Week 10 - Glomerular pathology Flashcards Preview

Urinary > Week 10 - Glomerular pathology > Flashcards

Flashcards in Week 10 - Glomerular pathology Deck (32):
1

What urine abnormality is dominant in nephritic syndrome?

-Haematuria

2

What urine abnormality is dominant in nephrotic syndrome?

-Proteinuria

3

Which group of glomerular pathology leads to hypoalbuminaemia?

-Nephrotic syndrome

4

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

5

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

6

Which part of the glomerulus is affected in nephritic syndrome?

-Problems with epithelia

7

Which part of the glomerulus is affected in nephrotic syndrome?

-Podocyte damage

8

What are the 3 common primary causes of nephrotic syndrome?

-Minimal change glomerulonephritis
-Focal Segmental Glomerulosclerosis
-Membranous glomerulonephritis

9

What is the most common secondary cause of nephrotic syndrome?

-Diabetes mellitus

10

When does minimal change glomerulonephritis present?

-In childhood/adolescence
-Incidence decreases with age

11

What is the primary urine abnormality in minimal change glomerulonephritis?

-Proteinuria

12

Does minimal change glomerulonephritis progress to renal failure?

-Not usually

13

What is the cause of minimal change glomerulonephritis?

-Destruction of podocytes via an unknown mechanism

14

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

15

What is the cause of membranous glomerulonephritis?

-Immune complex formation which become caught in the filter and cause a thickened glomerular basement membrane

16

What is thought to be the cause of immune complex formation in membranous glomerulonephritis?

-Phospholipase on podocytes causing an autoimmune response by IgG

17

What is the rule of 3rds in membranous glomerulonephritis?

-3rd patients remit
-3rd patients ill but stable
-3rd patients enter renal failure

18

What is thought to be a secondary cause of membranous glomerulonephritis?

-Lymphoma

19

How does diabetes mellitus lead to nephrotic syndrome?

-Microvascular damage leads to progressive proteinuria and progressive renal failure with mesangial sclerosis

20

What is the most common cause of glomerulonephritis?

-IgA nephropathy

21

Name 2 hereditary diseases which cause nephritic syndrome

-Alport
-Thin glomerular basement membrane disease

22

When does IgA nephropathy present?

-At any age

23

How does IgA nephropathy present?

-Usually with macro/microscopic haematuria

24

What is IgA nephropathy associated with mucosal infections?

-During infection there is an increased production of IgA which increases blockage in the glomerulus

25

Does IgA nephropathy progress to renal failure?

-Significant portion

26

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

27

Why does alports disease cause nephritic syndrome?

-Abnormal type 4 collagen in BM

28

What clinical problem is associated with alports disease?

-Deafness

29

Which hereditary nephritic syndrome progresses to renal failure?

-Alports
-Thin basement membrane disease does not

30

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

31

What is vasculitis and how does it cause nephritic syndrome?

-Group of systemic disorders which are associated with ANCA causing rapid progressive glomerulonephritis

32

What are the two types of pathology that can occur at the glomerulus?

-The filter can block -> nephritic syndrome
-The filter can leak -> nephrotic syndrome