Renal

Question 1

Nephrotic syndrome symptoms (triad)

Answer 1

1) Proteinuria
2) Hypoalbuminaemia
3) Oedema

Question 2

Other associations with nephrotic syndrome and why

Answer 2

• Hypercholerterolaemia - - Increased risk of VTE (renal loss of antithrombin3/protein C/protein S)
• Increased risk of infections (loss ofimmunoglobulins in urine)

Question 3

3 categories of causes of nephrotic syndrome

Answer 3

1) Glomerulonephritis
2) Systemic disease: SLE, amyloiidosis
3) Drugs: gold, penicillimine

Question 4

3 glomerularnephritis causes of nephrotic syndrome

Answer 4

1) Membranous glomerulonephritis
2) Minimal change glomerulonephritis
3) Focal segmental glomerularsclerosis

Question 5

Membranous glomerulonephritis causes

Answer 5

1) Infection: hep B, malaria
2) Malignancy
3) Antiphospholipase A2 antibodies

Question 6

What is the commonest cause of glomerulonephritis in adults?

Answer 6

Membranous glomerulonephritis

Question 7

What is the commonest cause of glomerulonephritis in children?

Answer 7

Minimal change glomerulonephritis

Question 8

Biopsy findings in membranous glomerulonephritis

Answer 8

• Spike and dome
• Thckened basement membrane
• Dense electron deposits (IgG, C3)

Question 9

Membranous glomerulonephritis treatment

Answer 9

ACEi/ARB
Steroids
Cyclophasphamide

Question 10

What cancer, infection and drugs can cause minimal change glomerulonephritis?

Answer 10

1) Idiopathic
2) Hodkins lymphoma
3) EBV
4) Drugs - NSAIDS

Question 11

What is the biopsy finding in minimal change glomerulonephritis?

Answer 11

Normal glomerulus
Podocyte fusion

Question 12

What is the pathophysiology behind minimal change glomerulonephritis

Answer 12

T cell damage to glomerular basement membrane causing anion loss and albumin leaking through membrane causing oedema

Question 13

Treatment of minimal change glomerulonephritis

Answer 13

Steroids (80% respond)
Cyclophosphamide

Question 14

Causes of focal segmental glomerulonephritis (3)

Answer 14

1) HIV
2) Heroin
2) Alport syndrome

Question 15

Symptoms of nephritic syndrome

Answer 15

1) Hypertension
2) Haematuria
3) Proteinuria

Question 16

Renal causes of nephritic syndrome

Answer 16

1) IgA nephropathy
2) Rapidly progressive (crescentic) glomerulonephritis

Question 17

Systemic causes of nephritic syndrome

Answer 17

1) SLE
2) Hep C
3) Endocarditis
4) Post streptococcal glomerulonephritis

Question 18

How long post URTI does post streptococcal glomerulonephritis occur?

Answer 18

1 - 2 weeks

Question 19

What is the classic presentation of IgA nephropathy?

Answer 19

Young adult with macroscopic haematuria 1 - 2 days after an URTI
Nephritic syndrome

Question 20

Associations with IgA nephropathy (4)

Answer 20

HSP
Coeliac
Liver cirrhosis
Dermatitis herpatiforms

Question 21

Biopsy findings in IgA nephropathy

Answer 21

mesangial hypercellularity with IgA and C3

Question 22

Presentation of rapidly progressive (crescenteric) glomerulonephritis

Answer 22

Nephritic syndrome
Haematuria with red cell casts
HTN
Oliguria
Acute renal failure

Question 23

Associations with rapidly progressive glomerulonephritis

Answer 23

Goodpastures syndrome
ANCA +ve vasculitis

Question 24

Glomerulonephritis that causes mixed nephritic and nephrotic syndrome (2)

Answer 24

1) Membranous proliferative glomerulonephritis
2) Diffuse proliferative glomerulonephritis