Glomerulonephritis

Question 1

what type hypersensitivity are the glomerulonephritises

Answer 1

all type III immune complex deposit except anti-GBM (type II)

Question 2

how is the pathology of glomerulonephritis classified

Answer 2

proliferative or non-proliferative

Question 3

what part of the glomerulus is damaged by a proliferative lesion

Answer 3

mesangial + endothelium

Question 4

what part of the glomerulus is damaged by a non-proliferative lession

Answer 4

podocytes

Question 5

does a proliferative or non-proliferative lesion present more rapidly

Answer 5

proliferative

Question 6

does a proliferative or non-proliferative lesion cause haematuria

Answer 6

proliferative

Question 7

does a proliferative or non-proliferative lesion cause proteinuria

Answer 7

non-proliferative

Question 8

how is the presentation of glomerulonephritis classified

Answer 8

nephritic or nephrotic syndrome

Question 9

what is characteristically seen on biopsy in rapidly progressive glomerulonephritis

Answer 9

crescents

Question 10

causes of RPGN

Answer 10

SLE, IgA, HSP, GPA, MPA, EGPA, anti-GBM

Question 11

management of RPGN

Answer 11

CCS, cyclophosphamide / azathioprine, plasmapharesis

Question 12

how does nephrotic syndrome always present

Answer 12

severe oedema, hypoalbuminaemia, proteinuria

Question 13

how is renal function affected by nephrotic syndrome

Answer 13

normal renal function

Question 14

management of nephrotic syndrome

Answer 14

fluid/Na restrict, loop diuretic, ACEI/ARB, immunosuppress

Question 15

does nephritic or nephrotic syndrome cause hypercholesterolaemia

Answer 15

nephrotic

Question 16

does nephritic or nephrotic syndrome cause HTN

Answer 16

both, but especially nephritic

Question 17

what are you looking for on urine microscopy in nephritic syndrome

Answer 17

dysmorphic RBC, RBC cast, lipiduria

Question 18

what 3 investigations are done after biopsy for glomerulonephritis

Answer 18

light microscopy, immunofluorescence see Ab, electron microscopy

Question 19

is complement elevated or decreased in nephritic syndrome

Answer 19

decreased

Question 20

what blood pressure are you aiming for in glomerulonephritis

Answer 20

<130/80

Question 21

what blood pressure are you aiming for in glomerulonephritis with proteinura

Answer 21

<120/75

Question 22

what are the primary causes of nephritic syndrome

Answer 22

IgA nephropathy, MPGN

Question 23

what is the commonest GN in a child

Answer 23

minimal change disease

Question 24

what is the commonest nephrotic syndrome in an adult in the UK

Answer 24

membranous nephropathy

Question 25

what is the commonest GN worldwide

Answer 25

IgA nephropathy

Question 26

presentation of minimal change disease

Answer 26

nephrotic syndrome, child

Question 27

diagnosis of minimal change disease

Answer 27

only on electron microscopy

Question 28

management of minimal change disease

Answer 28

PO CCS

Question 29

mechanism of cyclophosphamide

Answer 29

inhibits B cells

Question 30

presentation of FSGS

Answer 30

nephrotic synd

Question 31

associations of FSGS

Answer 31

HIV, obese, heroine

Question 32

management of FSGS

Answer 32

progressive, CCS

Question 33

associations of membranoproliferative GN

Answer 33

autoimmune disease, cancer

Question 34

presentation of IgA nephropathy

Answer 34

haematuria post GI/RTI

Question 35

management of IgA nephropathy

Answer 35

HTN / ACEI / ARB, progressive

Question 36

autoantibody in IgA nephropathy

Answer 36

anti-IgA1

Question 37

what is seen on immunofluroesence in IgA nephropathy

Answer 37

diffuse IgA/C3 deposit in mesangium

Question 38

presentation of anti-gbm

Answer 38

malaise, 1st cough / haemoptysis, 2nd haematuria, nephritic synd, rapid

Question 39

pathology of anti-GBM

Answer 39

IgG auto-ab IV collagen

Question 40

how does anti-GBM affect the lungs

Answer 40

restrictive lung disease

Question 41

investigations for anti-GBM

Answer 41

autoantibody, CXR, biopsy

Question 42

what is seen on IM in anti-GBM

Answer 42

linear IgG at BM

Question 43

what is seen on microscopy in anti-GBM

Answer 43

crescents

Question 44

management of anti-GBM

Answer 44

CCS + immunosuppress + plasmapharesis

Question 45

pathology of HSP

Answer 45

IgA driven

Question 46

where would you see a non-blanching purpuric rash in HSP

Answer 46

extensor surfaces, back of legs

Question 47

does SLE always affect the kidney

Answer 47

only 50% of patients

Question 48

presentation of lupus nephritis

Answer 48

mixed nephrotic and nephritic syndrome

Question 49

management of lupus nephritis

Answer 49

hydroxychloroquine