Flashcards in Glomerulonephritis Deck (30):
what are the two broad categories of glomerulonephritis? Describe each category in broad terms and whether they are more likely to cause a nephritic vs nephrotic presentation.
-Proliferative vs. non proliferative
Proliferative= increased numbers of cells in the glomeruli- generally cause nephritic syndrome
Non-proliferative= no increase in cell number in glomeruli- generally cause nephrotic syndrome
What are some subtypes of non-proliferative GN?
Minimal change, focal segmental and membranous glomerulonephritis
What are some subtypes of proliferative GN?
Wegners granulomatosis, Goodpastures, Post strep, IgA nephropathy, membranoproliferative glomerulonephritis
what is the cause of minimal change GN? How do we treat it?
unknown cause. Treat symptomatic oedema, and prednisolone. good outcome
what do we see on electron microscopy for minimal change GN?
what do we see in focal segmental GN?
focal segments of the glomerulus have sclerosed lesions.
what is the prognosis of focal segmental GN?
50% require a kidney transplant
what do we see histologically in membranous GN?
thickened BM due to immune complex deposition and complement activation
how do we treat membranous GN?
what is the prognosis of membranous GN?
1/3 chronic GN
what is the most common GN?
what causes IgA nephropathy?
IgA immune complex deposits after URTI
what classic symptom does IgA have?
how is IgA treated? what is the prognosis like?
steroids and cyclophosphanides. Variable prognosis- 20% can lead to ESRF
Post strep GN? which strep is it?
Strep pyogenes implicated usually, however can occur even without strep pyogenes infection. Hence also known as post infectious GN
Microscopy of post strep GN? how do we treat it?
Microscopy shows increased numbers of mesangial cells, neutrophils, monocytes, crescrentic Bowman's space
- we treat it with supportive therapy as it is self limiting
what is presentation of membranoproliferative GN? what is its prognosis?
combined nephritic/nephrotic syndrome. Poor prognosis. Most lead to ESRF
what do we see under the microscope for membranoproliferative GN?
Subendothelial IgG deposits in the glomerulus
Thickened mesangial and BM
what symptoms do we see in Good pastures?
haemoptysis and nephritic syndrome
what is the pathology of Goodpastures?
immune mediated, Anti GBM antibodies directed against BM antigens in alveoli and glomerulus
what type of disease is Wegner's granulomatosis?
vasculitis affecting kidney, lung and the organs
what antibody are you looking for in Wegner's granulomatosis?
Anti-Neutrophil Cytoplasmic Antibodies= cANCA
what is a key feature/characteristic of IgA nephropathy?
what colour urine is heavy microscopic urine?
tea color. Indicates GN
what colour urine is macroscopic urine?
what do you think if you saw red casts in the urine under the microscope?
glomerular nephritis. casts are the shredded tubules of the nephron into the urine.
what do we mean by synpharyngitic flares?
exacerbation of symptoms such as haematuria, loin pain or fatigue post infection/illness
what sort of glomerulonephritis is good pastures?
what is a characteristic of diabetic glomerulopathy?
sclerosis- acellular nodules, and hyalinosis. Kimmelsteil Wilson nodules