[Uro/Renal] Glomerulonephritis

Question 1

what is glomerulonephritis (GN)?

Answer 1

inflammation and damage to the glomeruli of the kidney

Question 2

what are the features of GN?

Answer 2

proteinuria and haematuria

others:
- oedema
- anaemia
- HTN
- low UO

Question 3

what are the causes of GN?

Answer 3

inflammatory or immune-mediated

Question 4

what is the 1st line ix for GN?

Answer 4

urine dip for protein / blood

Question 5

what are other ix done for GN?

Answer 5

• basic blood tests (FBC, U+E, LFT, lipid profile)

- immunological profiling to look for vasculitic causes e.g. ANA, ANCA, anti-GBM antibodies

Question 6

what is the gold standard ix for GN?

Answer 6

renal biopsy (not done in all cases)

Question 7

what are most cases of GN amendable to?

Answer 7

oral steroid therapy +/- immunosuppressants

Question 8

in reality, GN is…?

Answer 8

a spectrum of disease with varying levels of haematuria and proteinuria

Question 9

what is the symptomatic triad for nephrotic syndrome (non-proliferative GN)?

Answer 9

Hypoalbuminaemia
Oedema
Proteinuria

Question 10

what are the other features of nephrotic syndrome (non-proliferative GN)?

Answer 10

• frothy urine
• recurrent infections
• thromboses
• SOB

Question 11

what is the symptomatic triad for nephritic syndrome (proliferative GN)?

Answer 11

Haematuria
Oedema
HTN

Question 12

what are the other features of nephritic syndrome (proliferative GN)?

Answer 12

• oedema (less than nephrotic)
• oliguria
• blurred vision
• proteinuria

Question 13

what are some examples under nephrotic syndrome?

Answer 13

• minimal change

- FSGS

Question 14

what are some examples under nephritic syndrome?

Answer 14

• Goodpasture’s
• post-streptococcal
• IgA nephropathy

Question 15

what are some examples that could fall under nephrotic or nephritic syndrome?

Answer 15

• MPGN

- SLE

Question 16

what is Henoch Schonlein Purpura (HSP)?

Answer 16

post-infective vasculitis occurring most often in children (90%); 2x boys than girls

Question 17

what is the triad of sx usually present in HSP?

Answer 17

1. purpuric rash
2. joint pain
3. abdominal pain

Question 18

what is a condition that is important to differentiate HSP from?

Answer 18

immune thrombocytopenic purpura (ITP)

Question 19

what is the prognosis for HSP?

Answer 19

most cases will resolve in time and only require analgesia but can progress to GN

Question 20

what must be done while children with HSP exhibit sx?

Answer 20

serial urine dips

Question 21

what is given if renal involvement develops in a child with HSP?

Answer 21

oral steroids to manage HSP into remission

Question 22

post-URTI with flank pain. dx?

Answer 22

IgA nephropathy

Question 23

dry cough, dry/red eyes, sinusitis, joint pain and nephritic syndrome. dx?

Answer 23

granulomatosis with polyangitis

Question 24

pulmonary haemorrhage, rapidly progressive GN and anti-GBM antibodies. dx?

Answer 24

Goodpasture’s syndrome