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Year 4 > Glomerulonephritis > Flashcards

Glomerulonephritis Flashcards

1
Q

features of nephritic syndrome?

A

haematuria (can be microscopic or macroscopic)
oliguria
proteinuria (not as much as nephrotic so must be <3g)
fluid retention (can be central/peripheral/anywhere)

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2
Q

features of nephrotic syndrome?

A

peripheral oedema
proteinuria (3g or more in 24 hrs)
serum albumin <25g/L
hypercholesterolaemia

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3
Q

how are most types of glomerulonephritis treated?

A 
immunosuppression (eg steroids)
BP control (ACE inhibitors or ARBs)
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4
Q

what does nephrotic syndrome predispose to?

A

thrombosis
hypertension
high cholesterol

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5
Q

most common cause of nephrotic syndrome in children?

A

minimal change disease

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6
Q

what usually causes minimal change disease?

A

idiopathic

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7
Q

how is minimal change disease usually treated?

A

steroids

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8
Q

most common cause of nephrotic syndrome in adults?

A

focal segmental glomerulosclerosis

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9
Q

what is IgA nephropathy also known as?

A

bergers disease

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10
Q

most common cause of primary glomerulonephritis (not caused by another disease)?

A

IgA nephropathy

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11
Q

peak age of presentation of IgA nephropathy?

A

20s

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12
Q

what does histology show in IgA nephropathy?

A

IgA deposits

glomerular mesangial proliferation

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13
Q

most common glomerulonephritis overall?

A

membranous glomerulonephritis

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14
Q

peak incidence of membranous?

A

bimodal peak

in 20s and 60s

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15
Q

what does histology show in membranous?

A

IgG and complement deposits on basement membrane

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16
Q

what causes membranous?

A

70% are idiopathic

can be secondary to malignancy, rheumatic disorders and drugs (eg NSAIDs)

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17
Q

how does post-strep glomerulonephritis present?

A

patients usually under 30
1-3 weeks after strep infection (tonsillitis or impetigo)
develop nephritic syndrome
usually a full recovery

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18
Q

what happens in goodpastures syndrome?

A

anti GBM antibodies attach glomerulus and pulmonary basement membranes
this causes glomerulonephritis and pulmonary haemorrhage

19
Q

classic picture of goodpastures disease?

A

acute kidney failure and haemoptysis

20
Q

what will histology show in rapidly progressive glomerulonephritis?

A

crescentic glomerulonephritis

21
Q

how does rapidly progressive glomerulonephritis usually present?

A

very acute illness with sick patients

often secondary to goodpastures

22
Q

what is glomerulonephritis?

A

group of kidney diseases mainly characterised by inflammatory disease primarily affecting the glomeruli
can be primary or secondary to other systemic disorder such as diabetes

23
Q

how can glomerulonephritis present?

A

nephrotic or nephritic

24
Q

types of primary glomerulonephritis?

A 
membranous nephropathy
minimal change disease
focal segmental glomerulosclerosis
mesenagiocapillary (membranoproliferative)
IgA nephropathy
rapidly progressive glomerulonephritis
25
Q

which types of primary glomerulonephritis present with nephrotic syndrome?

A

membranous nephropathy
minimal change disease
focal segmental glomerulosclerosis
mesenagiocapillary (membranoproliferative)

26
Q

which types of primary glomerulonephritis present with nephritic syndrome?

A

IgA nephropathy

rapidly progressive glomerulonephritis

27
Q

types of rapidly progressive glomerulonephritis?

A

type 1 = anti-GBM disease
type 2 = immune complex (SLE, HSP, IgA)
type 3 = vasculitis

28
Q

main cause of glomerulonephritis in kids?

A

minimal change disease

29
Q

main cause of glomerulonephritis in adults in overall?

A

IgA nephropathy

30
Q

how do most glomerulonephritis develop?

A

result of immune dysregulation which can be due to inappropriate response to self antigen or foreign antigen

31
Q

diagnostic features of minimal change disease?

A

electron microscopy might show effacement of podocytes but light microscopy and immunofluorescence dont show any changes

32
Q

second most common cause of glomerulonephritis in adults?

A

membranous

33
Q

which type of glomerulonephritis can present nephrotic or nephritic?

A

mesangiocapillary (membranoproliferative)

34
Q

what cause mesangiocapillary (membranoproliferative) glomerulonephritis?

A

immune deposition in the glomerulus, thickening of basement membrane and activation of complement pathway leads to glomerular damage

35
Q

which type of glomerulonephritis is most associated with hep C?

A

mesangiocapillary (membranoproliferative)

36
Q

diagnostic features of IgA nephropathy?

A

IgA deposition seen in glomerulus

presents with haematuria 1-2 days after symptoms of a URTI

37
Q

how is glomerulonephritis diagnosed?

A 
urinalysis
routine bloods for renal function, clotting, LFTs, glucose and inflammatory markers
immuno-serological screen
imaging
renal biopsy
38
Q

how is urinalysis used in glomerulonephritis?

A

dipstick for urine anf blood
culture and cytology
microscopy can show dysmorphic red blood cells (low MCV) and casts

39
Q

types of serology screening in glomerulonephritis?

A 
ANCA
anti-GBM
ANA
anti-dsDNA
C3 and C4
HBV, HCV and HIV
serum immunoglobulins and urine electrophoresis (exclude myeloma)
40
Q

how is glomerulonephritis managed non pharmacologically?

A

lifestyle changes can help cases secondary to chronic disease (eg diabetes)
salt and water restriction

41
Q

how can glomerulonephritis be managed pharmacologically?

A

ACEi can decrease proteinuria and improve mortality
steroids reduce immunological factors and induce remission
diuretics help with oedema and BP control
statins help lipids
anticoagulation in nephrotic syndrome as it causes hypercoagulability
cyclophosphamide can be used in resistant cases (immune related)

42
Q

surgical management of glomerulonephritis?

A

renal transplant

43
Q

types of secondary glomerulonephritis that present nephrotic?

A

diabetes
SLE class 5-6
amylooid
hepatitis B/C

44
Q

what types of secondary glomerulonephritis present nephritic?

A

post-strep
SLE class 1-4
vasculitis (HSP, GPA)
goodpastures disease (anti-GBM)

Year 4 (83 decks)

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