Renal - Glomerulonephritis Flashcards

1
Q

What is glomerulonephritis?

A

Inflammation of the glomeruli

Pathology that occurs in various diseases, is not a disease in itself therefore treat underlying causes

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2
Q

What is nephritic syndrome?

A

Group of features that occur with nephritis

N
E
Proteinuria
Haematuria
Retention of fluid
olIguria
T
I
C

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3
Q

What is nephrotic syndrome?

A

Basement membrane in the glomerulus becomes highly permeable causing significant proteinuria

N
E
Proteinuria
Hypercholesterolaemia
Reduced serum albumin
Oedema
T
I
C

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4
Q

How does nephrotic syndrome present?

A

With oedema

Frothy urine due to high protein

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5
Q

What does nephrotic syndrome predispose a patient to?

A

Thrombosis
Hypertension
High cholesterol

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6
Q

What is the most common cause of nephrotic syndrome in children?

A

Minimal change disease

  • Idiopathic
  • Treated successfully with steroids
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7
Q

What are the most common causes of nephrotic syndrome in adults?

A

Membranous nephropathy
Focal segmental glomerulosclerosis

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8
Q

What are some potential causes of nephrotic syndrome?

A

Membranoproliferative glomerulonephritis
Henoch-Schonlein purpura
Diabetes
Infection (HIV)

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9
Q

What is IgA nephropathy?

A

Type of glomerulonephritis

Typical patient
Patient in 20s with haematuria

Histology
IgA deposits
Mesangial proliferation

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10
Q

What is membranous nephropathy?

A

Type of glomerulonephritis

Deposits of immune complexes in the glomerular basement membrane
- Causes thickening and malfunctioning of the membrane and proteinuria

Histology
IgG and complement deposits on the basement membrane

Key cause of nephrotic syndrome in adults

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11
Q

What causes membranous nephropathy?

A

Mainly idiopathic

Can be secondary to malignancy, SLE or NSAIDs

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12
Q

What is membranoproliferative glomerulonephritis?

A

AKA Mesangiocapillary glomerulonephritis

Typically affects patients under 30

Histology
Immune complex deposits
Mesangial proliferation

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13
Q

What is post-streptococcal glomerulonephritis?

A

Affects patients under 30

1-3 weeks post streptococcal infection (tonsillitis or impetigo)

Patients make full recovery

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14
Q

What is rapidly progressive glomerulonephritis?

A

AKA Crescentic glomerulonephritis

Acute severe illness but responds well to treatment

Histology
Glomerular crescents

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15
Q

What is Goodpasture syndrome?

A

AKA anti-glomerular basement membrane disease (anti-GBM)

Anti-GBM antibodies attack the glomerulus and pulmonary basement membranes

Causes glomerulonephritis and pulmonary haemorrhage

Typical patient is in their 20s or 60s with AKI and haemoptysis

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16
Q

What systemic diseases cause glomerulonephritis?

A
  • Henoch-Schonlein purpura
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis
  • Lupus nephritis
17
Q

If a patient presents with significant AKI and haemoptysis how can you differentiate based on antibodies?

A

Anti-GBM- Goodpasture syndrome

p-ANCA or MPO antibodies- microscopic polyangitis

c-ANCA or PR3 antibodies- granulomatosis with polyangiitis

18
Q

How are patients with glomerulonephritis managed?

A

Diagnosis may require renal biopsy for histology

Supportive care
Immunosuppression