Glomerulonephritis Flashcards Preview

Renal > Glomerulonephritis > Flashcards

Flashcards in Glomerulonephritis Deck (32):
1

What is GN?

Immune medated disease of the kidneys affecting the glomeruli

2

What are the 3 aspects of the pathogenesis of GN?

Humoral - antibody mediated
Cell mediated
Inflammatory cells, mediators and complement

3

Damage to endothelial or mesangial cells leads to what kind of lesion in GN?

Proliferative lesions and blood in urine - nephritic syndrome

4

Damage to podocytes leads to what kind of lesion in GN?

Non-proliferative lesion and protein in urine - nephrotic syndrome

5

How does GN present?

Oedema
Haematuria
Tired
HTN
Nephrotic syndrome - proteinuria
Nephritic syndrome - haematuria

6

What level of proteinuria classified as the nephrotic syndrome?

>3g/day

7

RBCs in the urine from the glomerulus are described as what shaped?

Dysmorphic

8

What 3 investigations are required for biopsy sample in GN?

Light microscopy
Electron microscopy
Immunofluorescence

9

How does cresentic GN form?

Cells burst into Bowman's sapce ad forma cresta round the glomerulus which compresses it and it becomes ischaemic and dies.

10

What are the main aims of treatment for GN?

Reduce degree of proteinuria
Induce remission of nephrotic syndrome
Preserve long term renal function

11

In general what treatment can be given for GN?

ACEi/ARBs
Diuretcs
Statins
Steriods
AZA
Cyclophosphamide
Calcineurin inhibitors - Cyclosporin/Tacrolimus
Mycophenolate Mofetil (MMF)
Plasmapharesis
Antibodies

12

What is the target BP for GN?

<120/75 if proteinuria

13

How is minimal change GN diagnosed?

EM: foot process fusion
Normal biopsy, LM and IF

14

What is the treatment for minimal change GN?

Oral steroids
If steroid-resistant/ dependent then biopsy and cyclophosphamide/CSA

15

Does minimal change GN cause progressive renal failure?

No

16

Is minimal change GN proliferative or non-proliferative lesions?

Non-proliferative lesion

17

What is the most common cause of nephrotic syndrome in adults and children?

Children - Minimal change GN
Adults - Focal Segmental Glomerulosclerosis

18

What are the secondary causes of focal segmental glomerulosclerosis?

HIV
Heroin use
Obesity
Reflux nephropathy

19

Describe focal segmental glomerulosclerosis as seen on biopsy?

Minimal Ig deposition on LM
Complement deposition on IF

20

What is the treatment for focal segmental glomerulosclerosis?

Prolonged steroids

21

What is the second most common cause of nephrotic syndrome in adults?

Membranous nephropathy

22

What can cause secondary membranous nephropathy?

Infections - HepB, parasites
CTDs - SLE
Malignancies - carcinomas, lymphomas
Drugs - gold, penicillamine

23

Describe membranous nephropathy as seen on biopsy?

Subepithelial immune complex deposition in the basement membrane

24

Does the BM become thicker in membranous nephropathy?

Yes

25

What is IgA nephropathy?

Abnormality of IgA which gets stuck in the kidneys and causes damage - prolifertive lesion

26

Which can IgA nephropathy cause, AKI or CKD?

Both

27

IgA nephropathy on biopsy looks like what?

Mesangial cell prolifertion and expansion on light microscopy with IgA deposits in mesangium on IF

28

What treatment is given for IgA nephropathy?

ACEi/ARB
Fish oil

29

What is rapidly progressive GN?

rapid deterioration in renal function over days/ weeks
a treatable cause of cute renal failure

30

What is RPGN associated with?

Systemic disease - pANCA > nANCA
Glomerular cresents on biopsy

31

Is RPGN a proliferative lesion?

Yes

32

What is the treatment for RPGN?

Steroids - IV Methylprednisolone/ Oral Prednisolone
Immunosuppression - Cyclophosphamide/ MMF/ AZA
Plasmapharesis