Glomerulonephritis

Question 1

define nephrotic syndrom

Answer 1

Albumin <30 g/L
Proteinuria >3g/24 hours
+/- oedema

Question 2

5 presentations of GN

Answer 2

Asymptomatic urinary abnormalities
CKD
Nephrotic syndrome
Nephritic syndrome
Rapidly progressive GN

Question 3

2 roles of mesangial cells

Answer 3

structure

communication

Question 4

what is the specialisation of the epithelial cell of the capillary loop?

Answer 4

fenestration

Question 5

what type of cell is a podocyte

Answer 5

epithelial

Question 6

role of podocytes

Answer 6

important in charge and size permeability of the barrier

Question 7

4 responses of podocytes to injury

Answer 7

apoptosis

foot process effacement

detachment from GBM

loss of slit diaphragm

Question 8

3 examples of glomerular diseases

Answer 8

minimal change disease
FSGS- Focal segmental glomerulosclerosis
diabetic nephropathy

Question 9

4 primary causes of nephrotic disease

Answer 9

focal segmental glomerulosclerosis

membranous

minimal change

membranoproliferative

Question 10

5 secondary causes of nephrotic disease

Answer 10

drugs e.g. NSAIDs, tamoxifen, lithium, antimicrobials

infections e.g. HIV, hep B, hep C, syphilis, malaria

Question 11

3 types of investigations into nephrotic disease

Answer 11

immunology e.g. ANA, dsDNA, C3 and C4, myeloma screen

microbiology e.g. hep B and C

radiolog e.g. renal USS +/- doppler, CXR

Question 12

5 complications of nephrotic disease

Answer 12

thromboembolism- loss of anticoag factors

infection- loss of IgG

hyperlipidaemia- loss of LDLR

nutrition

AKI- renal vein problems

Question 13

what do you see on microscopy in minimal change

Answer 13

normal light microscopy

diffuse foot effacement on electron microscopy

Question 14

5 secondary causes of minimal change

Answer 14

H and NHL
malignant thymoma
renal cell carcinoma
GVHD
lithium
NSAIDs

Question 15

3 categories of causes that can cause focal segmental glomerulosclerosis

Answer 15

familial e.g. mutation in nephrin gene

virus associated e.g. HIV, EBV

medication e.g. ecstasy

Question 16

primary cause of membranous nephropathy

Answer 16

autoimmune reaction of a circulating antibody directed to a specific antigen on the podocyte surface

Question 17

3 mechanisms of glomerular immune complex deposition

Answer 17

• circulating immune complex trapping
• in situ immune deposit formation (exogenous antigens)- ag and ab from within the body meet in the kidney
• in situ immune deposit formation (endogenous antigens)- abs meet ags already in the kidney

Question 18

What is the most common cause of glomerulonephritis

Answer 18

IgA nephropathy

Question 19

basic pathophysiology of IgA nephropathy

Answer 19

mesangial cell deposition of IgA

Question 20

how do we classify vasculitis

Answer 20

according to size of blood vessel involved