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Y4R3 - Medicine II 🩺 > L3: Glomerulonephritis - Intro > Flashcards

L3: Glomerulonephritis - Intro Flashcards

1
Q

Def of Glomerulonephritis

A

Glomerular injury and/or inflammation (mainly immune mediated).

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2
Q

Terminology of Glomerulonephritis

A
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3
Q

Terminology of Glomerulonephritis

  • Primary Vs Secondary
A

Primary: Kidney disease specifically affecting the glomeruli

Secondary: The glomeruli are affected in the context of a systemic disease (e.g., SLE)

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4
Q

Terminology of Glomerulonephritis

  • Diffuse Vs Focal
A

DIFFUSE ▪ > 50% of glomeruli affected
FOCAL ▪ < 50% of glomeruli affected

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5
Q

Terminology of Glomerulonephritis

  • Global Vs Segmental
A

GLOBAL ▪ Entire glomerulus is affected

SEGMENTAL ▪ Only part of the glomerulus is affected

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6
Q

Terminology of Glomerulonephritis

  • Sclerosing Vs Necrotizing
A

SCLEROSING ▪ Scaring of the glomerulus

NECROTIZING ▪ Tissue damage/death within the glomerulus

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7
Q

Terminology of Glomerulonephritis

  • Proleferative Vs Membranous Vs Cresentric
A
  • PROLIFERATIVE
    ▪ Increased proliferation of glomerular cells
  • MEMBRANOUS
    ▪ Thickening of the glomerular basement membrane
  • CRESCENTIC
    ▪ Crescentic shaped accumulation of cells in the bowman’s space denoting severe inflammation and damage.
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8
Q

Etiology of Glomerulonephritis

A
  • Primary
  • Secondary
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9
Q

Etiology of Glomerulonephritis

  • Primary
A

① Idiopathic

② Hereditary (e.g., Alport’s syndrome - Fabry’s disease - Thin BM disease).

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10
Q

Etiology of Glomerulonephritis

  • Secondary
A
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11
Q

Secondary Causes of Glomerulonephritis

A
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12
Q

Secondary Causes of Glomerulonephritis

  • Infections
A

Bacteria:
▪ PSGN
▪ Endocarditis

Viruses:
▪ HCV
▪ HBV
▪ HIV

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13
Q

Secondary Causes of Glomerulonephritis

  • Immune
A

◈ SLE
◈ ANCA vasculitis
◈ GPS
◈ HSP

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14
Q

Secondary Causes of Glomerulonephritis

  • Metabolic
A

DM

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15
Q

Secondary Causes of Glomerulonephritis

  • Malignancy
A

◈ Lymphoma
◈ Multiple myeloma

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16
Q

Secondary Causes of Glomerulonephritis

  • Drus / Toxins
A

◈ NSAIDs
◈ Heroin

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17
Q

Secondary Causes of Glomerulonephritis

  • Thrombotic Microangiopathy
A

◈ HUS
◈ TTP

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18
Q

Pathophysiology of Glomerulonephritis

A
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19
Q

Pathophysiology of Glomerulonephritis

  • Compostition of Filtration Barrier
A
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20
Q

Compostition of Filtration Barrier

  • Capillary endothelium
A
  • Fenestrated glomerular capillary endothelium prevents large proteins from passing through.
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21
Q

Compostition of Filtration Barrier

  • GBM
A
  • Glomerular Basement Membrane contains a negative charge produced by heparan sulfate.
22
Q

Compostition of Filtration Barrier

  • Visceral Epithelial Cells
A
  • Produce/maintain the GBM and contain intercellular junctions created by podocytes that prevent further protein loss.
23
Q

Damage to the glomeruli → …..

A
  • disruption of the glomerular filtration barrier → can lead to nephritic or nephrotic syndrome.
24
Q

CP of Glomerular Diseases

A

① Asymptomatic
② Macroscopic hematuria
③ Nephrotic syndrome
④ Nephritic syndrome
⑤ Rapidly progressive glomerulonephritis
⑥ Chronic glomerulonephritis

25
Q

Pathology of Glomerular Diseases

A
26
Q

Underlying Pathology in Nephrotic Syndrome

A

① Minimal change disease
② Focal segmental glomerulosclerosis
③ Membranous nephropathy

27
Q

Underlying Pathology in Nephritic Syndrome

A

① Mesangio-proliferative GN
② Diffuse proliferative GN

28
Q

Underlying Pathology in Nephritic OR Nephritic syndrome

A

Membranoproliferative glomerulonephritis

MPGN

29
Q

Epidemeology of Minimal Change Disease

A

MCD is the most common cause of nephrotic syndrome in children.

30
Q

Etiology of Minimal Change Disease

A
31
Q

Pathology in Minimal Change Disease

A
32
Q

Presentation of Minimal Change Disease

A

Usually nephrotic syndrome.

33
Q

TTT of Minimal Change Disease

A

① Corticosteroids are the treatment of choice.

② Treatment of the cause if present.

34
Q

Prognosis of Minimal Change Disease

A
  • Higher rate of remission after steroid treatment, with better long-term kidney outcomes.
35
Q

Etiology of FSGS

A
36
Q

Pathology in FSGS

A
37
Q

Presentation of FSGS

A

① Hematuria
② Hypertension
③ Any level of proteinuria
④ Renal insufficiency.

38
Q

TTT of FSGS

A

① Treatment of the cause.

② BP control with ACEIs/ARBs & salt restriction.

③ Corticosteroids/immunosuppressives.

39
Q

Etiology of Membranous Glomerulonephritis

A
40
Q

Pathology in Membranous Glomerulonephritis

A
41
Q

Presentation of Membranous Glomerulonephritis

A

Nephrotic syndrome.

42
Q

INVx for Membranous Glomerulonephritis

A

① Investigations for nephrotic syndrome diagnosis (see later)

② Investigations for secondary causes (e.g., SLE)

③ Anti-PLA2R antibodies in primary form.

43
Q

TTT of Membranous Glomerulonephritis

A

① Treatment of the cause.
② BP control with ACEIs/ARBs.
③ Corticosteroids + immunosuppressives.

44
Q

Etiology of MPGN

A
45
Q

Etiology of MPGN

  • Immunocomplex mediated
A

associated with:
1) Chronic infections (e.g., HCV - HBV - SBE).
2) Autoimmune diseases (e.g., SLE - RA).
3) Monoclonal gammopathies (e.g., Multiple myeloma).

46
Q

Etiology of MPGN

  • Complement mediated
A

dysregulation in the complement pathway

47
Q

Etiology of MPGN

  • MPGN without immunocomplex or complement.
A

….

48
Q

Pathology of MPGN

A
49
Q

Presentation of MPGN

A

① Nephrotic syndrome
② Nephritic syndrome
③ Nephritic-nephrotic.

50
Q

Done

A

…..

Y4R3 - Medicine II 🩺 (35 decks)

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