Glomerular Diseases

Question 1

normal glomerulus what is NOT filtered out?

Answer 1

RBCs

proteins

Question 2

in tubules, what are NOT reabsorbed?

Answer 2

creatinine

urea

Question 3

capillary lining of endothelium in glomerulus is special how?

Answer 3

large fenestrated endothelium

podocytes

Question 4

what so special about the basement membrane in glomerulus?

Answer 4

negatively charge Type IV collagen

Question 5

3 types of cells in glomerulus are?

Answer 5

endothelial: lining
mesangial: contractile: stalk
epithelium: podocytes

Question 6

what is dropsy?

Answer 6

severe proteinuria and you get crazy full body swelling

Question 7

which protein is lost in proteinuria? how much?

Answer 7

albumin 3-4 g/day

Question 8

why do swell in proteinuria?

Answer 8

not enough proteins in vessels to generate oncotic pressure of fluid back into vessels so all fluid just leaks out into tissues

Question 9

3 reasons why proteins stay in glomerulus?

Answer 9

1. negative charged BM
2. Physical structure of Type IV collagen
3. proteins in slit membranes (Nephrin)

Question 10

Finnish subpopulation have a defect in Nephrin which causes what?

Answer 10

protein leakage from birth in urine

Question 11

What is Alport syndrome?

Answer 11

mutated collagen IV subtype in BM = proteinuria

Question 12

4 common reasons for proteinuria?

Answer 12

DMII
glomerulonephritis
amyloid deposition
Nephrin deficiency

Question 13

Acute renal ‘failure’ refers specifically to what?

Answer 13

decrease GFR = reduced creatinine clearance

increased serum urea and creatinine

Question 14

renal causes of acute renal failure? 4 main?

Answer 14

acute tubular necrosis
acute glomerulonephritis
acute interstitial nephritis
other. eg. vascular disease

Question 15

Glomerulonephritis one or group of conditions? most often due to what?

Answer 15

group of conditions

immune mediated: immune complex deposition

Question 16

Is there Glomerulonephritis without immune complexes?

Answer 16

yes. rare: pauci-immune

Question 17

Acute Glomerulonephritis acute or chronic?

Answer 17

Can be both

Question 18

Acute Glomerulonephritis cause?

Answer 18

post-streptococcal GN

Question 19

Chronic Glomerulonephritis cause?

Answer 19

IgA nephropathy

Question 20

what do you get if you get severe necrosis from acute Glomerulonephritis ?

Answer 20

crescents

Question 21

What’s most common form of Glomerulonephritis in Australia?

Answer 21

IgA nephropathy

Question 22

in Glomerulonephritis , how do glomeruli react?

Answer 22

BM new layers: spikes/protrusions
cell proliferation
inflammatory cell arrival

Question 23

How many glomeruli are affected in diffuse or global?

Answer 23

ALL OF THEM!

Question 24

Lots of what in Acute post-infectious Glomerulonephritis ?

Answer 24

neutrophils

IgG clumps on BM

Question 25

what else can cause acute Glomerulonephritis besides post strep immune complexes?

Answer 25

antibiotic reaction

Question 26

4 tools for diagnosis of Glomerulonephritis?

Answer 26

clinical findings light microscopy immunostains electron microscopy

Question 27

Glomerulonephritis in systemic lupus erythematosis histologically?

Answer 27

immune complex deposition in glomeruli

Question 28

IgA nephropathy have immune complexes where?

Answer 28

mesangium

Question 29

immune complexes deposit where in membranous nephropathy?

Answer 29

outer aspect of basement membrane

Question 30

What is a Crescent in the glomerulus made of?

Answer 30

exuded fibrin, monocytes and podocytes

Question 31

are crescents specific for one form of GN?

Answer 31

Nope, any response to severe injury

Question 32

Injury to Gl progression

Answer 32

Necrotizing lesions sclerosing lesions sclerotic ball without capillaries

Question 33

Does Glomerulonephritis resolve completely?

Answer 33

Some acute

Question 34

Which Glomerulonephritis progress to chronic?

Answer 34

Lupus, HIV due to continued stimulus

Question 35

Does IgA nephropathy have good prognosis?

Answer 35

Used to be yes. Now, not so much due to immune complex deposition

Question 36

Is Diabetec nephropathy due to autoimmune?

Answer 36

Nope: hyperglycemia

Question 37

what is THE most common cause of end stage renal failure?

Answer 37

Diabetec nephropathy

Question 38

What renal features of early and late Diabetec nephropathy?

Answer 38

early: protein leakage/nephrotic syndrome late: chronic renal failure

Question 39

HUS/TTP, sever hypertension, scleroderma causes what?

Answer 39

acute endothelial injury