Glomerular Disorders

Question 1

Functional unit of the kidney

Answer 1

Nephron

Question 2

glomerulonephritis

Answer 2

Various conditions that cause inflammation of glomeruli

Can be focal or diffuse

Third leading cause of kidney failure in US

Question 3

is glomerulonephritis a cell mediated or immune mediated process?

Answer 3

Immune mediated

Question 4

glomerulus

Answer 4

Delicate network of arterials within Bowmans capsule

Question 5

Tubules

Answer 5

Massive consumer of O2

Question 6

Afferent renal artery

Answer 6

Takes blood in

Question 7

efferent renal artery

Answer 7

Takes blood out

Question 8

what is a glomerular disorder?

Answer 8

Alteration in glomerular capillary

Question 9

Capillary membranes

Answer 9

Endothelial
Basement membrane
Podocytes

Question 10

primary glomerulonephritis

Answer 10

Isolated in kidney

Question 11

secondary glomerulonephritis

Answer 11

Caused by systemic disease

Question 12

diffused damage to glomeruli

Answer 12

Both kidneys

Question 13

focal damage to glomeruli

Answer 13

Only some of glomeruli

Question 14

Local damage to glomeruli

Answer 14

Area of glomerulus

Question 15

Type 2 reaction

Answer 15

occurs on cell surface
Results in direct cell death/malfunction

Question 16

type 3 reaction

Answer 16

immune complexes are deposited into tissue and result in inflammation that destroys tissues

Question 17

What type of reaction involves anti-GBM antibodies?

Answer 17

Type two

Question 18

What type of reaction involves immune complexes in GBM?

Answer 18

Type three

Question 19

what do both forms of injuries involve?

Answer 19

Accumulation of antigens, antibodies, complement

Complement Activation results in tissue injury

Question 20

is acute glomerulonephritis rapid or slow onset?

Answer 20

Abrupt onset

Question 21

s/sx of acute glomerulonephritis

Answer 21

HARP
Hematuria
Azotemia
Retention – sodium and water, oliguria – hypertension, and edema
Proteinuria – hypoproteinemia

Question 22

post infectious

Answer 22

Post strep, and non-strep
Bacterial, viral, parasitic

Question 23

primary disease

Answer 23

berger disease
IgA builds up in kidney

Question 24

Multi system disease

Answer 24

Good posture syndrome
systemic lupus
Vasculitis
erythematosus

Question 25

which multisystem disease is an auto immune?

Answer 25

Good posture syndrome Anti-GBM antibodies, attack self

Question 26

pathogenesis

Answer 26

Trigger Immune complex forms Complement activated – inflammation Release of mediators Tissue injury Hematuria, proteinuria, decreased GFR

Question 27

chronic glomerulonephritis

Answer 27

Long-term inflammation– months to years Build up of scar tissue – can’t filter properly

Question 28

s/sx chronic glomerulonephritis

Answer 28

Depends on the severity Progression – renal failure Slow and progressive destruction

Question 29

what does chronic glomerulonephritis end with?

Answer 29

End stage renal disease – dialysis

Question 30

pharm treatment for glomerulonephritis

Answer 30

corticosteroids – prednisone Diuretics Immuno suppressants Antihypertensives – ACE/ARB Dialysis, diet – less sodium, potassium, protein

Question 31

s/sx glomerulonephritis

Answer 31

hematuria – coffee/cola, urine color Oliguria – <400mL/day Fluid retention – generalized edema, HTN Labs – increased BUN and Cr (>20:1) + protein in urine – hypoproteinemia, low albumin

Question 32

Diabetic neuropathy

Answer 32

Gross thickening of GBM Uncontrolled blood sugar Can’t filter out Les urine – more toxins

Question 33

hypertensive glomerular disease

Answer 33

Increased pressure Decreased Renal perfusion Sclerotic glomerular changes

Question 34

thickening is associated with?

Answer 34

Diabetic neuropathy

Question 35

scarring is associated with?

Answer 35

Hypertensive glomerular disease

Question 36

nephrotic syndrome

Answer 36

Glomerulus is permeable to plasma membranes Elimination >3g protein/day

Question 37

how should urine be tested with nephrotic syndrome?

Answer 37

24 hour urine – measure proteins

Question 38

Cause of nephrotic syndrome

Answer 38

glomerulonephritis Diabetes

Question 39

pathogenesis of nephrotic syndrome

Answer 39

Damage to glomerulus Increased glomerular permeability Proteinuria Hypoalbuminemia

Question 40

what happens when there is more protein in the urine?

Answer 40

Less in circulation

Question 41

s/sx nephrotic syndrome

Answer 41

edema – loss of oncotic pressure, fluid into third space HTN, HLD Hypercoagulation – loss of antithrombin III and plasminogen