Glomerulonephritis aetiologies n that

Question 1

Define nephritic syndrome?

Answer 1

Nephritisis a very generic term that means inflammation of the kidneys.

Question 2

What are the set criteria for nephritic syndrome?

Answer 2

There are no set criteria (unlike nephrotic syndrome)

Question 3

What are the symptoms of nephritic syndrome?

Answer 3

1 - Haematuria (micro- or macroscopic)
2 - Proteinuria (progressive)
3 - Oliguria (significant reduction in urine production)
4 - Fluid retention

Question 4

What are the criteria for nephrotic syndrome?

Answer 4

1 - Peripheral oedema
2 - Proteinuria (>3g/day)
3 - Hypoalbuminaemia
4 - Hypercholesterolaemia/lipidaemia

Question 5

What is glomerulonephritis?

Answer 5

Glomerulonephritisis an umbrella term applied to conditions that causeinflammation of or around the glomerulus.

Question 6

What are the two key parts of treating most conditions characterised as glomerulonephritis?

Answer 6

1) . Immunosuppression (E.g Steroids)

2) . Blocking the RAAS system (ACE Inhibitors and ARBs)

Question 7

How does nephrotic syndrome predispose people to thrombosis, DVT and PE?

Answer 7

Loss of AT-III (anti-thrombin III)

Question 8

What is the most common cause of nephrotic syndrome in children?

Answer 8

Minimal change disease

Question 9

What is the most common cause of nephrotic syndrome in adults?

Answer 9

Focal segment glomerulosclerosis

Question 10

Treatment for minimal change disease?

Answer 10

Steroids - Prednisolone

Question 11

Aetiology of minimal change disease?

Answer 11

Most are primary/idiopathic

Some are secondary:

• Drugs (NSAIDs, Lithium)
• Paraneoplastic (Haematological malignancy, usually Hodgkin’s Lymphoma)

Question 12

Aetiology of focal segment glomerulosclerosis?

Answer 12

Primary/idiopathic
      or
Secondary:
 - HIV
 - Heroin
 - lithium
 - Lymphoma
 - Any cause of reduced kidney mass
 - Kidney scarring due to another GN

Question 13

Synonym for IgA GLomerulonephritis?

Answer 13

Berger’s Disease

Question 14

Histological findings of IgA GN?

Answer 14

Histology shows “IgA deposits and glomerular mesangial proliferation”

Question 15

Most common cause of glomerular pathology and chronic kidney disease in the UK?

Answer 15

Diabetic nephropathy

Question 16

What is the the most common type of glomerulonephritis?

Answer 16

Membranous glomerulonephritis

Question 17

Explain the histological findings of membranous glomerulonephritis?

Answer 17

Histology shows “IgG and complement deposits on the basement membrane”

Question 18

Aetiology of membranous glomerulonephritis?

Answer 18

Primary/Idiopathic ~ 70%
Secondary:
 - Malignancies
 - Infection (Hep. B/C, Malaria, Strep)
 - Rheumatoids disease
 - Drugs (NSAIDs)

Question 19

Common sights of malignancies in malignant aetiology Secondary Membranous Glomerulonephritis? (5)

Answer 19

• Lung
• Breast
• GI
• Prostate
• Haemitological malignancies

Question 20

What is post-streptococcal glomerulonephritis also called?

Answer 20

Diffuse proliferative glomerulonephritis

Question 21

What is post-streptococcal glomerulonephritis?

Answer 21

Occurring 1 - 3 weeks after a streptococcal infection (throat or impetigo)

Develop nephritic syndrome

Usually a full recovery

Question 22

Synonym for “Goodpasture” syndrome?

Answer 22

Anti-GBM antibodies - (GBM = Glomerular basement membrane

Question 23

What is Goodpasture syndrome

Answer 23

Rare, auto-antibodies developed into Type IV collagen - this is found only within the glomerular and alveolar basement membrane

Question 24

A typical presentation of Goodpasture disease?

Answer 24

1 - Haemturia (Nephritic syndrome)

2 - Haemoptysis

Question 25

Histological findings in Rapidly Progressive GN (RPGN)?

Answer 25

Crescentic glomerulonephritis

Question 26

How does RPGN present?

Answer 26

• It presents with a very acute illness with sick patients but it responds well to treatment

Question 27

3 most common aetiologies of RPGN?

Answer 27

1 - Goodpasture syndrome (most common)
2 - Granulomatous with polyangiitis (Wegener’s Disease)
3 - Systemic lupus erythematosus

Question 28

What are “Kimelsteil-Wilson” lesions?

Answer 28

Nodule of mesangial matrix found in diabetic nephropathy