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Glomerulonephropathies Flashcards

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1
Q

Name two features of nephritic syndrome

A

hypertension, red cell casts on urine microscopy, haematuria

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2
Q

Name four features of nephrotic syndrome

A 
peripheral oedema
increased risk of infection
increased risk of VTE
hypoalbuminaemia
(hypoalbuminaemia, hyperlipidaemia, hypercoagluopathy)
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3
Q

Which glomerulonephritis are associated with crescent formation?

A

IgA nephropathy
Post-strep glomerulonephritis
Anti-glomerular basesment membrane disease

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4
Q

Which is the most common causes of nephrotic syndrome in children?

A

minimal change disease

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5
Q

Which glomerulonephritis is associated with cANCA/PR3 antibodies?

A

granulomatosis with polyangitis GPA

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6
Q

What is the triad of nephritic syndrome?

A

haematuria, hypertension, oedema, (mild proteinuria, decreased urine output)

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7
Q

What are the three presentations of glomerulonephritis?

A
  1. asymptomatic haematuria
  2. nephrotic syndrome
  3. nephritic syndrome
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8
Q

What are general causes of glomerulonephritis?

A 
IDA
Idiopathic
Immune
Infection
Drugs
Amyloid
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9
Q

Examples of immune causes of glomerulonephritis?

A

SLE, goodpastures/anti-GBM, vasculitis

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10
Q

Examples of infections?

A

HBV, HCV, strep, HIV

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11
Q

What are the three key features of nephritic syndrome?

A

HTN, haematuria, proteinuria

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12
Q

What are two causes of nephritic syndrome?

A
  1. Proliferative/post-strep
  2. Goodpasture’s
  3. IgA nephropathy
  4. Henoch Schonlein purpura
  5. Haemolytic anaemia
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13
Q

What is a typical presentation of post-strep nephritis?

A

young child develops malaise, smoky urine 1-2 weeks after sore throat or skin infection

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14
Q

What would biopsy show in post-strep?

A

IgG and C3 deposition

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15
Q

What are two types of cresentic nephritis/ rapidly progressive GN?

A

Anti-GBM (5%), immune complex deposition (45%), pauci syndrome (50%)

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16
Q

Two symptoms of anti-GBM?

A

haemoptysis and haematuria (alveolar and GBM haemorrhage)

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17
Q

Which condition is associated with Pauci immune?

A

systemic vasculitis

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18
Q

Name three systemic diseases that cause glomerulonephritis

A
  1. Diabetes
  2. SLE
  3. Myeloma
  4. Amyloidosis
  5. Sarcoidosis
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19
Q

What are the three features of nephrotic syndrome?

A

proteinuria, hypoalbuminaemia, oedema (PHO-soup)

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20
Q

Name three complications of nephrotic syndrome?

A
  1. infection (due to decreased Ig +complement activity)
  2. VTE
  3. Hyperlipidaemia
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21
Q

What are the features of GN screen?

A

ANCA, C3+ C4, immunoglobulins, hep B/C, urine bence jones

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22
Q

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

A

minimal change disease

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23
Q

Name three cause of nephrotic syndrome

A

minimal change disease
membranous nephropathy
focal segmental glomerulosclerosis

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24
Q

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

A

membranous nephropathy

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25
Q

Which feature on electron microscopy is observed in minimal change disease?

A

fusion of podocytes

26
Q

Which feature is seen on microscopy in IgA GN?

A

proliferation of mesangial cells

27
Q

Which antibody is present in 70% of membranous GN?

A

anti-PLA2R

28
Q

Which part of nephron is affected in membranous GN?

29
Q

Which condition is associated with IgA nephropathy?

A

Henoch schonlein purpura –> systemic IgA variant nephropathy

30
Q

Which other conditions is membranous nephropathy connected to?

A

secondary to cancer, infection (HBV), AI- SLE, thyroid disease

31
Q

What is the most important investigation for glomerulonephropathies?

32
Q

What is the general management for glomerulonephropathies?

