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Jason's Renal Block > Glomerular Diseases > Flashcards

Glomerular Diseases Flashcards

1
Q

normal glomerulus what is NOT filtered out?

A

RBCs

proteins

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2
Q

in tubules, what are NOT reabsorbed?

A

creatinine

urea

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3
Q

capillary lining of endothelium in glomerulus is special how?

A

large fenestrated endothelium

podocytes

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4
Q

what so special about the basement membrane in glomerulus?

A

negatively charge Type IV collagen

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5
Q

3 types of cells in glomerulus are?

A

endothelial: lining
mesangial: contractile: stalk
epithelium: podocytes

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6
Q

what is dropsy?

A

severe proteinuria and you get crazy full body swelling

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7
Q

which protein is lost in proteinuria? how much?

A

albumin 3-4 g/day

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8
Q

why do swell in proteinuria?

A

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

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9
Q

3 reasons why proteins stay in glomerulus?

A
  1. negative charged BM
  2. Physical structure of Type IV collagen
  3. proteins in slit membranes (Nephrin)
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10
Q

Finnish subpopulation have a defect in Nephrin which causes what?

A

protein leakage from birth in urine

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11
Q

What is Alport syndrome?

A

mutated collagen IV subtype in BM = proteinuria

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12
Q

4 common reasons for proteinuria?

A

DMII
glomerulonephritis
amyloid deposition
Nephrin deficiency

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13
Q

Acute renal ‘failure’ refers specifically to what?

A

decrease GFR = reduced creatinine clearance

increased serum urea and creatinine

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14
Q

renal causes of acute renal failure? 4 main?

A

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

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15
Q

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

A

group of conditions

immune mediated: immune complex deposition

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16
Q

Is there Glomerulonephritis without immune complexes?

A

yes. rare: pauci-immune

17
Q

Acute Glomerulonephritis acute or chronic?

A

Can be both

18
Q

Acute Glomerulonephritis cause?

A

post-streptococcal GN

19
Q

Chronic Glomerulonephritis cause?

A

IgA nephropathy

20
Q

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

A

crescents

21
Q

What’s most common form of Glomerulonephritis in Australia?

A

IgA nephropathy

22
Q

in Glomerulonephritis , how do glomeruli react?

A

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

23
Q

How many glomeruli are affected in diffuse or global?

A

ALL OF THEM!

24
Q

Lots of what in Acute post-infectious Glomerulonephritis ?

A

neutrophils

IgG clumps on BM

25
Q

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

A

antibiotic reaction

26
Q

4 tools for diagnosis of Glomerulonephritis?

A

clinical findings
light microscopy
immunostains
electron microscopy

27
Q

Glomerulonephritis in systemic lupus erythematosis histologically?

A

immune complex deposition in glomeruli

28
Q

IgA nephropathy have immune complexes where?

A

mesangium

29
Q

immune complexes deposit where in membranous nephropathy?

A

outer aspect of basement membrane

30
Q

What is a Crescent in the glomerulus made of?

A

exuded fibrin, monocytes and podocytes

31
Q

are crescents specific for one form of GN?

A

Nope, any response to severe injury

32
Q

Injury to Gl progression

A

Necrotizing lesions
sclerosing lesions
sclerotic ball without capillaries

33
Q

Does Glomerulonephritis resolve completely?

A

Some acute

34
Q

Which Glomerulonephritis progress to chronic?

A

Lupus, HIV due to continued stimulus

35
Q

Does IgA nephropathy have good prognosis?

A

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

36
Q

Is Diabetec nephropathy due to autoimmune?

A

Nope: hyperglycemia

37
Q

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

A

Diabetec nephropathy

38
Q

What renal features of early and late Diabetec nephropathy?

A

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

39
Q

HUS/TTP, sever hypertension, scleroderma causes what?

A

acute endothelial injury

Jason's Renal Block (20 decks)

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