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Medicine Nephrology > Glomerulus Anatomy > Flashcards

Glomerulus Anatomy Flashcards

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1
Q

What is the diameter of the fenestration slits of capillary endothlim in the filtration barrier?

A

50-100 nm

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2
Q

What are the characteristics of capillary endothelium?

A

Contains fenestrations

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3
Q

What is the function of podocalixin in the filtration barrier?

A

Prevents proteinuria (albuminuria) and nephrotoxicity

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4
Q

What disease is associated with capillary endothelium pathology?

A

Post Streptococcal Glomerulo Nephritis (PsGN)

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5
Q

Does PSGN pose a risk for chronic kidney disease (CKD)?

A

No risk for CKD

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6
Q

What are the factors determining passage through the filtration barrier?

A

Based on Size

  • Effective diameter < 4 nm: passes through
  • Effective diameter > 8-10 nm: doesn’t pass

Based on charge
Negative charge will not pass

If the diameter is less than 8nm the only factor responsible to inhibit proteinuria is negative charge

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7
Q

What is the effective diameter range that allows proteins to pass through the filtration barrier?

A

4-8 nm

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8
Q

What type of proteins are repelled by the filtration barrier?

A

Negatively charged proteins

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9
Q

What is the size of albumin in relation to the filtration barrier?

A

7 nm, negatively charged cannot pass through filtration barrier

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10
Q

What is the consequence of hyperfiltration by remaining nephrons?

A

Intraglomerular hypertension (HTN)

Which results in increased capillary pore diameter

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11
Q

What substance formation causes Tubulo interstitial fibrosis ?

A

TGF-B

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12
Q

Fill in the blank: The effective diameter for passage through the filtration barrier is ______.

A

4-8 nm

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13
Q

True or False: Podocytes have a positive charge.

A

False

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14
Q

What is the role of mesangial matrix in the glomerulus?

A

Supports capillary structure

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15
Q

What happens to capillary pore during intraglomerular hypertension ?

A

Stretching of capillary pore Increases its diameter

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16
Q

What are parts of filtration barrier ?

A

1) Capillary endothelium with fenestrations

2) Glomerular Basement Membrane

3) Slit diaphragm

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17
Q

Capillary endothelium in filtration barrier is coated with what protein ?

A

Podocalyxin

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18
Q

Will hematuria occur in PSGN ?

A

Microhematuria will occur (RBC is visible only using microscope)

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19
Q

Will proteinuria occur in PSGN ?

A

Minimal proteinuria will occur

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20
Q

Microscopic feature in capillary endothelium lumen of filtration barrier in PSGN ?

A

Exudative neutrophilic infiltration

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21
Q

What is the primary constituent of the Glomerular Basement Membrane (GBM)?

A

Type 4 collagen

Type 4 collagen is a major component that provides structural support in the GBM.

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22
Q

What is the normal thickness range of the Glomerular Basement Membrane?

A

350-400 nm

This thickness is crucial for the filtration barrier function of the kidney.

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23
Q

Which cells are referred to as supporting cells of the filtration barrier in the glomerulus?

A

Mesangial cells

Mesangial cells play a key role in maintaining the structure and function of the glomerulus.

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24
Q

What type of microscopy is used to visualize the Glomerular Basement Membrane?

A

Electron microscopy

Electron microscopy provides high-resolution images necessary for observing the fine structure of the GBM.

