Glomerulonephritis Flashcards

1
Q

What 3 layers compose the filtration barrier at the glomerulus?

A
Endothelial lining (fenestrated)
Basal lamina
Podocytes
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2
Q

What is the glomerulus?

A

A ball of looped capillaries

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3
Q

Through which vessels does blood enter the glomerulus?

A

Afferent arteriole

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4
Q

Through which vessels does blood exit the glomerulus?

A

Efferent arteriole

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5
Q

What type of molecules are not filtered out the blood?

A

Proteins (equal or bigger than albumin)

RBC

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6
Q

What cells are responsible for supporting the glomerulus?

A

Mesangial cells

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7
Q

Where does filtrate go after leaving the glomerulus?

A

Bowman’s space

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8
Q

What is the pathology of glomerulonephritis?

A

Disease of glomerulus, can be inflammatory or non-inflammatory

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9
Q

What are the 4 most common presentations of glomerulonephritis?

A

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

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10
Q

What are the main causes of haematuria?

A

UTI
Urinary tract stone
Urinary tract tumour
Glomerulonephritis

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11
Q

What types of haematuria can occur?

A

Macroscopic - discoloured urine

Microscopic (2)

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12
Q

What tests would you do in someone presenting with discoloured urine?

A

Dipstick test
MSSU - urine culture
Ultrasound scan
Renal biopsy

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13
Q

What pathological findings will be observed in biopsy associated with IgA glomerulonephritis?

A

IgA (immnoglobulin)

C3 complement

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14
Q

What is the cause of IgA glomerulonephritis?

A

Unknown - antibody excess

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15
Q

What disease progress is observed in IgA glomerulonephritis?

A

Accumulation of IgA at the glomerulus, clogging the filter membrane

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16
Q

What happens to the mesangial cells in IgA glomerulonephritis?

A

Proliferation & matrix expansion

17
Q

What is observed in the urine in IgA glomerulonephritis?

A

Blood cells

18
Q

What is the prognosis for IgA glomerulonephritis?

A

Usually self-limiting

Small % develop chronic renal failure

19
Q

If high levels of albumin are present in urine what would this suggest?


A

Leaky glomeruli filtration barrier

20
Q

If there is heavy protein loss, (>2g/day) what is this suggestive of?

A

Nephrotic syndrome

21
Q

What investigations would you carry out if suspected nephrotic syndrome?

A

Renal biopsy

22
Q

In membranous glomerulonephritis, what deposits are found between the pdocytes & BL?

A

IgG

23
Q

In membranous glomerulonephritis, what does IgG activate? What action does it have?

A

C3 complement & results in holes being punched in glomerular membrane

24
Q

What is the underlying cause of IgG (membranous glomerulonephritis)?

A

Unknown

25
Q

If there is a massive loss of plasma protein, would sign will be observed peripherally?

A

Oedema

26
Q

In a diabetic nephropathy, what causes leakage of albumin out of glomerulus?

A

Glycated molecules deposit in BL & mesangium resulting in thickened BL & mesangial matrix

27
Q

In diabetic nephropathy, what is another name for nodules of mesangial matrix?

A

Kimmelsteil-Wilson lesion

28
Q

What hastens poor prognosis in diabetic nephropathy?

A

Poor glycemic control

29
Q

What tests would you do to test GFR?

A

Serum creatinine

30
Q

What would rapidly rising creatinine be indicative of?

A

Acute kidney failure

31
Q

What does US allow you to visualise in renal tract?

A

Presence/absence of obstruction

32
Q

When the glomerulus is crushed by a crescent of macrophages, what is this called?

A

Crescenteric glomerulonephritis

33
Q

What causes crescentic gloermulonephritis?

A

Wegners granulomatosis

34
Q

What is another name for Wegners granulomatosis?

A

Granulomatosis with polyangiitis

35
Q

What is Granulomatosis with polyangiitis?

A

A form of vasculitis which affects the vessels of kidneys, nose & lungs

36
Q

What tests could you perform to test for Wegners granulomatosis?

A

serum ANCA test (anti-neutrophil cytoplasmic antibodies)

37
Q

What are ANCA antibodies directed against?

A

Enzymes in primary granules of neutrophils

38
Q

What can be used to treat Wegeners?

A

Cyclophosphamide

39
Q

What are the 4 different types of glomerulonephritis?

A

IgA glomerulonephritis
Membranous glomerulonephritis
Diabetic nephropathy
Crescentic glomerulonephritis