Glomerulonephritis

Question 1

What is the name of kidney condition caused by SLE?

Answer 1

lupus nephritis

Question 2

How does SLE damage the kidney?

Answer 2

Antibodies lodge in the glomeruli which causes inflammation. The inflammation causes scarring on the kidney that prevent it from working

Question 3

Treatment for lupus nephritis

Answer 3

Cyclophosphomide and pred. sometimes mychophenolate mofetil (MMF) is used instead of cyclo

Question 4

What is goodpasture syndrome?

Answer 4

This is where antibodies attack the BM in lungs and kidney. Leads to bleeding in the lungs and renal failure

Question 5

Most common causes of glomerular disease?

Answer 5

Diabetic nephropathy
Membranous nephropathy
FSGS

Question 6

Blood testing if you suspect GN?

Answer 6

FBC
U+Es
LFT
CRP
immunoglobulins
autoantibodies: ANA, ANCA, Anti-DsDNA, anti-GBM
Blood culture

Question 7

Urine testing for GN?

Answer 7

Urine dip
MC+S
ACR/PCR
24h urine collection
Bence-jones proteins
RBC casts

Question 8

Imaging if you suspect GN?

Answer 8

Renal USS
CXR (pulmonary haemorrhage in pulmonary-renal syndrome)
Renal biopsy required for Dx

Question 9

Gold standard for Dx of GN?

Answer 9

renal biopsy

Question 10

Managment of GN?

Answer 10

CKD management (ACE/ARB)
Control HbA1c
Salt intake reduced
Immunosuppression depending on type of GN

Question 11

Nephrotic syndromes

Answer 11

Minimal change
FSGS
Membranous nephropathy
Diabetic nephropathy

Question 12

Nephritic syndromes

Answer 12

Anti-GBM
IgA
Post-strep
Rapidly progressing GN

Question 13

Criteria for nephrotic syndrome?

Answer 13

1. oedema
2. hypoalbuminaemia <30g/L
3. proteinuria >3g/day

Question 14

Management of nephrotic syndrome?

Answer 14

1) reduce oedema
2) treat underlying cause
3) manage proteinuria
4) manage complications

Question 15

What are the complications of nephrotic syndrome?

Answer 15

thromboembolism, infection, hyperlipidaemia

Question 16

Triad of HUS?

Answer 16

Anaemia
Thrombocytopenia
AKI

Question 17

Cause of transient non-visible haemturia

Answer 17

UTI
Sexual intercourse
vigorous exercise
Menstruation

Question 18

Causes of persistent non-visible haematuria

Answer 18

Cancer (renal, bladder, prostate)
Stones
BPH
Urethritis eg chlamydia
Prostatitis
Renal causes eg IgA nephropathy

Question 19

2ww for haematuria

Answer 19

• Visible haematuria

- 45< with NVH in absence of UTI

Question 20

Shrunken kidneys on USS

Answer 20

CKD
GN
Chronic pyelonephropathy

Question 21

Large kidneys on USS

Answer 21

HIV associated nephropathy
ADPKD
Diabetes nephropathy

Question 22

Management of hyperkalaemia?

Answer 22

<6.5mmol: Ask for ECG
6.5+ or ECG changes:
Ca gluconate 10%
10U actrapid in 50mL of 50% glucose 
Salbutamol nebs

Question 23

Most common extra-renal manifestation on ADPKD?

Answer 23

Liver cysts - can cause hepatomegaly