Glomerulonephritis

Question 1

What is it

Answer 1

Immune mediated inflammation of the glomeruli

Question 2

Types of primary

Answer 2

Minimal change 
IgA nephropathy (Berger's disease)
Focal segmental glomerulosclerosis 
Membranous 
Membranoproliferative

Question 3

Causes of secondary

Answer 3

Malignancy
Infection/drugs
Systemic disease

Question 4

Which type of nephropathy is most common

Answer 4

IgA nephropathy

Question 5

IgA nephropathy is preceded by what

Answer 5

Resp or GI infection

Question 6

IgA nephropathy associated with which systemic condition

Answer 6

HSP

Question 7

Describe HSP

Answer 7

Purpuric rash on extensor surfaces (particularly buttocks/back of legs), polyarthritis, colitis

Question 8

Seen on biopsy of IgA nephropathy

Answer 8

Mesangial cell proliferation

IgA deposits

Question 9

Presentation of IgA nephropathy

Answer 9

Haematuria
Proteinuria
Hypertension

Question 10

1st line treatment of IgA nephropathy

Answer 10

Ciclosporin

Question 11

What cells are damaged in minimal change nephropathy

Answer 11

Podocytes

Question 12

What cells mediate minimal change nephropathy

Answer 12

T cells

Question 13

What is seen on electron microscopy of minimal change nephropathy

Answer 13

Foot process fusion

Question 14

Most common cause of nephrotic syndrome in children

Answer 14

Minimal change nephropathy

Question 15

Signs of nephrotic syndrome

Answer 15

Proteinuria (>3g/24hr) Hypoalbuminaemia (>30g/L)
Odema (Sodium retention)
Hypercholesterolaemia
Hypertriglycerideaemia

Question 16

1st line treatment of minimal change nephropathy

Answer 16

Prednisolone 60mg orally

Question 17

2nd line treatment of minimal change nephropathy not responsive to steroids

Answer 17

Cyclophosphamide

Question 18

Commonest cause of nephrotic syndrome in adults

Answer 18

Focal segmental glomeruloscerolis

Question 19

What is focal segmental glomerulosclerosis associated with

Answer 19

HIV
Obesity
Heroin

Question 20

50% of patients progress to ESFR in which type of glomerulonephritis

Answer 20

Focal segmental glomerulosclerosis

Question 21

Treatment of focal segmental glomerulosclerosis

Answer 21

Prolonged steroids

Question 22

What is seen on biopsy of membranous nephropathy

Answer 22

Sub-epithelial immune complex deposition in the basement membrane- ‘spike + dome’ appearance

Question 23

Antibody seen in 70% of patients with membranous nephropathy

Answer 23

anti-PLA2r

Question 24

What is membranous nephropathy associated with

Answer 24

SLE
Hep B
Hodgkins lymphoma 
Gold
Penicillamine

Question 25

Treatment of membranous nephropathy

Answer 25

Steroids B cell monoclonal antibodies Alkylating agents

Question 26

Urinary sediments in rapid progressive glomerulonephritis

Answer 26

RBCs | RBC + granular casts

Question 27

What is seen in biopsy of rapid progressive glomerulonephritis

Answer 27

Cresents affecting glomeruli

Question 28

Haemoptysis + rapidly progressive glomerulonephritis suggests which autoimmune disease

Answer 28

Goodpastures disease

Question 29

Anti-body present in good pastures disease

Answer 29

Anti-GBM

Question 30

Anti-dsDNA present in blood suggests which disease is causing glomerulonephritis

Answer 30

SLE

Question 31

ANCA positive immune diseases that cause rapidly progressive GN

Answer 31

GPA (cANCA) | EGPA (pANCA)

Question 32

1st line treatment of rapidly progressive GN

Answer 32

Immunosuppression with high dose corticosteroids Cyclophosphamide Plasmapheresis

Question 33

Which types of glomerulonephritis present with nephrotic syndrome

Answer 33

Minimal Change Focal segmental Membranous

Question 34

Treatment of nephrotic syndrome

Answer 34

``` Fluid+ Salt restriction Thiazide diuretic followed by furosemide if unresponsive ACEi/ARB Anti-coagulation Statin for hypercholesterolaemia IV albumin if volume deplete ```