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Urinary Systems #2 > Pathophysiology of Glomerular Disease (Cianciolo) > Flashcards

Pathophysiology of Glomerular Disease (Cianciolo) Flashcards

1
Q

What are the three components of the glomerular filtration barrier?

A
  • Capillary endothelium
    - Fenestrated
    - Covered by glycocalyx (negatively charged)
  • Glomerular Basement Membrane (GBM)
    - Mostly composed of Type IV Collagen
    - Also glycosaminoglycans
  • Podocytes
    - very rarely able to replace themselves
    - Production of VEGF to maintain endothelial cell health
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2
Q

Maintains structural integrity of the glomerular tuft

A

Mesangial Cell

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3
Q

(T/F) Mesangial lesions are always clinically significant

A

False

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4
Q

What is a hallmark of glomerular disease?

A

Proteinuria

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5
Q

What might be seen in nephrotic syndrome?

A
  • Proteinuria
  • Hypoalbuminemia / Hypoproteinemia
  • Edema/ascites
  • Hypercholesterolemia / hyperlipidemia
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6
Q

(T/F) Azotemia is not a criterion for diagnosis of nephrotic syndrome

A

True

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7
Q

What should a kidney report describe?

A
  • Hypercellularity
  • Mesangium
  • Sclerosis or Hyalinosis
  • Immune deposits
  • Capillary wall
  • Synechia
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8
Q

What are the two hypercellularity?

A
  • Mesangial
  • Endocapillary
  • These are not mutually exclusive
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9
Q

Plasma was pushed into the mesangium or GBM

A

Hyalinosis

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10
Q

Same extracellular matrix components but MORE

A

Segmental sclerosis (Scarring of the glomerulus)

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11
Q

Adhesions between the glomerular tuft and Bowman’s capsule

A

Synechiae (podocytes have been damaged)

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12
Q

(T/F) We know that GBM is normal when we see some remodeling

A

False, when it has a normal smooth contour

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13
Q

Occurs when the GBM ruptures and the material in circulation pours into Bowman’s space

A

Crescents

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14
Q

(T/F) Crescents are common in small animals

A

False, rare in small animals and seen more often in pigs

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15
Q

What are the 2 large categories of Glomerular Disease in animals?

A
  • Immune complex-mediated glomerulonephritis (ICGN)
  • Non- ICGN
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16
Q

(T/F) Immunosuppression of non-ICGN is not recommended

A

True

17
Q

(T/F) You can try to treat ICGN with immunosuppressive agents

A

True

18
Q
  • Immune complexes are aggregates of antigens and antibodies which can be deposited in glomeruli
  • Location in which it is trapped depends on size and charge
A

ICGN

19
Q
  • Is an immune complex
  • Complement pathway is activated on the OUTSIDE of the capillary lumen (inflammatory cells are not attracted to tuft)
  • Complexes likely contain antigens released by
    - Infections
    - Drugs
    - Neoplasia
  • We almost never ID the antigen in small animals
A

Membranous Glomerulonephritis (MGN)

20
Q
  • Endocapillary hypercellularity due to subendothelial deposits
  • Mesangial hypercellularity
  • GBM remodeling
A

Membranoproliferative GN (ICGN)

21
Q

What are 2 common examples of Non-ICGN?

A
  • Amyloidosis
    - fibrils get deposited in glomeruli
    - irreversible process
    - generated from Serum Amyloid A protein (in the liver) in states of systemic inflammation
  • Focal segmental glomerulosclerosis
    - Due to podocyte injury
22
Q
  • Diagnosed in about 1/4 biopsies from proteinuric dogs
  • Primary
    - Assumed to be due to abnormal podocyte genes/proteins
A

Focal Segmental Glomerulosclerosis

23
Q
  • Secondary (or Adaptive) due to podocyte injury
    - Systemic hypertension
    - Obesity
    - decreased nephron mass -> increased single nephron GFR
    - Drugs or viruses
  • Significant tuft scarring in immune-mediated GN, it is called “sclerosing ICGN”
A

Focal Segmental Glomerulosclerosis

24
Q

Compression and effacement of peripheral capillary loops

A

Sclerosis

25
Q
  • Is thought to be hereditary
  • Most don’t know the mutation/pattern of inheritance except for Alport syndrome
    - Alport is due to a mutation in Type IV collagen
A

Glomerular Basement Membrane Lesions

26
Q

Multifocal embolic nephritis in young foals due to _____________________

A

Actinobacillus equuili

Urinary Systems #2 (9 decks)

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