glomerulonephropathies

Question 1

What are glomerulonephropathies?

Answer 1

Glomerulonephropathies are a group of diseases that cause inflammation in the glomeruli, the filtering units of the kidneys.

Question 2

How are glomerular diseases broadly classified?

Answer 2

They are broadly classified into nephrotic syndrome and nephritic syndrome.

Question 3

What characterizes nephrotic syndrome?

Answer 3

Nephrotic syndrome is characterized by significant proteinuria (≥3.5 g/day), hypoalbuminaemia (serum albumin ≤30 g/L), and oedema.

Question 4

What characterizes nephritic syndrome?

Answer 4

Nephritic syndrome is characterized by haematuria (blood in urine), proteinuria, hypertension, and often reduced kidney function.

Question 5

What are common causes of nephrotic syndrome?

Answer 5

Common causes include minimal change disease, membranous glomerulopathy, and focal segmental glomerulosclerosis.

Question 6

What are common causes of nephritic syndrome?

Answer 6

Common causes include post-infectious glomerulonephritis, IgA nephropathy, and rapidly progressive glomerulonephritis.

Question 7

How does minimal change disease present clinically?

Answer 7

It often presents with nephrotic syndrome, especially in children, and typically responds well to corticosteroids.

Question 8

What is the typical presentation of IgA nephropathy?

Answer 8

IgA nephropathy commonly presents with episodes of macroscopic haematuria, often following upper respiratory tract infections.

Question 9

What is the significance of anti-glomerular basement membrane (GBM) antibodies?

Answer 9

The presence of anti-GBM antibodies is associated with Goodpasture syndrome, which can cause rapidly progressive glomerulonephritis.

Question 10

How is membranous glomerulopathy typically diagnosed?

Answer 10

Diagnosis is often made via renal biopsy, showing thickening of the glomerular basement membrane without significant cellular proliferation.

Question 11

What is the role of immunofluorescence in diagnosing glomerular diseases?

Answer 11

Immunofluorescence can detect the presence of immune deposits in the glomeruli, aiding in the diagnosis of specific glomerular diseases.

Question 12

How does focal segmental glomerulosclerosis (FSGS) present?

Answer 12

FSGS presents with proteinuria, which can be in the nephrotic range, and may lead to progressive kidney dysfunction.

Question 13

What is the typical treatment approach for minimal change disease?

Answer 13

Treatment usually involves corticosteroids, to which most patients respond favorably.

Question 14

How is post-infectious glomerulonephritis managed?

Answer 14

Management is primarily supportive, including blood pressure control and, if necessary, diuretics to manage oedema.

Question 15

What are crescents on renal biopsy indicative of?

Answer 15

Crescents on renal biopsy are indicative of severe glomerular injury and are commonly seen in rapidly progressive glomerulonephritis.

Question 16

How does diabetic nephropathy affect the glomeruli?

Answer 16

Diabetic nephropathy leads to glomerular basement membrane thickening and mesangial expansion, resulting in proteinuria and progressive kidney dysfunction.

Question 17

What is the significance of the nephrin protein in the glomerulus?

Answer 17

Nephrin is a key component of the slit diaphragm between podocytes; mutations can lead to congenital nephrotic syndrome.

Question 18

How does systemic lupus erythematosus (SLE) involve the glomeruli?

Answer 18

SLE can cause lupus nephritis, characterized by immune complex deposition in the glomeruli, leading to a range of glomerular diseases from mild to severe.

Question 19

What is the typical presentation of Alport syndrome?

Answer 19

Alport syndrome presents with haematuria, progressive renal failure, sensorineural hearing loss, and ocular abnormalities.

Question 20

How is membranoproliferative glomerulonephritis (MPGN) characterized?

Answer 20

MPGN is characterized by mesangial cell proliferation and capillary wall thickening, often leading to nephrotic or nephritic syndrome.

Question 21

What is the role of plasmapheresis in treating certain glomerular diseases?

Answer 21

Plasmapheresis can be used to remove pathogenic antibodies, such as in anti-GBM disease or ANCA-associated vasculitis.

Question 22

How does amyloidosis affect the glomeruli?

Answer 22

Amyloidosis leads to the deposition of amyloid proteins in the glomeruli, causing proteinuria and progressive renal dysfunction.

Question 23

What is the significance of the ANCA test in glomerular diseases?

Answer 23

A positive ANCA test is associated with certain types of vasculitis that can cause rapidly progressive glomerulonephritis.

Question 24

How does hypertension contribute to glomerular disease?

Answer 24

Hypertension can cause glomerulosclerosis, leading to proteinuria and chronic kidney disease.

Question 25

What is the typical management strategy for nephrotic syndrome?

Answer 25

Management includes addressing the underlying cause, controlling blood pressure, reducing proteinuria with ACE inhibitors or ARBs, managing oedema with diuretics, and preventing complications such as thrombosis and infection.