Glomerulonephritis Flashcards Preview

Core conditions Olivia MD > Glomerulonephritis > Flashcards

Flashcards in Glomerulonephritis Deck (30):
1

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

2

What are some subtypes of non-proliferative GN?

Minimal change, focal segmental and membranous glomerulonephritis

3

What are some subtypes of proliferative GN?

Wegners granulomatosis, Goodpastures, Post strep, IgA nephropathy, membranoproliferative glomerulonephritis

4

what is the cause of minimal change GN? How do we treat it?

unknown cause. Treat symptomatic oedema, and prednisolone. good outcome

5

what do we see on electron microscopy for minimal change GN?

fused podocytes

6

what do we see in focal segmental GN?

focal segments of the glomerulus have sclerosed lesions.

7

what is the prognosis of focal segmental GN?

50% require a kidney transplant

8

what do we see histologically in membranous GN?

thickened BM due to immune complex deposition and complement activation

9

how do we treat membranous GN?

steroids

10

what is the prognosis of membranous GN?

1/3 chronic GN
1/3 remission
1/3 ESRF

11

what is the most common GN?

IgA nephropathy

12

what causes IgA nephropathy?

IgA immune complex deposits after URTI

13

what classic symptom does IgA have?

macroscopic haematuria

14

how is IgA treated? what is the prognosis like?

steroids and cyclophosphanides. Variable prognosis- 20% can lead to ESRF

15

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

16

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

17

what is presentation of membranoproliferative GN? what is its prognosis?

combined nephritic/nephrotic syndrome. Poor prognosis. Most lead to ESRF

18

what do we see under the microscope for membranoproliferative GN?

Subendothelial IgG deposits in the glomerulus
Thickened mesangial and BM

19

what symptoms do we see in Good pastures?

haemoptysis and nephritic syndrome

20

what is the pathology of Goodpastures?

immune mediated, Anti GBM antibodies directed against BM antigens in alveoli and glomerulus

21

what type of disease is Wegner's granulomatosis?

vasculitis affecting kidney, lung and the organs

22

what antibody are you looking for in Wegner's granulomatosis?

Anti-Neutrophil Cytoplasmic Antibodies= cANCA

23

what is a key feature/characteristic of IgA nephropathy?

synpharyngitic flares

24

what colour urine is heavy microscopic urine?

tea color. Indicates GN

25

what colour urine is macroscopic urine?

red colour

26

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.

27

what do we mean by synpharyngitic flares?

exacerbation of symptoms such as haematuria, loin pain or fatigue post infection/illness

28

what sort of glomerulonephritis is good pastures?

crescentic glomerulonephritis

29

what is a characteristic of diabetic glomerulopathy?

sclerosis- acellular nodules, and hyalinosis. Kimmelsteil Wilson nodules

30

3 cardinal features of nephrotic syndrome

oedema
heavy proteinuria
hypoalbuminemia