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Glomerulonephropathies Flashcards

see virtual ward week 9 (60 cards)

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1
Q

Name two features of nephritic syndrome

A

hypertension, red cell casts on urine microscopy, haematuria

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2
Q

Name four features of nephrotic syndrome

A 
peripheral oedema
increased risk of infection
increased risk of VTE
hypoalbuminaemia
(hypoalbuminaemia, hyperlipidaemia, hypercoagluopathy)
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3
Q

Which glomerulonephritis are associated with crescent formation?

A

IgA nephropathy
Post-strep glomerulonephritis
Anti-glomerular basesment membrane disease

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4
Q

Which is the most common causes of nephrotic syndrome in children?

A

minimal change disease

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5
Q

Which glomerulonephritis is associated with cANCA/PR3 antibodies?

A

granulomatosis with polyangitis GPA

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6
Q

What is the triad of nephritic syndrome?

A

haematuria, hypertension, oedema, (mild proteinuria, decreased urine output)

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7
Q

What are the three presentations of glomerulonephritis?

A
  1. asymptomatic haematuria
  2. nephrotic syndrome
  3. nephritic syndrome
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8
Q

What are general causes of glomerulonephritis?

A 
IDA
Idiopathic
Immune
Infection
Drugs
Amyloid
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9
Q

Examples of immune causes of glomerulonephritis?

A

SLE, goodpastures/anti-GBM, vasculitis

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10
Q

Examples of infections?

A

HBV, HCV, strep, HIV

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11
Q

What are the three key features of nephritic syndrome?

A

HTN, haematuria, proteinuria

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12
Q

What are two causes of nephritic syndrome?

A
  1. Proliferative/post-strep
  2. Goodpasture’s
  3. IgA nephropathy
  4. Henoch Schonlein purpura
  5. Haemolytic anaemia
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13
Q

What is a typical presentation of post-strep nephritis?

A

young child develops malaise, smoky urine 1-2 weeks after sore throat or skin infection

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14
Q

What would biopsy show in post-strep?

A

IgG and C3 deposition

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15
Q

What are two types of cresentic nephritis/ rapidly progressive GN?

A

Anti-GBM (5%), immune complex deposition (45%), pauci syndrome (50%)

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16
Q

Two symptoms of anti-GBM?

A

haemoptysis and haematuria (alveolar and GBM haemorrhage)

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17
Q

Which condition is associated with Pauci immune?

A

systemic vasculitis

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18
Q

Name three systemic diseases that cause glomerulonephritis

A
  1. Diabetes
  2. SLE
  3. Myeloma
  4. Amyloidosis
  5. Sarcoidosis
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19
Q

What are the three features of nephrotic syndrome?

A

proteinuria, hypoalbuminaemia, oedema (PHO-soup)

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20
Q

Name three complications of nephrotic syndrome?

A
  1. infection (due to decreased Ig +complement activity)
  2. VTE
  3. Hyperlipidaemia
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21
Q

What are the features of GN screen?

A

ANCA, C3+ C4, immunoglobulins, hep B/C, urine bence jones

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22
Q

Which is the most common cause of nephrotic syndrome in children?

A

minimal change disease

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23
Q

Name three cause of nephrotic syndrome

A

minimal change disease
membranous nephropathy
focal segmental glomerulosclerosis

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24
Q

Which is the most common cause of nephrotic syndrome in adults?

A

membranous nephropathy

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25
Which feature on electron microscopy is observed in minimal change disease?
fusion of podocytes
26
Which feature is seen on microscopy in IgA GN?
proliferation of mesangial cells
27
Which antibody is present in 70% of membranous GN?
anti-PLA2R
28
Which part of nephron is affected in membranous GN?
BM
29
Which condition is associated with IgA nephropathy?
Henoch schonlein purpura --> systemic IgA variant nephropathy
30
Which other conditions is membranous nephropathy connected to?
secondary to cancer, infection (HBV), AI- SLE, thyroid disease
31
What is the most important investigation for glomerulonephropathies?
biopsy
32
What is the general management for glomerulonephropathies?
1. Monitor U+Es, BP, fluid balance, weight 2. Treat underlying cause 3. Oedema- salt and fluid restriction + furosemide 4. Proteinuria- ACEi, ARB 4. Statins (to reduce lipids in nephrotic syndrome) 5. VTE prophylaxis 6. BP control- antihypertensives
33
How can nephrotic and nephritic syndrome be distinguished based on the concentration of protein in the urine?
>3.5g/day nephrotic syndrome (nePROTic syndrome- lots of protein) <3.5g/day nephritic syndrome
34
Is diabetic glomerulonephropathy nephritic or nephrotic?
nephrotic
35
What are the three components of the glomerular basement membrane?
podocytes, endothelial cells, basement membrane
36
Which nephrotic syndrome is associated with sickle cell disease and HIV?
focal segmental glomerulosclerosis (therefore most common syndrome in african american and hispanic populations)
37
Which disease is associated with kimmelstiel wilson nodules?
diabetic nephropathy (think of owen wilson + jimmy kimmel picture)
38
Which protein does goodpasture syndrome affect?
Type IV collagen
39
What is alport syndrome?
can't see, can't pee, can't hear thee, nephritic syndrome. Basket weaving
40
Which disease is likely to be overlapping with nephritic and nephrotic syndromes?
membranoproliferative glomerulonephritis
41
Patient shows proteinuria on urinalysis. You suspect nephrotic syndrome. Name two lab tests that would confirm this diagnosis
Triglycerides- hyper Albumin- hypo Urine PCR
42
Name 3 investigations prior to performing renal biopsy
USS Coag screen FBC U+Es Group and save
43
Name two complications of renal biopsy
haemorrhage infection damage to adjacent structures
44
Name the two autoantibodies most commonly detected in SLE
ANA | anti dsDNA
45
Name four criteria a patient must have in order to diagnose nephrotic syndrome
1. Peripheral oedema 2. Proetinuria 3. Serum albuminaemia 4. Hypercholesterolaemia
46
Is there a set criteria for nephritic syndrome?
No...unlike nephrotic syndrome
47
List three features of nephritic syndrome
haematuria oligouria (reduced urine output) proteinuria fluid retention
48
Level of protein to be classed as nephrotic syndrome?
>3g/24 hr
49
As a general rule, two treatment options for all glomerulonephropathies?
1. Immunosuppresion- steroids 2. Blood pressure control (ACEi +ARBs) (3. most glomerular nephropathies are idopathic)
50
What is the most common cause of nephrotic syndrome in adults?
membranous nepropathy
51
What is the most common cause of nephrotic syndrome in children?
minimal change disease
52
What is the most common cause of primary glomuerlonephritis?
IgA nephropathy= Berger's disease
53
Histology of IgA nephropathy?
IgA deposits and glomerular mesangial proliferation
54
Histology of membranous glomerulonephritis?
IgG and complement deposits on the basement membrane
55
What is the most common glomerulonephritis overall?
membranous glomerulonephritis
56
Patient presents with AKI and haemoptysis. Which glomerulonephritis are they likely to have?
Goodpasteure syndrome= anti-GBM disease (antibodies attack glomerulus and pulmonary basement membrane)
57
Histology shows crescentic glomerulonephritis. What is the diagnosis?
rapidly progressive glomerulonephritis
58
Synonym for IgA nephropathy?
Berger's disease
59
Name two autoantibodies most likely to present in SLE
ANA | Anti-DNA antibodies
60
List two likely histological diagnosis on renal biopsy of a patient presenting with nephrotic syndrome
Glomerulonephritis | Membranous glomerulonephritis

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