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Stage 4: CSIM 2 > Week 11: Glomerulonephritis > Flashcards

Week 11: Glomerulonephritis Flashcards

1
Q

5 types of glomerulonephritis associated with nephritic syndrome due to: infections

A
  1. Post-strep glomerulonephritis
  2. Non-strep post infectious (eg Hep B/C, malaria)
  3. Infective endocarditis
  4. Shunt nephritis
  5. Visceral abscesses
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2
Q

2 types of glomerulonephritis associated with nephritic syndrome due to: autoimmune conditions

A
  1. Goodpasture’s

2. HSP

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3
Q

4 types of primary glomerular disease which cause nephrotic syndrome

A
  1. Minimal change glomerular disease
  2. Membranous nephropathy
  3. Focal segmental glomerulosclerosis
  4. Congenital nephrotic syndrome
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4
Q

2 secondary causes of nephrotic syndrome

A
  1. Amyloidosis

2. Diabetic nephropathy

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5
Q

Differentiate the following terms in glomerular disease:

  1. Focal vs Diffuse
  2. Segmental vs Global
A

NUMBER OF GLOMERULI
Focal: Affects some glomeruli
Diffuse: Affects most glomeruli

HOW MUCH OF A SINGLE GLOMERULUS
Segmental: Affects part of glomerulus
Global: Affects entire glomerulus

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6
Q

Most common nephropathy worldwide

A

IgA nephropathy

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7
Q

Pathophysiology of IgA nephropathy

A

IgA deposition in glomerular mesangium (+ IgG, C3)

Precipitated by infection/ hypersensitivity

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8
Q

Which complement protein is normally deposited in mesangial cells in glomerulonephritis associated with nephritic syndrome

A

C3

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9
Q

Important differential to rule out in Goodpasture’s disease.

How to differentiate between Goodpasture’s disease and this differential

A

ANCA vasculitis

ANCA vasculitis has systemic symptoms (fever, weight loss)

Goodpasture’s disease rarely has systemic symptoms

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10
Q

Pathophysiology of Goodpasture’s disease

A

IgG against alpha3 chain of type 4 collagen

alpha3 chain found in basement membrane of glomerulus and alveolus

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11
Q

Presentation of Goodpasture’s disease

A

Rapidly progressive nephritis + pulmonary haemorrhage

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12
Q

Which nephrotic syndrome glomerulonephritis is more common in children than adults

A

Minimal change glomerular disease

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13
Q

What generally can be found on urine microscopy of nephrotic syndrome glomerulonephritis

A
  1. Fat bodies
  2. Hyaline
  3. Granular casts
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14
Q

List 3 hereditary nephropathies and their type of inheritance

A
  1. Polycystic kidney disease (x-linked)
  2. Alport syndrome (AD)
  3. Thin membrane disease (AD)
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15
Q

Triad of symptoms in Alport syndrome

A
  1. Progressive nephropathy
  2. Sensorineural hearing loss
  3. Eye abnormalities (conical lens causing distorted vision)
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16
Q

Pathophysiology in Alport syndrome

A

Defective basement membrane formation in glomerulus, cochlea, eye

17
Q

Pathophysiology in thin membrane disease

A

Inadequate integration of Type 4 collagen into GBM

GBM <200nm (instead of normal 350nm)

18
Q

Pathophysiology in polycystic kidney disease

A
  1. Defective synthesis of proteins polycystin 1 and 2
  2. Uncontrolled tubular cell proliferation in response to growth factors
  3. Formation of tubular cysts
  4. Tubular cysts close off the associated nephron and grow large over time
19
Q
  1. Polycystic kidney disease
  2. Alport syndrome
  3. Thin membrane disease

is more associated with haematuria/ proteinuria

A

PKD: haematuria

Alport syndrome: proteinuria

Thin membrane: haematuria

20
Q

List the 3 ANCA-associated vasculitis.

A
  1. Wegener’s/ Granulomatosis with polyangiitis
  2. Churg-Strauss/ Eosinophilic granulomatosis with polyangiitis
  3. Microscopic polyangiitis
21
Q

Most common cause of pulmonary renal syndrome

+other causes

A

Most common:
Microscopic polyangiitis

Other causes:

  • Goodpastures
  • Wegener’s/ Granulomatosis with polyangiitis
22
Q

Does lupus nephritis tend to cause nephrotic or nephritic syndrome

A

Nephrotic syndrome

23
Q

Kimmelstein WIlson nodules are associated with what

A

Diabetic nephropathy

24
Q

What type of nephropathy is associated with the following:

CHILD WITH SWOLLEN FACE

Is this more associated with nephrotic or nephritic syndrome?

A

Minimal change nephropathy

Nephrotic syndrome

25
Q

What type of nephropathy is associated with the following:

SPIKES ON SILVER STAIN

Is this more associated with nephrotic or nephritic syndrome?

A

Membranous nephropathy

Nephrotic syndrome

26
Q

What type of nephropathy is associated with the following:

KAPPA AND LAMBDA LIGHT CHAINS

Is this more associated with nephrotic or nephritic syndrome?

A

Amyloidosis

Nephrotic syndrome

27
Q

What type of nephropathy is associated with the following:

DOME SHAPED SUBENDOTHELIAL DEPOSITS

Is this more associated with nephrotic or nephritic syndrome?

A

Post-infectious nephritis

Nephritic syndrome

28
Q

How long after infection does post-infectious nephropathy tend to occur

A

2-3 weeks after infection

29
Q

What tends to precipitate IgA nephropathy

A

Upper respi tract infection

IgA nephropathy tends to happen 24-48h afterwards

30
Q

Which nephropathy is associated with HIV/ heroin

A

FSGS

31
Q

Which nephropathy is associated with Hep C

A

Membranoproliferative
aka mesangiocapillary

Note: can be associated with Hep C or SLE

32
Q

Which nephropathy is associated with sickle cell

A

FSGS

33
Q

Most common nephropathy in children

A

Minimal change nephropathy

34
Q

Most common nephropathy in adults in UK

A

Membranous nephropathhy

35
Q

In Goodpasture’s, what type of immune complex is deposited in the GBM

A

Linear IgG complexes

Stage 4: CSIM 2 (47 decks)

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