Glomerulonephritis

Question 1

Name 3 types of glomerulonephritis.

Answer 1

Minimal change glomerulonephritis

Focal segmental glomerulosclerosis

Membranous glomerulonephritis

Question 2

What is the difference between nephrotic syndrome and nephritic syndrome?

Answer 2

Nephrotic syndrome involves the loss of a lot of protein, whereas nephritic syndrome involves the loss of a lot of blood.

Question 3

State 3 clinical features of a nephrotic syndrome.

Answer 3

Proteinuria. Hypoalbuminaemia (albumin is lost in the urine). Odema. Hyperlipidemia.

Question 4

State 3 clinical features of a nephritic syndrome.

Answer 4

Haematuria
+++ Blood – microscopic or macroscopic haematuria

Haematuria (blood in urine) occurs due to podocytes developing large pores which allows blood and protein to escape into the urine.

Proteinuria
++ Protein (small amount)

Hypertension
Usually only mild

Low urine volume <300ml/day

Question 5

What is the difference between nephrotic syndromes and renal disorders?

Answer 5

Nephrotic syndrome is concerned with disorders of the nephron e.g. glomerulonephritis, while renal disorders are concerned with the kidney e.g. pyelonephritis.

Question 6

What is glomerulonephritis?

Answer 6

Inflammation in the glomeruli (tiny clusters of capillaries that transport blood behaving as filtering units). Therefore, blood and protein leak out into the urine.

Question 7

What is pyelonephritis?

Answer 7

Inflammation of the kidney that starts within the bladder and migrates up the the ureters and into the kidneys.

Question 8

Glomerulonephritis is categorized into either…

Answer 8

Proliferative or non-proliferative.

Question 9

State 3 types of Non-proliferative Glomerulonephritis.

Answer 9

Minimal change glomerulonephritis. Focal segmental glomerulonephritis. Membranous glomerulonephritis.

Question 10

State 3 types of Proliferative Glomerulonephritis.

Answer 10

IgA Nephropathy. Rapidly progressive glomerulonephritis. Membranoproliferative glomerulonephritis. Post infectious glomerulonephritis.

Question 11

State 2 primary (membranous damage) causes of Nephrotic Syndrome.

Answer 11

Minimal change glomerulonephritis

Focal segmental glomerulosclerosis

Membranous glomerulonephritis

IgA nephropathy (diabetic kidney disease)

Alport syndrome (genetic kidney disease condition)

Thin basement membrane disease

Question 12

State 2 secondary (part of the generalized disease) causes of Nephrotic Syndrome.

Answer 12

SLE

Hep B and C

HIV

Diabetes mellitus

Malignancy - bladder tumour, renal tumour

Renal stones

Question 13

State 3 presentations of nephrotic syndrome.

Answer 13

Heavy proteinuria (greater than 3.5g/day). Hypoalbuminuaemia. Oedema. Hyperlipidaemia (decreased oncotic pressure stimulates liver to increase lipoprotein synthesis resulting in high cholesterol).

Question 14

What kidney disease is linked to diabetes?

Answer 14

IgA nephropathy - leads to end stage kidney disease.

Question 15

Rapidly progressive glomerulonephritis can lead to what sort of disorders?

Answer 15

Vasculitic disorders. https://geekymedics.com/glomerulonephritis/
https://geekymedics.com/nephrotic-vs-nephritic-syndrome/

Question 16

State 2 vasculitis disorders which are a localised to a specific vessel.

Answer 16

Wegener’s granulomatosis. Microscopic Polyangiitis. Churg Strauss disease

Question 17

State a vasculitic disorder which is systemic.

Answer 17

Henoch-Schönlein purpura - deposition of IgA in small blood vessels in the skin and kidneys.

Question 18

State a feature of Henoch-Schönlein purpura.

Answer 18

Rash of raised red or purple spots. The spots look like small bruises or blood spots. Common in young children.

Question 19

What is acute kidney injury?

Answer 19

Kidney failure due to the build of waste products in the blood.

Question 20

What is minimal change disease?

Answer 20

Sudden onset of oedema.

Question 21

What is focal segmental glomerulosclerosis?

Answer 21

Lesion not a disease. Areas of mesangial collapse and sclerosis seen in a microscope.

Question 22

What is membranous glomerulosclerosis?

Answer 22

Basement membrane thickening - electron dense deposits in glomerular basement membrane.

Question 23

State 3 treatments for Nephrotic Syndrome.

Answer 23

Diuretics - increase production of urine. ACE - lower BP. Anticoagulant. Statin. Renal biopsy.

Question 24

State 3 causes of haematuria (blood in urine).

Answer 24

Malignancy in renal tract. Renal stones. Trauma. Prostatitis. Inflammation in urinary tract.

Question 25

What is pulmonary renal syndrome?

Answer 25

A a rare medical syndrome in which respiratory failure involving bleeding in the lungs and kidney failure (glomerulonephritis) occur.

Question 26

What is ANCA Vasculitis?

Answer 26

Anti-Neutrophilic Cytoplasmic Autoantibody.

When ANCAs (the autoantibodies) attach to neutrophils, it makes the neutrophils attack small blood vessels in the body. When blood vessels in the kidney are affected, it can cause blood and protein to leak into the urine, as well as kidney damage.

Question 27

What is Goodpasture’s syndrome?

Answer 27

An anti-GBM disease. When autoantibodies to glomerular basement membrane causing rapidly progressive glomerulonephritis.

Causes haematuria and pulmonary haemorrhage.

Question 28

If the urine is cloudy, it suggests…

Answer 28

An infection.

Question 29

If the urine is brown, it suggests…

Answer 29

Haematuria.

Question 30

If the urine is frothy, it suggests…

Answer 30

Proteinuria.

Question 31

If the urine is cloudy, it suggests…

Answer 31

Rhabdomyolysis - death of muscle fibres release contents into bloodstream.

Question 32

What 2 inflammatory related mediators could be identified in a blood test?

Answer 32

Rheumatoid factor. C3 and C4.

Question 33

What is Rheumatoid factor?

Answer 33

An antibody that attaches to normal antibodies e.g. Fc portion of IgG (therefore called autoantibodies).

Question 34

High levels of RhF suggest?

Answer 34

SLE. Rheumatoid arthritis. Hepatitis. Syphilis (STI). Tuberculosis. Liver disease. Sjogren’s syndrome (disorder of the immune system identified by its two most common symptoms — dry eyes and a dry mouth).

Question 35

A cause of a decrease in complement levels could be…

Answer 35

Lupus nephritis. Endocarditis. Atheroembolic renal disease.