Glomerulonepthritis Flashcards

1
Q

What are the 3 parts of the glomerular membrane?

A

Fenestrated endothelium
Basal Lamina
Foot processes of Podocytes

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2
Q

What are mesangial cells?

A

“tree-like” groups of cells that support capillaries in the glomerulus

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3
Q

Define glomerulonephritis?

A

Any disease of the glomerulonephritis, doesn’t have to be inflammatory

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4
Q

What are the 4 main presentations of glomerular disease?

A
  • Haematuria
  • Heavy Proteinuria
  • Slowly increasing proteinuria
  • Acute renal failure
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5
Q

What could cause haematuria?

A

Mainly:

  • UTI
  • UT Stone
  • UT tumour
  • Glomerulonephritis
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6
Q

4 Main causes of glomerulonephritis?

A

Cases with immunoglobulin deposition:

  • IgA Glomerulonephritis
  • Membranous Glomerulonephritis

Without immunoglobulin deposition:

  • Diabetic Glomerular disease
  • Crescentic Glomerulonephritis
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7
Q

Explain the pathology of IgA glomerulonephritis?

A

IgA gets stuck in the mesangium causing irritation which stimulates matrix and mesangium formation

This can lead to blood in the urine

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8
Q

Prognosis for IgA glomerulonephritis

A

Mostly self limiting

Some can progress so far they cause chronic renal failure

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9
Q

Explain the pathology of IgG glomerulonephritis?

A

IgG gets deposited between the basal lamina and podocytes causing thickening
It then activates complement C3 which punches holes in the filter, allowing albumin through –> Nephrotic syndrome

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10
Q

Prognosis for IgG glomerulonephritis?

A

25% reach chronic renal failure within 10 yrs

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11
Q

How does diabetic glomerular disease occur?

A

Glycalated molecules deposited in the basal lamina and mesangial matrix leading to a thick leaky basement membrane and compressed capillaries

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12
Q

What is a kimmelsteil-wilson lesion?

A

A nodule of mesangial matrix formed during Diabetic glomerular disease

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13
Q

Pathology of Crescentic Glomerulonephritis?

A

A number of conditions cause:
cellular proliferation and influx of macrophages, forming a crescent within the bowman’s space that crushes the glomerulus

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14
Q

What can cause crescentic glomerulonephritis?

A
  • Wegener’s Granulomatosis
  • Microscopic polyarteritis
  • Antiglomerular basement membrane disease
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15
Q

What is wegener’s granulomatosis?

A

A form of vasculitis in kidneys, nose and lungs.

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16
Q

How do you test for and treat wegener’s granulomatosis?

A

Serum ANCA (Anti-neutrophil cytoplasmic antibodies) test.

Treat with cyclophosphamide, untreated mean survival is 6 months

17
Q

What tests are relevant to glomerular disease?

A
  • urine cultures to rule out infection
  • Abdo US to rule out tumours/stones
  • Dipstic for haematuria
  • Clotting screen
  • Renal biopsy