Week 11: Glomerulonephritis Flashcards
5 types of glomerulonephritis associated with nephritic syndrome due to: infections
- Post-strep glomerulonephritis
- Non-strep post infectious (eg Hep B/C, malaria)
- Infective endocarditis
- Shunt nephritis
- Visceral abscesses
2 types of glomerulonephritis associated with nephritic syndrome due to: autoimmune conditions
- Goodpasture’s
2. HSP
4 types of primary glomerular disease which cause nephrotic syndrome
- Minimal change glomerular disease
- Membranous nephropathy
- Focal segmental glomerulosclerosis
- Congenital nephrotic syndrome
2 secondary causes of nephrotic syndrome
- Amyloidosis
2. Diabetic nephropathy
Differentiate the following terms in glomerular disease:
- Focal vs Diffuse
- Segmental vs Global
NUMBER OF GLOMERULI
Focal: Affects some glomeruli
Diffuse: Affects most glomeruli
HOW MUCH OF A SINGLE GLOMERULUS
Segmental: Affects part of glomerulus
Global: Affects entire glomerulus
Most common nephropathy worldwide
IgA nephropathy
Pathophysiology of IgA nephropathy
IgA deposition in glomerular mesangium (+ IgG, C3)
Precipitated by infection/ hypersensitivity
Which complement protein is normally deposited in mesangial cells in glomerulonephritis associated with nephritic syndrome
C3
Important differential to rule out in Goodpasture’s disease.
How to differentiate between Goodpasture’s disease and this differential
ANCA vasculitis
ANCA vasculitis has systemic symptoms (fever, weight loss)
Goodpasture’s disease rarely has systemic symptoms
Pathophysiology of Goodpasture’s disease
IgG against alpha3 chain of type 4 collagen
alpha3 chain found in basement membrane of glomerulus and alveolus
Presentation of Goodpasture’s disease
Rapidly progressive nephritis + pulmonary haemorrhage
Which nephrotic syndrome glomerulonephritis is more common in children than adults
Minimal change glomerular disease
What generally can be found on urine microscopy of nephrotic syndrome glomerulonephritis
- Fat bodies
- Hyaline
- Granular casts
List 3 hereditary nephropathies and their type of inheritance
- Polycystic kidney disease (x-linked)
- Alport syndrome (AD)
- Thin membrane disease (AD)
Triad of symptoms in Alport syndrome
- Progressive nephropathy
- Sensorineural hearing loss
- Eye abnormalities (conical lens causing distorted vision)
Pathophysiology in Alport syndrome
Defective basement membrane formation in glomerulus, cochlea, eye
Pathophysiology in thin membrane disease
Inadequate integration of Type 4 collagen into GBM
GBM <200nm (instead of normal 350nm)
Pathophysiology in polycystic kidney disease
- Defective synthesis of proteins polycystin 1 and 2
- Uncontrolled tubular cell proliferation in response to growth factors
- Formation of tubular cysts
- Tubular cysts close off the associated nephron and grow large over time
- Polycystic kidney disease
- Alport syndrome
- Thin membrane disease
is more associated with haematuria/ proteinuria
PKD: haematuria
Alport syndrome: proteinuria
Thin membrane: haematuria
List the 3 ANCA-associated vasculitis.
- Wegener’s/ Granulomatosis with polyangiitis
- Churg-Strauss/ Eosinophilic granulomatosis with polyangiitis
- Microscopic polyangiitis
Most common cause of pulmonary renal syndrome
+other causes
Most common:
Microscopic polyangiitis
Other causes:
- Goodpastures
- Wegener’s/ Granulomatosis with polyangiitis
Does lupus nephritis tend to cause nephrotic or nephritic syndrome
Nephrotic syndrome
Kimmelstein WIlson nodules are associated with what
Diabetic nephropathy
What type of nephropathy is associated with the following:
CHILD WITH SWOLLEN FACE
Is this more associated with nephrotic or nephritic syndrome?
Minimal change nephropathy
Nephrotic syndrome
