Renal - Glomerulonephritides

Question 1

what are the triad of features involved in nephrotic syndrome?

Answer 1

proteinuria
hypoalbuminaemia
oedema

Question 2

what are podocytes?

Answer 2

cells in the bowman’s capsule that make a lining that filters blood

Question 3

why can people be prothrombotic in nephrotic syndrome?

Answer 3

antithrombotic factors lost through urine

Question 4

in nephrotic syndrome, what other abnormal blood result can occur?

Answer 4

hyperlipidaemia

Question 5

causes of primary nephrotic syndrome?

Answer 5

FSGS
minimal change
membranous

Question 6

causes of secondary nephrotic syndrome?

Answer 6

hepatitis B/C
SLE
diabetic nephropathy 
amyloidosis
HIV

Question 7

what drugs can cause a secondary nephrotic syndrome?

Answer 7

NSAIDs
penicillin
anti TNF
gold

Question 8

what is the triad of symptoms in nephritic syndrome?

Answer 8

oliguria
hypertension/oedema
active urinary sediment

Question 9

in nephritic syndrome, what can urinary sediment consist of?

Answer 9

haematuria
proteinuria
RBC
casts

Question 10

pathology of nephritic syndrome?

Answer 10

damage to endothelium
proliferative lesion results
red and inflammatory cells leak out in urine

Question 11

causes of nephritic syndrome?

Answer 11

post strep
IgA nephropathy
rapidly progressive

Question 12

out of anti anti GBM, GPA, eGPA and MPA - which are their related ‘ANCA’?

Answer 12

anti GBM - ANCE -ve
GPA - cANCA +ve
MPA- pANCA +ve
eGPA - pANCA

Question 13

Ix for glomerulonephritis?

Answer 13

urinalysis
urine protein electrophoresis
renal biopsy

Question 14

who does minimal change most commonly affect?

Answer 14

children

Question 15

if the biopsy showed abnormal podocyte foot processes, what would the most likely diagnosis be?

Answer 15

minimal change (nephrotic)

Question 16

Tx for minimal change? complications?

Answer 16

steroids
cyclophosphamide

no renal failure

Question 17

who does FSGS most commonly affect?

Answer 17

adults

Question 18

if the biopsy showed glomeruli scarring with IgM + C3 deposits, what would the most likely diagnosis be?

Answer 18

FSGS

Question 19

Tx for FSGS? complications?

Answer 19

steroids
cyclophosphamide
1/2 get renal failure

Question 20

who does membranous most commonly affect? associations?

Answer 20

older adults

drug causes

Question 21

if the biopsy showed thickened GBM with IgG + C3 deposits, what would the most likely diagnosis be?

Answer 21

membranous

Question 22

Tx for membranous and complications?

Answer 22

steroids
cyclophosphamide
1/3 get renal failure

Question 23

features of post strep nephritic? Tx?

Answer 23

1-12wks post sore throat/skin infection
supportive
resolves over 2-4wks

Question 24

who commonly gets IgA nephropathy?

Answer 24

young people

commonest

Question 25

what is IgA nephropathy associated with?

Answer 25

henoch schonlein purpura

Question 26

Tx for IgA nephropathy? complications?

Answer 26

``` BP control (ACE) 1/3rd get renal failure ```

Question 27

what is the most aggressive glomerulonephritis?

Answer 27

rapidly progressive (nephritic)

Question 28

features of rapidly progressive?

Answer 28

fever myalgia wt loss haemoptysis (pulmonary haemorrhage)

Question 29

Tx for rapidly progressive?

Answer 29

steroids cyclophosphamide plasma exchange

Question 30

what is affected in GPA?

Answer 30

small and medium vessels URT kidneys lungs

Question 31

what is the triad of features of eGPA?

Answer 31

asthma eosinophilia vasculitis

Question 32

what is the pathology behind anti GBM?

Answer 32

anti GBM antibodies against type IV collagen

Question 33

what can cause rapidly progressive glomerulonephritis?

Answer 33

GPA eGPA MPA anti GBM