Glomerulonephritis

Question 1

Glumerulonephritis def

Answer 1

Inflammation of glomeruli and nephrons

Question 2

Consequences of damage to glomerulus

Answer 2

Constriction of blood flow-> raised BP

Protein and blood enter urine

AKI

Question 3

Nephrotic syndrome sx

Answer 3

BP; normal-mild rise

Urine; proteinuria

GFR; normal-mild drop

Question 4

Nephritic syndrome sx

Answer 4

BP; mod-severe rise

Urine; haematuria

GFR; mod-severe drop

Question 5

Primary causes of nephrotic syndrome

Answer 5

Minimal change

FSGS

Membranous

Mesangiocapillary GN

Question 6

Secondary causes of nephrotic

Answer 6

DM

SLE

Amyloid

Hep B/C

Question 7

Primary causes of nephritic syndrome

Answer 7

IgA nephropathy

Mesangiocapillary GN

Question 8

Secondary causes of nephritic syndrome

Answer 8

Post strep

Vasculitis

SLE

Anti-GBM

Cryoglobulinaemia

Question 9

IgA nephropathy presentation

Answer 9

Young man with micro/macroscopic episodes of haematuria

Rapid recovery between the attacks

Question 10

Renal biopsy results for IgA nephropathy

Answer 10

IgA and C3 deposits on immunofluorescence

Mesangial proliferation

Question 11

IgA nephropathy rx

Answer 11

BP control with ACEi (<130/80, or 125/75 with proteinuria)

Question 12

Henoch Shonlein Purpura features

Answer 12

Systemic variant of IgA nephropathy

Same biopsy results and treatment

Question 13

HSP sx

Answer 13

purpric rash on extensors (legs esp)

polyarthritis

abdo pain

Question 14

Anti-GBM aka

Answer 14

anti glomerular basement membrane

Goodpasture’s disease

Question 15

Cause of anti-GBM

Answer 15

antibodies against IV collagen GBM

Question 16

Where type IV collagen found

Answer 16

GBM

Lung (haemaptosis)

Question 17

Anti-GBM rx

Answer 17

Plasma exchange

steroids

+/- cytotoxics

(if started early, good prognosis)

Question 18

Post-strep GN presentation

Answer 18

Occurs 1-12wks after sore throat/skin infection

Question 19

Post-strep GN pathogenesis

Answer 19

Streptococcal antigen deposited under skin,

Question 20

Post-strep GN biposy result

Answer 20

IgA and C3 deposits

Question 21

Post-strep GN serology

Answer 21

Riased ASOT and C3

Question 22

Post-strep GN rx

Answer 22

supportive, 95% full recovery

Question 23

Rapidly progressive GN (RPGN) features

Answer 23

Most aggressive GN

With potential to cause end-stage kidney failure within days

Question 24

Causes of RPGN

Answer 24

Immune complex

Pauci-immune disease

Anti-GBM disease

Question 25

Immune complex causes of RPGN

Answer 25

post-infectious

SLE

IgA/HSP

Question 26

Pauci-immune disease causes of RPGN

Answer 26

Granulomatosis with polyangitis (Wegners),

Microscopic polyangitis

Churg-Strauss disease

Question 27

Churg-Srauss disease

Answer 27

autoimmine small/medium vessel vasculitis

hx of airway hypersensitivity

Question 28

Wegner’s disease antibody

Answer 28

ANCA

Question 29

Microscopic polyangitis antibody

Answer 29

p-ANCA

Question 30

RPGN rx

Answer 30

Aggressive immunosuppression:

high-dose IV steroids

cyclo- phosphamide

± plasma exchange

Question 31

Nephrotic triad

Answer 31

Proteinuria

hypoalbuminaemia

oedema

(+ sometimes hyperlipidaemia)

Question 32

Pathophysiology of nephrotic syndrome

Answer 32

injury to podocytes

leaks protein through

Question 33

Biopsy for nephrotic syndrome

Answer 33

All adults should get

Children only if unresponsive to steroid treatment

Question 34

Complications of nephrotic syndrome

Answer 34

VTE

infection

hyperlipidaemia

Question 35

Rx of nephrotic

Answer 35

1. diuretics (furosemide)
2. ACEi (for proteinuria)
3. Complications: anticoagulant, statins, pneumovax

Question 36

Minimal change GN electron microscopy

Answer 36

effacement of podocytes (normal under light microscopy)

Question 37

Minimal change disease rx

Answer 37

steroids

If frequently relapsing: cyclophosphamide or ciclosporin

Question 38

Membranous neuropathy biopsy results

Answer 38

thick GBM

IgG and C3

Question 39

Membranous neuropathy rx

Answer 39

ACE/ARB

diuretics