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25
What substance Provide a negative charge in the GBM?
Heparin sulfate proteoglycans ## Footnote Examples include perlecan and agrin, which contribute to the filtration barrier.
26
What is the prototype disease associated with mesangial cell proliferation?
IgA nephropathy
27
What are the common staining methods used to visualize the GBM under light microscopy ?
Jones Methenamine silver stain Masson's Trichrome stain
28
Fill in the blank: The thickness of the Glomerular Basement Membrane in Thin Basement Membrane disease is typically less than _______.
< 200 nm
29
True or False: The Glomerular Basement Membrane is primarily made up of type 1 collagen.
False ## Footnote The GBM is primarily composed of type 4 collagen, not type 1.
30
What is the effect of violent contraction of mesangial cells leading to rupture of capillaries in the glomerulus?
Macrohematuria ## Footnote This condition can lead to the presence of blood in urine, indicating glomerular damage.
31
What is the role of the visceral layer in the glomerulus?
Forms part of the filtration barrier ## Footnote The visceral layer contains podocytes that wrap around capillaries, playing a crucial role in filtration.
32
What is the significance of capillary surface area in relation to GFR?
Increased surface area increases GFR ## Footnote The greater the surface area available for filtration, the higher the glomerular filtration rate (GFR).
33
Which type of microscopy allows for visualization of the capillary lumen?
Electron microscopy ## Footnote This type of microscopy provides detailed images of the capillary structures.
34
35
Type 4 collagen configuration at birth ?
Alpha 1 alpha 1 alpha 2
36
Type 4 collagen configuration in GBM also found in what membranes
Alpha 3 alpha 4 alpha 5 Also found in Cochlear BM Ocular BM
37
Type 4 collagen configuration in epidermis (Normal skin)
Alpha 5 alpha 5 alpha 6
38
Modes of inheritance of alport syndrome
X linked (alpha 5 defect) Autosomal Dominant or recessive (Alpha 3 + alpha 4 defect)
39
How to differentiate between X linked inheritance and AD/AR mode of inheritance of Alport Syndrome ?
Perform Skin immunoflorescence If alpha 5 is defect then stain will not be present so we can confirm x linked inheritance
40
What happens to GFR during contraction of mesangial cells ?
GFR reduces due to reduction in surface area of glomerulus
41
Can podocytes regenerate ?
Podocytes cannot be regenerated. They are Terminally differentiated cells
42
What protein is anchored to the glomerular basement membrane by foot processes?
Podocytes
43
What role does nephrin play in podocytes?
Prevents protein leak and Maintains podocyte integrity
44
What happens when there is downregulation of nephrin?
Loss of podocyte integrity ## Footnote This can lead to conditions known as podocytopathies.
45
What is podocyturia?
Presence of podocytes in urine ## Footnote This condition indicates damage to the glomerular filtration barrier.
46
What is the diameter range of the filtration slits?
30-50 nm ## Footnote This small size is crucial for selective filtration.
47
What receptor does angiotensin II bind to in podocytes?
Angiotensin II binding receptor in podocyte
48
When does podocytopenia occur ?
When podocytutia occur there is loss of Podocytes in nephrons so reduction in count occur
49
What type of epithelium do the parietal cells of Bowman's capsule consist of?
Simple squamous epithelium ## Footnote This structure is essential for the initial filtration process in the kidneys.
50
True or False: Podocytes can regenerate after injury.
False ## Footnote Podocytes are terminally differentiated and cannot regenerate.
51
What condition is indicated by glomerulosclerosis?
Scarring of the glomeruli ## Footnote This condition can lead to chronic kidney disease (CKD).
52
What role of ACE inhibitors in diabetic nephropathy?
Blocks Angiotensin II receptor
53
Where is nephrin situated ?
It is a protein situated in Slit diaphragm
54
What is slit diaphragm?
It is space between two Podocytes
55
What does binding of angiotensin 2 to podocyte cause to nephrin ?
Downregulation of nephrin which causes loss of podocyte integrity
56
What happens to GBM in podocytopenia ?
GBM attaches to parietal layer of bowman capsule which causes sinechae formation leading to Glomerulosclerosis
57
Type of sclerosis in Finnish type Congenital Nephrotic syndrome
Diffuse mesangial sclerosis
58
Mode of inheritance in Finnish type Congenital Nephrotic syndrome and where is the defect
Autosomal recessive There is defect in nephrins
59
Mode of inheritance of Podocin type of Congenital Nephrotic syndrome
Autosomal recessive
60
True or False Podocin type and Autosomal Dominant type of Congenital Nephrotic syndrome can be treated with steroids
False They are 100% steroid resistant
61
Type of Sclerosis in Podocin type and Autosomal Dominant type of Congenital Nephrotic syndrome
FSGS
62
Read pg 733 last table in marrow very important
Can recall!!!!

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