RENAL

Question 1

Nephritic syndrome signs ?

Answer 1

• hematuria , proteinuria
• RBC casts in urine
• HT
  -Oedema

Question 2

Nephrotic syndrome signs +

Answer 2

• LARGE PROTEINURIA
• no hematuria

Question 3

PSGN ?
when and features

Answer 3

2-4 WEEKS after strep group A
type 3 hypersensitivity
+ children IgG and IgM form immune complexes and deposit in membrane

+ C3 is low in blood
+ strep Is +
- IgG and IgM present
- starry sky appearance

resolves on its own

Question 4

IgA Nephropathy
Bergers

pathology and when ?
which antibody

Answer 4

Immune complexes of IGA
- In mesangium
- increase inflammation
+ straight after cold or GI infection

Question 5

henoch Schonlein Purpura

Answer 5

IgA vasculitis
can cause nephrotic or nephritic syndrome
+ colicky abdominal pain
+ skin lesions

Question 6

Membranoproliferative GN
Management and features

Answer 6

Autoimmune = SLE, due to MALIGNANCY , infections like hep b and c ,
>50% of both kidneys affected
+ thickened capillary wall

Management = Ace inhibitor or ARB

Question 7

Goodpasteurs disease
Anti -GBM

Answer 7

• inflammation of glomerulus
  break glomerular membrane
  type 1 = good pastures disease

LUNGS AND KIDENY
+ antibodies to type 4 collagen

Diagnosis :
+ IgG deposits on biopsy and antibodies to type 4 collagen
crescentic sign !

treatment is plasmapheresis and immunosuppression

Question 8

Granulomatosis with Polyangitis
Wegners

Answer 8

ELK
ENT , Lungs and kidney
C-ANCA +

SINUSES ARE AFFECTED MORE

Treatment :
If asymptomatic and no organ damage : Methotrexate
immunosuppression with cyclophosphamide

Question 9

Eosinophilic granulomatosis with polyangitis ( Churg strauss )

Answer 9

Late onset asthma , eosinophilia
multiple sites
P-ANCA
Treatment is steroids and cyclophosphamide

Question 10

Minimal change disease

Answer 10

• childhood
• IgM
  . FACE , feet and abdomen are swollen
  URTI
  foot fusion of the podocytes

Treatment : Corticosteriods

Question 11

focal segmental glomerulosclerosis

Answer 11

damage to the podocytes –> proteinuria
+ afro carribean people
IgM
+ HIV

treatment is with steroids

Question 12

Membranous Glomerulonephritis
( nephrotic )

Answer 12

most common nephrotic syndrome in adults

1) biopsy shows damage to the podocytes and foot projections
2)protein can get through = swelling
3)thickened basement membrane and
4) IgG

Associated with :
- cancers : lung , colon , breast
and infection

40% spontaneous remission