrome treatments
35
Q

How does focal and segmental GN present?

A

nephrotic syndrome

focal and segmental sclerosis

36
Q

Problem with focal and segmental glomerulosclerosis

A

resistant to steroids

37
Q

Treatment of focal and segmental glomerulosclerosis

A

general measures
steroids?
ciclosporin, cyclophosphamide, rituximab

38
Q

How is membranous nephropathy diagnosed?

A

histology

2 serum positive enzymes

39
Q

Secondary causes of membranous nephropathy

A

malignancy
SLE
rheumatoid arthritis
Drugs eg NSAIDs

40
Q

Treatment of membranous nephropathy

A

general measures for 6 months
immunosuppression if not improving
cyclophosphamide and steroids
cyclosporin and rituximab

Year 2 Urinary (JK) (26 decks)

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