4: Glomerulonephritis Flashcards Preview

Renal Week 2 2017/18 > 4: Glomerulonephritis > Flashcards

Flashcards in 4: Glomerulonephritis Deck (56)
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1

What is glomerulonephritis?

Autoimmune disease of the glomeruli

2

What is the commonest cause of renal failure after diabetes?

Glomerulonephritis

3

What immune components mediate glomerulonephritis?

Antibodies

T cells

Inflammatory cells, cytokines, complement

4

What are the three layers of the glomerular membrane?

Endothelium of glomerular capillary

Glomerular basement membrane

Podocytes

5

Glomerulonephritis causes disruption of which structure?

What symptoms are seen?

Glomerular membrane

Proteinuria

Haematuria

6

What signs are produced if glomerulonephritis damages

a) endothelial or mesangial cells

b) podocytes?

a) Haematuria

b) Proteinuria

7

What happens to podocytes when they are damaged by glomerulonephritis?

Atrophy

No inflammation, but allows leakage of protein

8

What happens to mesangial cells if they are damaged by glomerulonephritis?

Proliferation

Vasoconstriction (by angiotensin II)

Inflammatory response

Haematuria

9

What happens to endothelial cells if they are damaged by glomerulonephritis?

Vasculitis

Haematuria

10

Endothelial damage causes (slow / rapid) decline in renal function.

rapid decline in renal function

11

Does mesangial damage cause rapid decline in renal function?

No

Haematuria and proteinuria

12

What urine tests can be done for someone with glomerulonephritis?

Urinalysis

Urine microscopy - for cell casts, culture

P/C ratio - to quantify proteinuria

13

What investigation can you do if you're struggling to classify glomerulonephritis after urine analysis?

Kidney biopsy

14

Is haematuria painful?

No

may be in UTI

15

On urine microscopy, what do red blood cells look like if they've come from the

a) kidneys

b) bladder?

a) Dysmorphic

b) Intact

16

What type of casts are seen in glomerulonephritis?

Red cell casts

pathognomic of GN, usually endothelial damage

17

What can acutely or chronically deteriorate due to glomerulonephritis?

Renal function

18

What are the presentations of

a) NEPHRITIC SYNDROME

b) NEPHROTIC SYNDROME?

a) Acute renal failure, oliguria, oedema, hypertension, urinary sediment

caused by inflammation

b) Proteinuria, hypoalbuminaemia, oedema, hypercholesterolaemia

due to inability of kidneys to retain albumin

19

What type of glomerulonephritis causes nephritic syndrome?

Endothelial

Mesangial

because they proliferate and cause inflammation

20

What type of glomerulonephritis causes nephrotic syndrome?

Podocyte damage

21

What is renal function like in

a) nephrotic syndrome

b) nephritic syndrome?

a) Normal

b) Gammied

22

What are people with nephrotic syndrome at increased risk of?

Cardiovascular disease

Infection

23

How does the presentation of GN differ from that of interstitial nephritis?

Shouldn't see proteinuria, haematuria on dipstick

As glomerulus isn't involved

24

What is the cause of primary GN?

Idiopathic autoimmune disease

25

What are some causes of secondary GN?

Infections

Drugs

Malignancy

Vasculitis

Connective tissue diseases

26

What cells tend to proliferate when damaged in GN?

Mesangial cells

Endothelial cells

27

What is the difference between focal and diffuse GN?

Focal - < 50% affected

Diffuse - > 50% affected

28

How is glomerulonephritis treated with drugs?

Antihypertensive drugs - ACE inhibitors, ARBs, diuretics (also help with fluid overload)

Statins

then

Immunosuppression - IV steroids, azathioprine, antibody injections, biologic agents

 

29

How are people with nephrotic syndrome managed?

Oedema, so:

fluid restriction

salt restriction

diuretics

ACE inhibitors / ARBs

30

People with glomerulonephritis usually need ___ after symptomatic relief.

immunosuppression