Renal disease - glomerular

Question 1

true or false
majority of disorders associated with the glomerulus are immune origin - immune complex deposition

Answer 1

true

Question 2

describe damage that can occur to the glomerulus in glomerular disorders generally

Answer 2

• cellular proliferation: increased basement cells causing overlap and lack of filtration
• leukocyte infiltration
• thickening of glomerular basement membrane - pushed podocytes out of the way

Question 3

define sclerosis

Answer 3

glomerulus walled off by fibrin and scars leading to renal failure

Question 4

describe non immune glomerular damage

Answer 4

• chemicals
• electrical membrane charge changes
• deposition of amyloid material
• thickening from diabetic nephropathy

Question 5

define glomerulonephritis

Answer 5

sterile, inflammatory process that affects the glomerulus. Associated with blood, protein and casts in urine

Question 6

describe acute post strep GN

Answer 6

• immune complex deposition
• formation of ASO antibodies
• usually in children ALWAYS after strep infection

Question 7

describe rapidly progressive GN (RPGN)

Answer 7

• serious form of acute glomerular disease
• initiated by deposition of immune complex
• macrophage damage to glomerulus
• permanent damage
• Markeldy enhanced protein

Question 8

describe goodpastures syndrome

Answer 8

• follows viral respiratory infections
• autoAb against glomerular and alceolar basement membranes
• detectable in serum
• anti glomerular basement membrane antibody

Question 9

describe vasculitis

Answer 9

• inflammation of the blood vessels and may result in glomerular involvement

Question 10

describe Wegener’s granulomatosis

Answer 10

• vasculitis
• cases a granuloma producing inflammation of small blood vessels
• ANCA found in serum
• increased BUN and creatinine due to walled off glomerulus

Question 11

describe Henoch-Schonlein purpura

Answer 11

primarily in children
- follows upper respiratory infection
- red patches on skin
- platelets may be increased
- glomerulonephritis -> vasculitis

Question 12

list the main difference between membranous GN vs Membranoproliferative GN

Answer 12

• memranous: IgG complexes w/o mesangial cell involvment
• membranoproliferative: children w/ mesangial cell involvment

Question 13

describe membranous GN

Answer 13

• thickening of glomerular basement membrane from deposition of IgG immune complexes

Question 14

describe membranoproliferative GN

Answer 14

two kinds affecting children
1) thickening of walls in bowmans from increasing cellularity
2) dense deposits in glomerular basement membrane

Question 15

describe immunoglobin A nephropathy (Berger’s disease)

Answer 15

• most common cause of glomerular nephritis
• from mucosal infection or resp infection causing IgA deposition
• microscopic hematuria persists for >20 yrs
  - increased serum IgA

Question 16

name the most common cause of glomerular nephritis

Answer 16

IgA nephropathy (Berger’s)

Question 17

describe chronic glomerulonephritis

Answer 17

accumulation of damage from glomerular disorders leading to a chronic condition
- glomerulus is scared and has less functionality