Glomerulonephritis Flashcards Preview

Renal (Zoe's cards) > Glomerulonephritis > Flashcards

Flashcards in Glomerulonephritis Deck (41):
1

What is glomerulonephritis?

An immune mediated disease affecting the glomerulus with secondary tubulointerstitial damage.

2

What is the most common process underpinning glomerulonephritis?

Autoimmune

3

What do you get in the urine of there is damage to endothelial or mesanglial cells?

Proliferative lesion and red cells in urine.

4

If there is endothelial damage then what sorts of lesions do you get in the kidney?

Proliferative

5

If the podocytes are damaged what sort of lesions are there?

Non proliferative

6

What substance appears in the urine if there is damage to podocytes?

Protein

7

Is microscopic haematuria more likely to be a problem in the kidney or lower urinary tract?

Kidney

8

Is macroscopic haematuria more likely to be a problem in the kidney or lower urinary tract?

Lower urinary tract

9

What condition do you get if the podocytes are damaged causing massive protein leakage but no decline in renal function?

Nephrotic syndrome

10

What level of protein in the urine counts as nephrotic syndrome?

More than 3g per day

11

On urine microscopy you see non dysmorphic red blood cells. Where is the blood coming from?

Lower urinary tract

12

On urine microscopy you see dysmorphic red blood cells. Where is the blood coming from?

Kidney. They are squashed to go through the glomerulus.

13

What causes frothy urine?

Protein

14

In nephritic syndrome a proliferative or non proliferative process?

Proliferative

15

A patient has oliguria, hypertension and her urine shows RBCs and granular casts

Nephritic syndrome

16

A patient presents with proteinuria, massive pitting oedema and normal renal function

Nephrotic syndrome

17

In nephrotic syndrome a proliferative or non proliferative condition?

Non proliferative

18

What could cause acute kidney injury in a patient with nephrotic sydrome?

Renal vein thrombosis

19

List some complications of nephrotic sydnrome?

Infections
Renal vein thrombosis
PE
Volume depletion
Vitamin D deficiency
Subclinical hypothyroidism

20

What does proliferative /non proliferative actually mean in glomerulonephritis?

Presence or absence of proliferation of mesangial cells.

21

How would you treat glomerulonephritis? (non immunosuppressive)

Anti hypertensives
ACE inhibitors/ARB
Diuretics
Statins
Anticoagulants if nephrotic syndrome

22

What is the target blood pressure for a patient with glomerulonephritis?

130/80

23

What is the first line immunosuppressive in glomerulonephritis?

Corticosteroids

24

How do you treat patients with nephrotic syndrome?

Fluid restrict
Salt restrict
Diuretics
ACE inhibitors/ARBs
Anticoagulation

25

When would you give a patient with nephrotic syndrome IV albumin?

If the become volume depleted ie the water is in the wrong place!

26

What is the most common type of renal disease seen in patients with SLE?

Diffuse proliferative glomerulonephritis

27

Which antibody shows a ribbon like pattern on immunofluresence?

Anti glomerular basement antibodies

28

What immunosuppressive treatments would you use for treatment of glomerulonephritis?

Steroids
Azathioprine
Cyclophosphamide
Cyclosporin
Mycophenolate
IV immunoglobulin
Monoclonal antibodies

29

What non drug treatment can you use in the treatment of glomerulonephritis?

Plasmapharesis

30

List the five main types of glomerulonephritis

Minimal change disease
FSGS
Membranous
Membranoproliferative
IgA nephropathy

31

What is the commonest cause of nephrotic syndrome in children?

Minimal change nephropathy

32

A 9 year old girl presents with proteinuria. Her renal biopsy in normal.

Minimal change nephropathy

33

What is the first line treatment for minimal change nephropathy?

Oral steroids

34

When would you use cyclophosphamide in the treatment of minimal change nephropathy?

If it was unresponsive to steroids/dependant on high doses

35

Does minimal change nephropathy cause progressive renal failure?

No

36

What are 4 causes of secondary membranous nephropathy?

Infections (parasites/hep B)
Lupus
Malignancy
Drus (Gold)

37

What do you see in the renal biopsy of membranous nephropathy?

Subepithelial immune complex deposition in the basement membrane

38

What kidney problem is associated with henoch schonlein purpura?

IgA nephropathy

39

You see glomerular crescents on a kidney biopsy. What is the most likely diagnosis?

Rapidly progressive glomerulonephritis

40

List three ANCA +ve diseases that cause glomerulonephritis

Systemic vasculitis
Wegners granulomatosis
Microscopic polyangiitis

41

List three ANCA negative causes of glomerulonephritis

Goodpastures
Henoch Scholein
SLE