glomerular disease pathology

Question 1

What aspect of the arterioles prevents large blood pressures reaching the delicate blood vessels in the glomerulus

Answer 1

They contain smooth muscle in their walls

Question 2

What is the glomerulus

Answer 2

A bag of capillaries sitting in between two arterioles

Question 3

What is a podocyte

Answer 3

glomerular epithelial cell

Question 4

What cells always lines capillaries

Answer 4

endothelial cells

Question 5

How does blood enter the glomerulus

Answer 5

The afferent arteriole

Question 6

What proteins are not filtered by the glomerulus

Answer 6

All proteins equal to or larger than albumin will not be filtered

Question 7

What are the 3 layers of the glomerular membrane

Answer 7

Endothelium
Basal lamina
Podocyte foot processes

Question 8

What are mesangial cells

Answer 8

‘Tree like’ group of cells which support capillaries

Question 9

Where do the unfiltered substances go

Answer 9

Some fluid, albumin and larger proteins exit the through the efferent arteriole

Question 10

Where does the efferent arteriole carry blood to

Answer 10

capillaries which are around the tubule

Question 11

What is glomerulonephritis

Answer 11

Disease of the kidneys

Question 12

What are the two categories of glomerulonephritis

Answer 12

Immunoglobulin deposition nephritis or non immunoglobulin nephritis

Question 13

What are the 4 common presentations for glomerulonephritis

Answer 13

Haematuria
Heavy proteinuria
Slowly increasing proteinuria
Acute renal failure

Question 14

What are the main causes of haematuria

Answer 14

UTI - most common cause
Urinary tract stone (calculi)
Urinary tract tumour
Glomeluonephritis can cause haematuria but it is less common then the other options

Question 15

What can deposits of IgA cause

Answer 15

Increased IgA deposits causes increased proliferation of mesangial cells

Question 16

Is IgA removed by the glomerulus

Answer 16

It is not known but is is a important part of the cause of the disease

Question 17

Does IgA get filtered in the urine

Answer 17

No, the IgA is stuck within the mesangium

Question 18

What is the prognosis for IgA nephropathy

Answer 18

Usually self limiting but some go onto develop chronic renal failure

Question 19

Why is albumin measured when glomerular abnormalities are expected

Answer 19

Albumin is slightly bigger than the glomerular basement membrane can filter so when there is an issue at the glomerular basement membrane, albumin is the first substance to be excreted

Question 20

How does IgG cause glomerulonephritis

Answer 20

It is too big to be filtered and deposits itself between basal lamina and podocyte

IgG then activates compliment 3 which punches holes into the filter - leaky filter allows proteins into the urine which leads to nephrotic syndrome

Question 21

What is the prognosis of mebranous glomerulonephritis

Answer 21

25% develop chronic renal failure within 10 years

Question 22

What happens in diabetic nephropathy

Answer 22

Thickened, narrowed arterioles which reduces blood flow to glomerulus

Increased mesangial matrix which compresses capillaries

Thickened capillary wall which is leaking albumin

Adhesions to bowmans capsule are the glomerulus attempt to stop major leakage of protein (albumin) into the urine

Question 23

What is the kimmelsteil-Wilson lesion which is seen in diabetic nephropathy

Answer 23

A very big excess of mesangial matrich which produces nodules

Question 24

What is rapidly rising creatinine a sign of

Answer 24

Acute renal failure

Question 25

What are anti-neutrophil cytoplasmic antibodies(ANCA)

Answer 25

Antibodies which are directed against proteinase 3 and myeloperoxidase which both are present as primary granl

Question 26

How do antibodies cause tissue damage

Answer 26

Interactions with primed neutrophils