updated GN Flashcards
How do you differentiate between glomerulonephritis-associated hematuria and other causes of hematuria?
GN hematuria is associated with an abnormally shaped RBC
normal morphology in non-GN hematuria
What are the different presentations associated with glomerular disease?
asymptomaticc proteinuria
asymmptommatic hematuria
nephrotic syndrome
nephritic syndrome
RPGN
chronic GN
What type of injury is associated with nephritic vs. nephrotic?
nephrotic is associated with podocyte injury
nephritic is associated with sub-endothelial cell injury and GBM injury
What is characteristically found in RPGN?
crescent formation
what is the difference in urinary protein levels between nephritic and nephrotic ?
more than 3.5g in nephrotic
less than 3g in nephritic
what are the associated presentations/complications of nephrotic syndrome ?
hyperlipidemia
lipiduria
negative nitrogen balance ( muscle wasting )
hypercoagulability
infection
AKI
when are oval fat bodies found in the urine ?
in nephrotic syndrome
what type of AKI is associated with nephrotic ?
pre renal or ATN
what are the diseases that fall under nephrotic syndrome ?
MAD MF
Minimal change disease
Amyloidosis
Diabetic nephropathy
Membranous nephropathy
Focal segmental glomerulosclerosis
what are the diseases associated with nephritic syndrome ?
1- Acute diffuse proliferative GN :
acute post strept GN
lupus proliferative GN
2- IgA nephropathy
3- Alport Syndrome
which disease may present with both nephritic and nephrotic ?
membranoproliferative GN
what are the diseases associated with RPGN ?
Type 1 - good pastures syndrome
Type 2 - immune complex mediated GN
Type 3 - ANCA associated vasclitis
what is the other name for good pastures disease ?
anti glomerular basement membrane disease
what are the general supportive measures for each of these symptoms :
hypoproteinemia
proteinuria
edema
hypertension
hyperlipidemia
hypercoagulability
infection
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
what is the target blood pressure in patients with glomerular disease ?
below 130/80
what is the cause of post streptococcal GN ?
a type of acute nephritis
due to group A beta hemolytic streptococcal infection of the pharynx or the skin
which part of the glomeruli is affected in post streptococcal GN ?
subendothelial cells hence the hematuria
what is the presentation of acute post streptococcal GN ?
nephritic syndrome 1-4 weeks after a throat or skin streptococcal infection
usually occcurs in childhood
what is the specific investigation for post strep GN ?
ASOT ( anti streptolysin )
what is the treatment for post strep GN ?
general supportive treatment
if there is an ongoing infection give ab
what are the specific investigations associated with systemic lupus GN ?
anti dsDNA
anti smith
ANA
what is the treatment for SLE GN ?
immunosuppressive treatment
what is the presentation of IgA nephropathy ?
recurrrent attacks of nephritic syndrome or macroscopicc hematuria 1-2 days after an URT or GIT infection
what disease is associated with IgA nephropathy ?
celiac disease
