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ICC3 > updated GN > Flashcards

updated GN Flashcards

1
Q

How do you differentiate between glomerulonephritis-associated hematuria and other causes of hematuria?

A

GN hematuria is associated with an abnormally shaped RBC
normal morphology in non-GN hematuria

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2
Q

What are the different presentations associated with glomerular disease?

A

asymptomaticc proteinuria
asymmptommatic hematuria
nephrotic syndrome
nephritic syndrome
RPGN
chronic GN

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3
Q

What type of injury is associated with nephritic vs. nephrotic?

A

nephrotic is associated with podocyte injury
nephritic is associated with sub-endothelial cell injury and GBM injury

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4
Q

What is characteristically found in RPGN?

A

crescent formation

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5
Q

what is the difference in urinary protein levels between nephritic and nephrotic ?

A

more than 3.5g in nephrotic
less than 3g in nephritic

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6
Q

what are the associated presentations/complications of nephrotic syndrome ?

A

hyperlipidemia
lipiduria
negative nitrogen balance ( muscle wasting )
hypercoagulability
infection
AKI

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7
Q

when are oval fat bodies found in the urine ?

A

in nephrotic syndrome

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8
Q

what type of AKI is associated with nephrotic ?

A

pre renal or ATN

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9
Q

what are the diseases that fall under nephrotic syndrome ?

A

MAD MF
Minimal change disease
Amyloidosis
Diabetic nephropathy
Membranous nephropathy
Focal segmental glomerulosclerosis

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10
Q

what are the diseases associated with nephritic syndrome ?

A

1- Acute diffuse proliferative GN :
acute post strept GN
lupus proliferative GN

2- IgA nephropathy
3- Alport Syndrome

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11
Q

which disease may present with both nephritic and nephrotic ?

A

membranoproliferative GN

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12
Q

what are the diseases associated with RPGN ?

A

Type 1 - good pastures syndrome
Type 2 - immune complex mediated GN
Type 3 - ANCA associated vasclitis

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13
Q

what is the other name for good pastures disease ?

A

anti glomerular basement membrane disease

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14
Q

what are the general supportive measures for each of these symptoms :
hypoproteinemia
proteinuria
edema
hypertension
hyperlipidemia
hypercoagulability
infection

A

hypoproteinemia - adequate protein intake

proteinuria - ACE or ARB

edema - loop diuretics and thiazide diuretics

hypertension- dietary salt restriction

hyperlipidemia - statins ezetimibe

hypercoagulability - prophylactic anticoag

infection - parental ab

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15
Q

what is the target blood pressure in patients with glomerular disease ?

A

below 130/80

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16
Q

what is the cause of post streptococcal GN ?

A

a type of acute nephritis
due to group A beta hemolytic streptococcal infection of the pharynx or the skin

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17
Q

which part of the glomeruli is affected in post streptococcal GN ?

A

subendothelial cells hence the hematuria

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18
Q

what is the presentation of acute post streptococcal GN ?

A

nephritic syndrome 1-4 weeks after a throat or skin streptococcal infection
usually occcurs in childhood

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19
Q

what is the specific investigation for post strep GN ?

A

ASOT ( anti streptolysin )

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20
Q

what is the treatment for post strep GN ?

A

general supportive treatment
if there is an ongoing infection give ab

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21
Q

what are the specific investigations associated with systemic lupus GN ?

A

anti dsDNA
anti smith
ANA

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22
Q

what is the treatment for SLE GN ?

A

immunosuppressive treatment

23
Q

what is the presentation of IgA nephropathy ?

A

recurrrent attacks of nephritic syndrome or macroscopicc hematuria 1-2 days after an URT or GIT infection

24
Q

what disease is associated with IgA nephropathy ?

A

celiac disease

25
Q

what is the specific investigation associated with IgA nephropathy ?

A

elevated serum IgA

26
Q

what is the treatment for IggA nephropathy ?

A

supportive +
immunosuppressive and ab if there is an ongoing infection

27
Q

what is the cause of alport syndrome ?

A

x linked hereditary glomerular disease

28
Q

what type of collagen is deficient in alports syndrome ?

A

type 4

29
Q

what is the clinical presentation of alports syndrome ?

A

nephritic syndrome
recurrent attacks of macroscopic hematuria
sensorineural deafness
ocular abnormalities

30
Q

what is the presentation of minimal change disease ?

A

nephrotic syndrome
more common in children

31
Q

what is the treatment of minimal change disease ?

A

1ry : corticosteroids
2ry : treat the cause

32
Q

what are the different causes associated with secondary FSGS ?

A

HIV
heroin
Obesity

33
Q

what is thee presentation of membranoproliferative GN ?

A

mixed nephritic and nephrotic

34
Q

what is the other namme for goood pastures disease ?

A

type 1 RPGN
or
Anti GBM membrane

35
Q

what is the clinical presentation associated with Goodpasture’s disease ?

A

pulmonary hge and hemoptysis

36
Q

what are the specificc antibodies associated with anti-GBM ?

A

anti GBM antibodies

37
Q

what is the treatment for goodpasteurs disease ?

A

immunosuppressive agents
plasma exchange

38
Q

what is the prognosis of acute poost streptococcal GN ?

A

self limmitng associated with full renal recovery

39
Q

what is thee prrognosis of minimal change disease ?

A

corticosteroids are usually useful in inducing remission but relapse is common

40
Q

what is the prognosis of alports syndrome ?

A

almost all cases prrogress to CCKD

41
Q

what is the prognosis of FSGS ?

A

almost all cases progress to CKD

42
Q

what is the prognosis of membranous nephropathy ?

A

1- 25% of cases are resistant to therapy and progress to CKD
2- 75% of cases enter remission

43
Q

what is the prognosis of lupus diffuse proliferative GN ?

A

outcomes are variable it depends

44
Q

what are the glomerular diseases associated with SLE ?

A

1- acute proliferative GN
2- membranous nephropathy
3- MPGN

45
Q

what are the glomerular diseases associated with HBV ?

A

membranous nephropathy
MPGN

46
Q

what aree the glomerular diseases associated with HCV ?

A

membranous nephropathy
MPGN

47
Q

what are the glomerular diseases associated with HIV ?

A

membranous nephropathy
FSGS

48
Q

what are the glomerular diseases associated with malignancy ?

A

membranous nephropathy

49
Q

what are the systemic diseases associated with minimal change disease ?

A

respiratory tract infection
Atopy
Hodgkin’s disease

50
Q

what are the drugs associated with causing secondary gloomerrular disease ?

A

NSAIDs
immunizations
Penicillamine
Pamidronate
Interferon
Heroin

51
Q

how can you differentiate between acute post streptococcal GN vs IgA nephropathy ?

A

post strep happens 1-4 weeks after a throat or skin infection whilst IgA nephropathy happens 1-2 days after an URT or GIT infection

52
Q

what are the diseases associated with membranoproliferative ?

A

HIV
HCV
HBV
SLE
plasma cell dyscrasias

53
Q

what is the prognosis of membranoproliferative ?

A

50% progress to CKD

54
Q

what is the prognosis of RPGN ?

A

renal function is rapidly lost

ICC3 (66 decks)

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