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Renal & Urology > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

Define Glomerulonephritis?

A

An immunologically mediated inflammation of the renal glomeruli

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2
Q

What are some types of Glomerulonephritis caused by?

A

Deposition of antigen-antibody complexes in the glomeruli
This leads to inflammation and activation of complement and coagulation cascades
The immune complexes may form within the glomerulus (more common) or be deposited from the circulation

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3
Q

What is Glomerulonephritis associated with?

A

Bacteria (e.g. Streptococcus viridans, Staphylococci)
Viruses (e.g. HBV, HCB, measles, mumps, EBV)
Protozoal (e.g. Plasmodium malariae, schistosomiasis)
Inflammatory/Systemic diseases (e.g. SLE, vasculitis, cryoglobulinaemia)
Drugs (e.g. gold, penicillinamine)
Tumour

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4
Q

What is the classification of Glomerulonephritis based on?

A

Site of nephron pathology and its distribution

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5
Q

What are the different types of Glomerulonephritis?

A

Minimal-change Glomerulonephritis
Membranous Glomerulonephritis
Membranoproliferative Glomerulonephritis (MPGN)
Focal segmental glomerulosclerosis
Focal segmental proliferative Glomerulonephritis
Diffuse proliferative Glomerulonephritis
IgA Nephropathy
Crescentic Glomerulonephritis
Focal Segmental Necrotising Glomerulonephritis

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6
Q

What do we see in microscopy for Minimal-change Glomerulonephritis?

A

Light microscopy - minimal change

Electron microscopy - loss of epithelial foot process

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7
Q

What are the characteristcs of Membranous Glomerulonephritis?

A

Thickening of glomerular basement membrane (GBM) from immune complex deposition
Assoiated with Goodpasture’s Syndrome

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8
Q

What are the characteristics of Membranoproliferative Glomerulonephritis (MPGN)?

A

Thickening of GBM

Mesangial cell proliferation and interdeposition

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9
Q

What are the characteristcs of Focal segmental Glomerulosclerosis?

A

Glomerular scarring

Associated with HIV

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10
Q

What are the characteristics of Focal segmental proliferative Glomerulonephritis?

A

Mesangial and endothelial cell proliferation
Focal = involvement of some glomeruli
Segmental = involvement of parts individual glomeruli

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11
Q

What are the characteristics of Diffuse Proliferative Glomerulonephritis?

A

Same as Focal Segmental Proliferative Glomerulonephritis but affects ALL glomeruli

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12
Q

What are the characteristcs of IgA Nephropathy?

A

Mesangial cell proliferation

Mesangial IgA and C3 deposits

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13
Q

What are the characteristcs of Crescentic Glomerulonephritis?

A

Crescent formation by macrophages and epithelial cells, which fills up Bowman’s space

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14
Q

What are the characteristcs of Focal Segmental Necrotising Glomerulonephritis?

A

Peripheral capillary loop necrosis (occurs in granulomatosis with polyangiitis, microscopy polyarteritis and other vasculitides)
Often evolves into crescentic Glomerulonephritis

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15
Q

What are Cryoglobulins?

A

Are immunoglobulins that precipitate in the cold

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16
Q

What is the epidemiology of Glomerulonephritis?

A

Accounts for 25% of the cases of chronic renal failure

17
Q

What are the presenting symptoms of Glomerulonephritis?

A 
Haematuria 
Subcutaneous oedema 
Polyuria or oliguria 
History of recent infection
Symptoms of uraemia or renal failure (acute and chronic)
18
Q

What are the signs of Glomerulonephritis?

A

Hypertension
Proteinuria
Haematuria (especially in IgA nephropathy)
Renal failure

19
Q

What does Nephrotic Syndrome consist of?

A

A Triad:
Proteinuria > 3.5 g/24 hrs
Low serum albumin < 24 g/L
Oedema

20
Q

What is the consequence of Hypoalbuminaema?

A

The liver tries to compensate and increases production of lipids, causing hyperlipidaemia

21
Q

What investigations do you do for Glomerulonephritis?

A 
Bloods 
Urine 
Imaging 
Renal Biopsy
Investigations for associated conditions (e.g. HBV, HCV and HIV serology)
22
Q

What bloods do you do for Glomerulonephritis?

A 
FBC 
U&Es + creatinine 
LFTs (check albumin)
Lipid profile 
Complement studies 
Antibodies
23
Q

What antibodies do we check for Glomerulonephritis?

A 
ANA 
Anti-dsDNA
ANCA
Anti-GBM antibody
Cryoglobulins
24
Q

What do we look for in the Urine for Glomerulonephritis?

A

Microscopy - check for red cell casts

24 hr collection: creatinine clearance and protein

25
Q

What imaging do we do for Glomerulonephritis?

A

Renal tract US to exclude other pathology (e.g. obstruction)

26
Q

Why do we do a Renal Biopsy for Glomerulonephritis?

A

For microscopy

Renal & Urology (18 decks)

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