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RENAL PATHOLOGY > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

What proteins will not be filtered?

A

All proteins = to or larger than albumin

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2
Q

What layers are contained within the filter barrier?

A

Endothelial cytoplasm
Basal lamina
Podocyte

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3
Q

What layers make up the glomerular membrane?

A

Endothelium
Basal lamina
Podocyte foot process

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4
Q

What are mesangial cells?

A

‘tree-like’ cell groups which support capillaries

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5
Q

What is glomerulonephritis?

A

Disease of glomerulus

Inflammatory or non-inflammatory

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6
Q

What is primary glomerulonephritis?

A

Disease only affecting the glomerulus

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7
Q

What is secondary glomerulonephritis?

A

Affects other parts of the body

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8
Q

What are the common presentations of glomerulonephritis?

A

Haematuria
Heavy proteinuria (nephrotic syndrome)
Slowly increasing proteinuria
Acute renal failure

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9
Q

What is nephrotic syndrome?

A

So much albumin lost into the urine that oncotic pressure is lost –> oedema

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10
Q

What are the main causes for haematuria?

A

UTI
Urinary tract stone
Urinary tract tumour
Glomerulonephritis

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11
Q

What should always be checked before taking a renal biopsy?

A

Check clotting function

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12
Q

How does IgA glomerulonephritis present histologically?

A

Accumulation of mesangial matrix with excess cells

IgA and complement component C3 in mesangial area

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13
Q

What is the effect of increased presence of IgA on the glomerulus in IgA glomerulonephritis?

A

IgA deposits cause increased mesangial cell proliferation

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14
Q

What gets clogged with IgA in glomerulonephritis?

A

Mesangium

NOT the filter membrane

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15
Q

What is the prognosis of IgA nephropathy?

A

Mostly self-limiting

Some –> Renal failure

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16
Q

What changes in the urine present in IgA nephropathy?

A

Blood in urine - sometimes microscopic

17
Q

How does Membranous glomerulonephritis present?

A

Spikes of new basement membrane matrix underneath podocytes
Thickened membrane
IgG deposits with spikes surrounding

18
Q

What immunoglobulin is seen in Membranous glomerulonephritis?

A

IgG stuck between basal lamina and podocyte

19
Q

What is the pathological effect of IgG being present in the membrane?

A

IgG is too big to be filtered

IgG activated C3 complement which punches holes in filter

20
Q

What is the role of complement?

A

Punches holes in the bacterial walls

21
Q

IgG is seen in the glomerular basement membrane in which condition?

A

Membranous Glomerularnephritis

22
Q

Leaking albumin through the filter causes what?

A

Nephrotic syndrome

23
Q

What is the prognosis of Membranous Glomerulonephritis?

A

1/4 in chronic renal failure within 10 years

24
Q

What is the most common antigen seen in membranous glomerulonephritis?

A

Phospholipase A2 receptor

25
Q

Patients with membranous glomerulonephritis sometimes have what?

A

Malignancy

26
Q

What are the renal implications of diabetic retinopathy?

A

Retinopathy = microvascular disease

?glomerular disease

27
Q

How does the glomerulus appear in diabetic nephropathy?

A

Matrix deposition in the basal lamina and mesangial matrix
Thick but leaky basement membrane
Mesangium compresses capillaries

28
Q

Why do adhesions to the Bowmans capsule appear in diabetic nephropathy?

A

Glomerulus’ attempt to stop massive leakage of albumin

29
Q

What are Kimmelsteil-Wilson lesions?

A

Gross excess of mesangial matrix forming nodules

30
Q

Kimmelsteil-Wilson lesions are seen in what?

A

In the glomerulus in diabetic nephropathy

31
Q

What is the prognosis of diabetic nephropathy?

A

Decline if established nephropathy and continued poor control

32
Q

Rapidly rising creatinine is suggestive of what?

A

Acute renal failure

33
Q

Cellular proliferation within Bowman’s space is seen in what?

A

Crescentic glomerulonephritis

34
Q

Crescentic glomerulonephritis is caused by what?

A

Granulomatosis with polyangitis
Microscopic polyarteritis
Antiglomerular basement membrane disease

35
Q

How does Crescentic glomerulonephritis present histologically?

A

Crescent bowmans space full of proliferated cells

Bowmans space crushing the capillaries

36
Q

Granulomatosis with polyangiitis affects what?

A

Vessels in Kidneys, Lungs and nose

37
Q

How do you test for Granulomatosis with polyangiitis?

A

ANCA serum test

anti-neutrophil cytoplasmic antibodies

38
Q

What do anti-neutrophil cytoplasmic antibodies do?

A

Antibodies against proteinase 3 and myeloperoxidase
(2 enzymes in primary granules of neutrophils)

Tissue damage via interactions with primed neutrophils and endothelial cells

39
Q

What is the prognosis of Granulomatosis with polyangiitis?

A

Fatal (6m) if untreated

Cyclophosphamide - 75% complete remission

RENAL PATHOLOGY (16 decks)

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