Pathology of Glomerular Disease Flashcards

(34 cards)

1
Q

what is a podocyte

A

a cell in the bowman’s capsule that wraps around the capillaries

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2
Q

proteins equal to and bigger/smaller than albumin will not be filtered at glomerulus

A

bigger

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3
Q

layer that capillary endothelium lies on

A

basal lamina

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4
Q

3 layers of glomerular membrane

A

endothelium, basal lamina and podocyte foot process

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5
Q

what is a podocyte foot process

A

a projections of the podocyte cell that wrap around the capillary and leave slits between

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6
Q

what are mesangial cells

A

group of cells which support capillaries

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7
Q

what do the mesangial cells make up

A

the mesangium

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8
Q

glomerulonephritis is inflammatory/non-inflammatory

A

can be either

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9
Q

some glomerulonephritis can be due to the deposition of

A

immunoglobulins

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10
Q

what is glomerulonephritis

A

a large range of diseases of the glomerulus

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11
Q

someone presents with discoloured urine with dipsticks positive for blood. What investigations should be done

A

urine culture and ultrasound, then biopsy if nothing found

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12
Q

how does IgA deposition cause nephropathy

A

IgA clogs the mesangium –> irritates the cells –> causes them to proliferate –> excess mesangial cells

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13
Q

IgA nephropathy is inflammatory/non-inflammatory

A

inflammatory

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14
Q

presentation of IgA nephropathy

A
  • blood in urine
  • flank pain
  • hand/feet oedema
  • hypertension
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15
Q

outcomes of IgA nephropathy

A

usually self-limiting and resolves

small amount of continued deposition –> glomerulus becomes more sclerosed –> chronic renal failure

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16
Q

in membranous glomerulonephritis where does IgG get stuck

A

between basal lamina and podocyte of glomerulus

17
Q

pathophysiology of membranous glomerulonephritis

A

IgG accumulates between basal lamina and podocyte –> activates C3 (complement) –> punches a hole in filter –> leaky filter lets albumin through –> nephrotic syndrome

18
Q

what would you expect to find in a blood test for membranous glomerulonephritis

A

low serum albumin

19
Q

what would you expect in urine of membranous glomerulonephritis

A

high albumin in urine (proteinuria)

20
Q

what is the membrane like in membranous glomerulonephritis

A

thickened and leaky

21
Q

what causes IgG production and accumulation in membranous

A

essentially unknown - can be malignancy

22
Q

presentation of membranous glomerulonephritis

A

proteinuria, feeling unwell, ankle and leg oedema, low serum albumin, weight gain

23
Q

why do a clotting screen before a renal biopsy

A

because bleeding is a big risk of a kidney biopsy so you want to make sure this isn’t likely

24
Q

pathophysiology of diabetic nephropathy

A

high blood glucose –> glycated molecules –> deposition in basal lamina and mesangial matrix –> thickened and leaky membrane and mesangium compressing capillaries

25
consequence of diabetic neuropathy on glomerular circulation
compressed capillaries and thickened, narrowed arterioles -->
26
name given to excess growth of mesangial matrix in diabetic nephropathy
nodules - kimmelsteil-wilson lesion
27
expected findings of blood test in diabetic nephropathy
low albumin (all leaking into urine)
28
rapidly rising creatinine is a sign of what
acute renal failure
29
what investigations would you do in suspected acute renal failure (rapidly rising creatinine)
ultrasound and renal biopsy
30
histology of crescentic glomerulonephrititis
influx of macrophages forming crescent around glomerulus
31
what is wegeners
a type of vasculitis which affects kidnyes, nose and lungs | in kidnyes it presents as crescentic glomerulonephritis
32
tests for wegeners
serum test for anti neutrophil cytoplasmic antibodies (ANCA)
33
what are anti-neutrophil cytoplasmic antibodies
antibodies directed against proteinase 3 and myeloperoxidase (enzymes in primary granules of neutrophils)
34
effect of ANCA on kidneys
damage endothelial tissue