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Renal > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

Chronic glomerulonephritis is the commonest cause of end stage renal failure. True/false?

A

False - second commonest after diabetes

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2
Q

What is glomerulonephritis?

A

Immune-mediated disease of the kidneys affecting the glomeruli

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3
Q

What usually drives the immune process in GN?

A

Antibodies

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4
Q

What are the three cells that can be affected in GN?

A

Endothelial
Mesangial
Podocyte

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5
Q

Damage to what cells causes a proliferative lesion and blood in urine?

A

Endothelial

Mesangial

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6
Q

Damage to what cells leads to a non-proliferative lesion and protein in urine?

A

Podocytes

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7
Q

What happens to a podocyte when it is damaged?

A

Loses its size and charge specific barrier

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8
Q

What happens a mesangial cell when it is damaged?

A

It proliferates and attracts inflammatory cells

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9
Q

What occurs when an endothelial cell is damaged?

A

Vasculitis

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10
Q

What is the gold standard test for GN?

A

Kidney biopsy

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11
Q

Name some ways urine can be examined

A

Urinalysis
Urine microscopy
Urine protein:creatinine ratio

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12
Q

What are signs of GN on urinalysis?

A

Haematuria

Proteinuria

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13
Q

What are signs of GN on urine microscopy?

A

Dysmorphic RBCs

Red cell casts

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14
Q

What are some clinical presentations of GN?

A

Nephrotic syndrome

Nephritic syndrome

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15
Q

What are signs of nephritic syndrome?

A

Oliguria
Oedema
Haematuria

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16
Q

What cells are affected in nephritic syndrome?

A

Mesangial cells

17
Q

What are signs of nephrotic syndrome?

A

Proteinuria
Hypoalbuminaemia
Oedema
Hypercholesterolaemia

18
Q

What cells are affected in nephrotic syndrome?

A

Podocytes

19
Q

Give some complications of nephrotic syndrome

A

Infections
Renal vein thrombosis
Pulmonary emboli

20
Q

The majority of glomerulonephritis is idiopathic. True/false?

A

True

21
Q

What are some secondary causes of GN?

A

Malignancy
Vasculitis
Goodpastures
HSP

22
Q

What are the histological classifications of GN?

A

Proliferative/non-proliferative
Focal/diffuse
Global/segmental

23
Q

Give examples of non-immunosuppressive treatment used in GN

A

Anti-hypertensives (ACEIs/ARBs)
Diuretics
Statins

24
Q

What immunosuppressive drugs can be used to treat GN?

A

Prednisolone
Azathioprine
Cyclophosphamide
Rituximab

25
Q

What is the general treatment for nephrotic patients?

A

Fluid/salt restriction
Diuretics
ACEIs/ARBs

26
Q

What are the main types of idiopathic GN?

A 
Minimal change
FSGS
Membranous
Membranoproliferative
IgA nephropathy
27
Q

Minimal change GN affects which cell?

A

Podocytes

28
Q

How is minimal change disease treated?

A

First line - oral steroids

Second line - cyclophosphamide

29
Q

What are the secondary causes of focal segmental glomerulosclerosis?

A

HIV

Heroin use

30
Q

Minimal change GN is the commonest cause of nephrotic syndrome in UK adults. True/false?

A

False - children

31
Q

What is the commonest cause of nephrotic syndrome in UK adults?

A

Membranous nephropathy

32
Q

What are the secondary causes of membranous nephropathy GN?

A

Infections (hep B)
Lupus
Malignancy
Drugs (gold)

33
Q

What occurs in membranous nephropathy GN?

A

Immune complex deposition in basement membrane

34
Q

What is the commonest glomerulonephritis in the world?

A

IgA nephropathy

35
Q

What occurs in IgA nephropathy?

A

Mesangial cell proliferation with IgA deposits in mesangium

36
Q

Rapidly progressive GN is associated with what diseases?

A

Systemic vasculitis (GPA)
Goodpasture’s
HSP
SLE

37
Q

What histological feature is associated with RPGN?

A

Glomerular crescents

38
Q

How is RPGN treated?

A

Immunosupression - steroids/cyclophosphamide

Plasmapharesis

Renal (14 decks)

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