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Urinary > Week 10 - Glomerular pathology > Flashcards

Week 10 - Glomerular pathology Flashcards

1
Q

What urine abnormality is dominant in nephritic syndrome?

A

-Haematuria

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2
Q

What urine abnormality is dominant in nephrotic syndrome?

A

-Proteinuria

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3
Q

Which group of glomerular pathology leads to hypoalbuminaemia?

A

-Nephrotic syndrome

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4
Q

Why do you get oedema in nephrotic syndrome?

A
  • Loss of albumin in the urine results in a decreased oncotic pressure in the capillaries
  • ECF which is pushed into the interstitium by hydrostatic pressure at the proximal capillary is not drawn back and oedema occurs
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5
Q

Why does hyperlipidaemia occur in nephrotic syndrome?

A
  • Due to hypoalbuminaemia
  • Liver tries to compensate by increasing protien production however there is a side effect of increasing lipid production
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6
Q

Which part of the glomerulus is affected in nephritic syndrome?

A

-Problems with epithelia

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7
Q

Which part of the glomerulus is affected in nephrotic syndrome?

A

-Podocyte damage

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8
Q

What are the 3 common primary causes of nephrotic syndrome?

A
  • Minimal change glomerulonephritis
  • Focal Segmental Glomerulosclerosis
  • Membranous glomerulonephritis
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9
Q

What is the most common secondary cause of nephrotic syndrome?

A

-Diabetes mellitus

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10
Q

When does minimal change glomerulonephritis present?

A
  • In childhood/adolescence

- Incidence decreases with age

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11
Q

What is the primary urine abnormality in minimal change glomerulonephritis?

A

-Proteinuria

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12
Q

Does minimal change glomerulonephritis progress to renal failure?

A

-Not usually

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13
Q

What is the cause of minimal change glomerulonephritis?

A

-Destruction of podocytes via an unknown mechanism

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14
Q

What are the differences between minimal change glomerulonephritis and focal segmental glomeruloslcerosis?

A
  • FGS occurs in adults
  • FGS is less responsive to setroids
  • FGS progresses to renal failure due to scarring
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15
Q

What is the cause of membranous glomerulonephritis?

A

-Immune complex formation which become caught in the filter and cause a thickened glomerular basement membrane

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16
Q

What is thought to be the cause of immune complex formation in membranous glomerulonephritis?

A

-Phospholipase on podocytes causing an autoimmune response by IgG

17
Q

What is the rule of 3rds in membranous glomerulonephritis?

A
  • 3rd patients remit
  • 3rd patients ill but stable
  • 3rd patients enter renal failure
18
Q

What is thought to be a secondary cause of membranous glomerulonephritis?

A

-Lymphoma

19
Q

How does diabetes mellitus lead to nephrotic syndrome?

A

-Microvascular damage leads to progressive proteinuria and progressive renal failure with mesangial sclerosis

20
Q

What is the most common cause of glomerulonephritis?

A

-IgA nephropathy

21
Q

Name 2 hereditary diseases which cause nephritic syndrome

A
  • Alport

- Thin glomerular basement membrane disease

22
Q

When does IgA nephropathy present?

A

-At any age

23
Q

How does IgA nephropathy present?

A

-Usually with macro/microscopic haematuria

24
Q

What is IgA nephropathy associated with mucosal infections?

A

-During infection there is an increased production of IgA which increases blockage in the glomerulus

25
Q

Does IgA nephropathy progress to renal failure?

A

-Significant portion

26
Q

What is the pathophysiology of IgA nephropathy?

A
  • IgA forms immune complexes which become deposited in the mesangium
  • Mesangial damage results in proliferation of mesangial cells and excessive matrix production
27
Q

Why does alports disease cause nephritic syndrome?

A

-Abnormal type 4 collagen in BM

28
Q

What clinical problem is associated with alports disease?

A

-Deafness

29
Q

Which hereditary nephritic syndrome progresses to renal failure?

A
  • Alports

- Thin basement membrane disease does not

30
Q

What is good-pasture syndrome? What is its cause? How is it treated?

A
  • Acute onset of severe nephritic syndrome which is rapidly progressive to renal failure (within 24 hours)
  • Caused by autoantibody to T4 collagen in glomerular BM
  • Treated with immunosuppressants and plasmophoresis if caught early
31
Q

What is vasculitis and how does it cause nephritic syndrome?

A

-Group of systemic disorders which are associated with ANCA causing rapid progressive glomerulonephritis

32
Q

What are the two types of pathology that can occur at the glomerulus?

A
  • The filter can block -> nephritic syndrome

- The filter can leak -> nephrotic syndrome

Urinary (21 decks)

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