Nephritic syndromes/Proliferative glomerulonephritis

Question 1

What are the signs of nephritic syndrome?

Answer 1

• Haematuria (micro or macroscopic)
• oliguria
• proteinuria <3.5g/24hrs
• fluid retention

Question 2

What is the thing that differentiates nephritic syndrome from nephrotic syndrome?

Answer 2

Proteinuria:
Nephritic syndrome <3.5g/day
Nephrotic syndrome >3.5g/day

Question 3

When is post streptococcal glomerulonephritis most likely to occur?

Answer 3

1-3 weeks after a streptococcal grow A infection of the larynx or skin.

Question 4

Which type of hypersensitivity reaction is post strep GN?

Answer 4

Type III

- IgG and IgM deposits in between the basement membrane and podocytes

Question 5

Which age is post strep GN most common in?

Answer 5

children

Question 6

What are the investigation findings in post strep GN?

Answer 6

light microscopy - enlarged glomeruli
Immunology - IgG, IgM, C3
electron microscopy - sub-epithelial deposits

Question 7

What is the prognosis of post strep GN?

Answer 7

Children - resolves on its own.

Adults - can sometimes progress to renal failure.

Question 8

what is IgA nephropathy?

Answer 8

when the body produces abnormal IgA and the body thinks theyre forgein so produces IgM antibodies against them.

Question 9

Where do the IgA-IgM complexes deposit?

Answer 9

Int he mesangium (supporting cells of the bowman capsule)

Question 10

What is the most likely trigger of IgA nephropathy?

Answer 10

GI or respiratory infection.

Question 11

What are the findings of IgA nephropathy?

Answer 11

Light microscopy - mesangial cell proliferation
Immunofluorescence - immune complexes in mesangium
Electron microscopy - immune complexes in mesangium

Question 12

What is the peak age of presentation of IgA nephropathy?

Answer 12

20s

Question 13

What is the main cause of diffuse proliferative glomerulonephritis?

Answer 13

systemic lupus erythematosus

Question 14

How much of the kidney is involved in diffuse proliferative glomerulonephritis?

Answer 14

> 50% of glomeruli in both kidneys

Question 15

in diffuse proliferative glomerulonephritis, where do the immune complexes deposit?

Answer 15

in between the endothelium and glomerular basement membrane.

Question 16

what are the findings of diffuse proliferative glomerulonephritis?

Answer 16

Light microscopy - thickening of capillary wall
immunofluorescence - granular immune complexes
electron microscopy - sub endothelial immune complex

Question 17

What are the 3 types of type III hypersensitivity?

Answer 17

• diffuse proliferative glomerulonephritis
• IgA nephropathy
• post streptococcal glomerulonephritis

Question 18

what is membranoproliferative glomerulonephritis?

Answer 18

proliferation of the mesangial cells and endothelial cells.

Question 19

what are common causes of membranoproliferative glomerulonephritis?

Answer 19

Hep B and Hep C

Question 20

in membranoproliferative glomerulonephritis, where do the immune complexes deposit?

Answer 20

In between the endothelial cells and the glomerular basement membrane.

Question 21

in membranoproliferazive glomerulonephritis, what are the investigation findings?

Answer 21

Light microscopy - tram track

immunofluorescence - the glomeruli appear granular

Question 22

what is the main histology finding of rapidly progressive glomerulonephritis?

Answer 22

Crescentic GN - moon shape of glomeruli - made by fibrin

Question 23

what is the main cause of rapidly progressive glomerulonephritis?

Answer 23

good pasture syndrome

Question 24

what is rapidly progressive glomerulonephritis?

Answer 24

where the inflammation of the glomerulus is so severe that it causes breaking of the glomerular basement membrane and a rapid decline in kidney function in days to weeks.