Path II-Glomerulonephritis

Question 1

T/F: Glomerular pathology is usually of inflammatory nature.

Answer 1

True

recall that not all glomeruli diseases are inflammatory

Question 2

Why was glomerulonephritis properly termed Glomerular disease or glomerulopathy recently?

Answer 2

Because not all glomerular disorders are of an inflammatory nature.

Question 3

This category of glomerular disease develops in the kidney, as the kidney is the primary target.

Answer 3

Primary glomerular disease

Question 4

Category of glomerular disease that results from systemic disease that affects the kidney.

Answer 4

Secondary glomerular disease

Question 5

What is the structure of the glomerulus?

Answer 5

Afferent arterioles —> capillaries (filter blood) —> efferent arterioles

Question 6

What are the name of the cells that surround the afferent arterioles?

Answer 6

Juxtaglomerular cells

Question 7

What is the hormone produced by the juxtaglomerular cells?

Answer 7

Renin

Question 8

What accounts for filtration in the glomeruli?

Answer 8

Hydrostatic pressure

Question 9

If BP drops <50mmHg, there is not enough pressure for filtration.

What is the regulation of blood pressure dependent on?

Answer 9

Afferent arteriole

Question 10

Inner structure of glomerular capillaries:

Cells with fenestration that promote filtration of blood and release of toxins.

Answer 10

Endothelial cells w/ fenestration

Question 11

Inner structure of glomerular capillaries:

Layer of glomerular capillary where the endothelial cells lie on.

Foundation of the capillary

Answer 11

Glomerular basement membrane

Question 12

Inner structure of glomerular capillaries:

Layer that covers the glomerular basement membrane from outside.

Answer 12

Visceral Epithelial cells AKA Podocytes

Question 13

Inner structure of glomerular capillaries:

The structure of podocytes contains?

Answer 13

1. Foot processes call Pedicels or pedicles

2. Filtration slits

Question 14

Inner structure of glomerular capillaries:

Layer of glomerular capillary that covers the inner surface of Bowman’s capsule.

Answer 14

Parietal epithelial cells

Question 15

Order of layers on glomeruli capillaries

Answer 15

Endothelial cells with fenestration

Glomerular basement membrane

Visceral epithelial cells AKA Podocytes

Parietal epithelial cells

Question 16

What is the name of the cell the fills the space between the tufts of the glomerular capillaries?

Answer 16

Mesangial cells

Question 17

Function of mesangial cell that helps hold glomerulus together.

Answer 17

Contractility

Question 18

Function of mesangial cells that is responsible for replacing lost tissue, ultimately healing.

Answer 18

Proliferation

Question 19

Function of the mesangial cells that leads to the stimulation of hematopoiesis.

Answer 19

Produce erythropoietin

Question 20

3 types of the glomerulonephritis:

Type of glomerulonephritis that corresponds to type 3 hypersensitivity rxn/immune complex mediated type.

Answer 20

Circulating immune complex deposition glomerulonephritis

Question 21

3 types of the glomerulonephritis:

Explain what happens with type 3 hypersensitivity rxn/ immune complex mediated type.

Answer 21

Intruder —>
Ab made, enters blood —>
Ag + Ab = Immune complex —>
IC in blood binds to BV wall —>
IC attracts phagocytes which digest IC—>
If in free flow IC is digested and when bound to BV wall, IC harder to digest because entire BV can’t be digested —>
Phagocytes then send out proteolytic enzymes —>
BV wall is damaged and development of inflammation = vasculitis

Question 22

3 types of the glomerulonephritis:

In the case of CICDG, does it correspond w/ immune complex mediated hypersensitivity?

Answer 22

The IC are deposited in between endothelial cells and basement membrane.

They attach to BV wall and attract phagocytes.

The phagocytes secrete proteolytic enzymes that destroy the BV wall and IC, leading to VASCULITIS

Question 23

3 types of the glomerulonephritis:

Term for IC deposits in between the endothelial cells and basement membrane.

Answer 23

Subendothelial deposits

Question 24

3 types of the glomerulonephritis:

Type of glomerulonephritis where the Ab of the glomerular basement membrane are regarded as non-self Ab.

Answer 24

Anti-GBM glomerulonephritis

Question 25

3 types of the glomerulonephritis:

Anti-GBM glomerulonephritis corresponds with which hypersensitivity rxn

Answer 25

Type two/ Ab-dependent

Subtype=complement dependent

Question 26

3 types of the glomerulonephritis:

What is the difference between the immune complex mediated/type 3 and Ab-dependent/type 2 hypersensitivity rxn?

Answer 26

Immune complex mediate: IC is made outside glomeruli then deposited into the subendothelial space

Ab-dependent: Ag is already a part of fixed tissue not in blood circulation. Ab have to go to the tissue for form IC.

Question 27

3 types of the glomerulonephritis:

Type 2/Ab-dependent & 3/immune complex mediated hypersensitivity rxn results in frustrated phagocytosis, explain what the entails.

Answer 27

Frustrated phagocytosis involves damage of entire wall of the glomerulus, it is not a specific attack on the intruder.

This occurs because the Ag is attached to the BV wall

Question 28

3 types of the glomerulonephritis:

What are the two components of heymann’s glomerulonephritis

Answer 28

1. Autoregression against Ag of podocytes

2. “Trash” of blood hides in between podocytes and GBM. IC finds them.

Question 29

3 types of the glomerulonephritis:

Which type of hypersensitivity rxn does Heymann’s glomerulonephritis correspond with?

Answer 29

No specific type

Question 30

3 types of the glomerulonephritis:

The deposits of Heymann’s glomerulonephritis are known as (subendothelial/subepithelial) deposits

Answer 30

Subepithelial deposits

Question 31

Permeability of glomerular capillaries:

What is the permeability of the glomeruli to water, blood cells and proteins?

Answer 31

Water= completely permeable

Proteins & Blood cells = No permeability at all