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ICC3 > immunology of the kidney > Flashcards

immunology of the kidney Flashcards

1
Q

what are the functions of the mesangial cells ?

A 
contractile 
phagocytic 
proliferating 
laying down collagen 
secreting mediators
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2
Q

what are the mechanisms in which glomerular injury happens ?

A

immunologically mediated :
in situ immune complex
circulating immune complex
other mechanisms of glomerular injury

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3
Q

what are the diseases associated with in situ immune complex deposition ?

A
  1. anti-glomerular basement membrane nephritis
  2. membranous glomerulonephritis
  3. antibodies against planted non-glomerular antigen
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4
Q

what is the pathogenesis in anti glomerular BM nephritis ?

A

antibodies are directed against BM

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5
Q

what is the immunofluroscense pattern in AGBM ?

A

linear diffuse pattern

binds along the entire length

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6
Q

what syndrome is commonly associated with AGBM ?

A

Goodpasture syndrome , which affects the lungs

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7
Q

what is the pathogenesis in membranous GN N?

A

antibodies reacting with an antigen located on basal surface of epithelial cells

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8
Q

what do antibodies in membranous GN cross-react with ?

A

proximal tubules brush surface antigens

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9
Q

what is the immunofluroscense patter in membranous GN ?

A

diffuse , granular deposits

due to sub epithelial deposits

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10
Q

what is the pathogenesis in Ab against planted non-glomerular antigen ?

A

cationic ions bind to anionic sites

viral or bacterial products

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11
Q

what is the immunofluorescence pattern in ab against planted non-glomerular ?

A

granular heterogenous pattern

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12
Q

what is the mechanism of injury in circulating immune complexes ?

A

a type 3 hypersensitivity reaction

where an Ab-Ag complex is trapped within the glomeruli allowing for the activation of complement

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13
Q

what is the immunofluorescence pattern in circulating immune complexes ?

A

dense granular deposits

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14
Q

what is the fate of circulating immune complexes ?

A 
single attack ( eg: post streptococcal )
showers of antigen ( e.g SLE, HBV )
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15
Q

what type of injury is seen in minimal change disease ?

A

epithelial cell injury

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16
Q

what does the morphological picture of glomerular injury reveal ?

A

hypercellularity
BM thickening
hyalinisation and sclerosis
other additional alterations

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17
Q

what is an example of hypercellularity ?

A

acute diffuse GN

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18
Q

what are the different clinical presentations of glomerular injury ?

A

nephritic syndrome
nephrotic syndrome
chronic GN
asymptomatic heamturia and proteinuria

19
Q

what are the primary and secondary GN that present with nephrotic syndrome ?

A 
minimal change nephrotic 
membranous nephropathy 
focal segmental glomerulosclerosis 
diabetic nephropathy 
renal amyloidosis
20
Q

what are the primary and secondary GN that present with nephritic syndrome ?

A 
IgA nephropathy 
anti-glomerular BMD 
thin BM nephropathy 
Lupus nephritis 
membranous proliferative GN 
post streptococcal GN
21
Q

what is the other name for post streptococcal GN ?

A

acute proliferative GN

22
Q

what is the most characteristic feature in the history of a post streptococcal patient ?

A

attack of streptococcal pharyngitis

23
Q

what type of casts would we find with acute proliferative GN ?

A

red cell casts

24
Q

what does the immunofluorescence of acute proliferative GN look like ?

A

diffuse granular deposits og IgG IgM and C

25
Q

what are the types of cresenteric or rapidly progressive GN ?

A

type 1 - linear deposits
type 2 - immune complex
type 3 - pauci-immune

26
Q

what is the presentation of RPGN ?

A

nephritic syndrome

27
Q

what is the other name for minimal change disease ?

A

lipid nephrosis

28
Q

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

A

Minimal change disease

29
Q

what are the events that may come before the onset of minimal change disease ?

A

respiratory tract infection
immunization
in association with atopy ( genetic tendency to develop allergic diseases)

30
Q

which disease in adults is associated with minimal change disease ?

A

Hodgkin’s disease or NSAIDs therapy

31
Q

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

A

membranous GN

32
Q

why does focal segmental GN present with nephrotic syndrome ?

A

due to effacement of podocytes and escape of proteins

33
Q

what is the immunofluroscense like in focal segmental glomerulosclerosis ?

A

IgM and C3

34
Q

which glomerular lesions will present with a mixture of nephritic and nephrotic syndrome ?

A

lupus nephritis
Ig A nephropathy
membrenoproliferative nephritis
Henoch-Schonlein purpra

35
Q

what is the other name for IgA nephropathy ?

A

Berger’s disease

36
Q

what is the most common clinical presentation of IgA nephropathy ?

A

a young child experiencing an episode of gross hematuria that occurs within 1 or 2 days of a non-specific URTI

37
Q

what is the hallmark of Bergers disease ?

A

deposition of IgA in the mesangium

38
Q

when are fatty casts seen ?

A

as a complication of nephrotic syndrome

39
Q

when are granular casts seen?

A

non specific

40
Q

when are RBC casts seen ?

A

disease affecting the glomerulus

41
Q

when are epithelial cell casts seen ?

A

tubular injury

42
Q

when are WBC seen ?

A

interstitial nephritis
pyelonephritis
parenchymal infection

43
Q

when are waxy casts seen ?

A

chronic kidney failure

ICC3 (66 decks)

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