Glomerulonephritis - Nephrotic Syndrome & Nephritic Syndrome

Question 1

Criteria of Nephrotic Syndrome (4).

Answer 1

CAPO :-

1. C - HyperCholesterolaemia.
2. A - HypoAlbuminaemia.
3. P - Proteinuria (3g+ in 24 hours).
4. O - Peripheral Oedema.

Question 2

Commonest Causes of Nephrotic Syndrome in Kids and Adults (2).

Answer 2

1. Kids - Minimal Change Disease.

2. Adults - Focal Segmental Glomerulosclerosis.

Question 3

Risks of Nephrotic Syndrome (7).

Answer 3

Increased Risk of :

1. Thrombosis - DVT, PE, Renal Vein Thrombosis (loss of Antithrombin III, Protein C and Protein S and rise in Fibrinogen levels).
2. Hypertension.
3. High Cholesterol - ACS.
4. Loss of TBG lowers Total (but not free) Thyroxine Levels.
5. Chronic Kidney Disease.
6. Infection (Urinary Ig Loss).
7. Hypocalcaemia (Vitamin D and Binding Protein Loss in Urine).

Question 4

Exclusive Causes of Nephrotic Syndrome (5).

Answer 4

1. Minimal Change Disease.
2. Membranous Glomerulonephritis.
3. Focal Segmental Glomerulosclerosis.
4. Amyloidosis.
5. Diabetic Nephropathy.

Question 5

Pathophysiology of Nephrotic Syndrome (5).

Answer 5

1. Cytokines damage podocytes - fuse together and destroy charge of the glomerular basement membrane.
2. Increased permeability to plasma proteins (Albumin).
3. Marked Oedema (less oncotic pressure).
4. Fluid leaks out into interstitial.
5. Hepatic Compensation : increased synthesis of lipoproteins.

Question 6

Features of Nephritic Syndrome (4).

Answer 6

FHPRO :

1. F - Fluid Retention.
2. H - Haematuria.
3. Pr - Proteinuria (Less than 3g in 24 hours).
4. O - Oliguria.

Question 7

Exclusive Causes of Nephritic Syndrome (3).

Answer 7

1. Rapidly Progressive Glomerulonephritis.
2. IgA Nephropathy.
3. Alport Syndrome.

Question 8

Causes of Both Nephrotic Syndrome and Nephritic Syndrome (3).

Answer 8

1. Diffuse Proliferative Glomerulonephritis.
2. Membraneproliferative Glomerulonephritis.
3. Post-Streptococcal Glomerulonephritis.