A
  1. Monitor U+Es, BP, fluid balance, weight
  2. Treat underlying cause
  3. Oedema- salt and fluid restriction + furosemide
  4. Proteinuria- ACEi, ARB
  5. Statins (to reduce lipids in nephrotic syndrome)
  6. VTE prophylaxis
  7. BP control- antihypertensives
33
Q

How can nephrotic and nephritic syndrome be distinguished based on the concentration of protein in the urine?

A

> 3.5g/day nephrotic syndrome (nePROTic syndrome- lots of protein)

<3.5g/day nephritic syndrome

34
Q

Is diabetic glomerulonephropathy nephritic or nephrotic?

35
Q

What are the three components of the glomerular basement membrane?

A

podocytes, endothelial cells, basement membrane

36
Q

Which nephrotic syndrome is associated with sickle cell disease and HIV?

A

focal segmental glomerulosclerosis (therefore most common syndrome in african american and hispanic populations)

37
Q

Which disease is associated with kimmelstiel wilson nodules?

A

diabetic nephropathy (think of owen wilson + jimmy kimmel picture)

38
Q

Which protein does goodpasture syndrome affect?

A

Type IV collagen

39
Q

What is alport syndrome?

A

can’t see, can’t pee, can’t hear thee, nephritic syndrome. Basket weaving

40
Q

Which disease is likely to be overlapping with nephritic and nephrotic syndromes?

A

membranoproliferative glomerulonephritis

41
Q

Patient shows proteinuria on urinalysis. You suspect nephrotic syndrome. Name two lab tests that would confirm this diagnosis

A

Triglycerides- hyper
Albumin- hypo
Urine PCR

42
Q

Name 3 investigations prior to performing renal biopsy

A

USS
Coag screen
FBC U+Es
Group and save

43
Q

Name two complications of renal biopsy

A

haemorrhage
infection
damage to adjacent structures

44
Q

Name the two autoantibodies most commonly detected in SLE

A

ANA

anti dsDNA

45
Q

Name four criteria a patient must have in order to diagnose nephrotic syndrome

A
  1. Peripheral oedema
  2. Proetinuria
  3. Serum albuminaemia
  4. Hypercholesterolaemia
46
Q

Is there a set criteria for nephritic syndrome?

A

No…unlike nephrotic syndrome

47
Q

List three features of nephritic syndrome

A

haematuria
oligouria (reduced urine output)
proteinuria
fluid retention

48
Q

Level of protein to be classed as nephrotic syndrome?

A

> 3g/24 hr

49
Q

As a general rule, two treatment options for all glomerulonephropathies?

A
  1. Immunosuppresion- steroids
  2. Blood pressure control (ACEi +ARBs)

(3. most glomerular nephropathies are idopathic)

50
Q

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

A

membranous nepropathy

51
Q

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

A

minimal change disease

52
Q

What is the most common cause of primary glomuerlonephritis?

A

IgA nephropathy= Berger’s disease

53
Q

Histology of IgA nephropathy?

A

IgA deposits and glomerular mesangial proliferation

54
Q

Histology of membranous glomerulonephritis?

A

IgG and complement deposits on the basement membrane

55
Q

What is the most common glomerulonephritis overall?

A

membranous glomerulonephritis

56
Q

Patient presents with AKI and haemoptysis. Which glomerulonephritis are they likely to have?

A

Goodpasteure syndrome= anti-GBM disease (antibodies attack glomerulus and pulmonary basement membrane)

57
Q

Histology shows crescentic glomerulonephritis. What is the diagnosis?

A

rapidly progressive glomerulonephritis

58
Q

Synonym for IgA nephropathy?

A

Berger’s disease

59
Q

Name two autoantibodies most likely to present in SLE

A

ANA

Anti-DNA antibodies

60
Q

List two likely histological diagnosis on renal biopsy of a patient presenting with nephrotic syndrome

A

Glomerulonephritis

Membranous glomerulonephritis

Nephrology (8 decks)

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