Flashcards in Week 10 - Glomerular pathology Deck (32)
What urine abnormality is dominant in nephritic syndrome?
What urine abnormality is dominant in nephrotic syndrome?
Which group of glomerular pathology leads to hypoalbuminaemia?
Why do you get oedema in nephrotic syndrome?
-Loss of albumin in the urine results in a decreased oncotic pressure in the capillaries
-ECF which is pushed into the interstitium by hydrostatic pressure at the proximal capillary is not drawn back and oedema occurs
Why does hyperlipidaemia occur in nephrotic syndrome?
-Due to hypoalbuminaemia
-Liver tries to compensate by increasing protien production however there is a side effect of increasing lipid production
Which part of the glomerulus is affected in nephritic syndrome?
-Problems with epithelia
Which part of the glomerulus is affected in nephrotic syndrome?
What are the 3 common primary causes of nephrotic syndrome?
-Minimal change glomerulonephritis
-Focal Segmental Glomerulosclerosis
What is the most common secondary cause of nephrotic syndrome?
When does minimal change glomerulonephritis present?
-Incidence decreases with age
What is the primary urine abnormality in minimal change glomerulonephritis?
Does minimal change glomerulonephritis progress to renal failure?
What is the cause of minimal change glomerulonephritis?
-Destruction of podocytes via an unknown mechanism
What are the differences between minimal change glomerulonephritis and focal segmental glomeruloslcerosis?
-FGS occurs in adults
-FGS is less responsive to setroids
-FGS progresses to renal failure due to scarring
What is the cause of membranous glomerulonephritis?
-Immune complex formation which become caught in the filter and cause a thickened glomerular basement membrane
What is thought to be the cause of immune complex formation in membranous glomerulonephritis?
-Phospholipase on podocytes causing an autoimmune response by IgG
What is the rule of 3rds in membranous glomerulonephritis?
-3rd patients remit
-3rd patients ill but stable
-3rd patients enter renal failure
What is thought to be a secondary cause of membranous glomerulonephritis?
How does diabetes mellitus lead to nephrotic syndrome?
-Microvascular damage leads to progressive proteinuria and progressive renal failure with mesangial sclerosis
What is the most common cause of glomerulonephritis?
Name 2 hereditary diseases which cause nephritic syndrome
-Thin glomerular basement membrane disease
When does IgA nephropathy present?
-At any age
How does IgA nephropathy present?
-Usually with macro/microscopic haematuria
What is IgA nephropathy associated with mucosal infections?
-During infection there is an increased production of IgA which increases blockage in the glomerulus
Does IgA nephropathy progress to renal failure?
What is the pathophysiology of IgA nephropathy?
-IgA forms immune complexes which become deposited in the mesangium
-Mesangial damage results in proliferation of mesangial cells and excessive matrix production
Why does alports disease cause nephritic syndrome?
-Abnormal type 4 collagen in BM
What clinical problem is associated with alports disease?
Which hereditary nephritic syndrome progresses to renal failure?
-Thin basement membrane disease does not
What is good-pasture syndrome? What is its cause? How is it treated?
-Acute onset of severe nephritic syndrome which is rapidly progressive to renal failure (within 24 hours)
-Caused by autoantibody to T4 collagen in glomerular BM
-Treated with immunosuppressants and plasmophoresis if caught early
What is vasculitis and how does it cause nephritic syndrome?
-Group of systemic disorders which are associated with ANCA causing rapid progressive glomerulonephritis