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Questions and Answers
Which of the following is a characteristic finding in membranous glomerulonephritis?
Which of the following disorders is not associated with membranous glomerulonephritis?
In membranoproliferative glomerulonephritis type 1, which area of the glomerulus is affected?
Which of the following is a characteristic finding in membranoproliferative glomerulonephritis type 2?
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Which of the following is not a common laboratory finding in chronic glomerulonephritis?
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Which of the following is a characteristic finding in acute glomerulonephritis?
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Which of the following symptoms is NOT typically associated with Acute Poststreptococcal Glomerulonephritis?
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What is the characteristic feature found in Bowman's space in Rapidly Progressive Glomerulonephritis?
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Which antibody is typically found in Goodpasture's Syndrome?
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What is a common laboratory finding in Wegener's Granulomatosis?
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Which form of vasculitis primarily affects small vessels and is associated with IgA-dominant immune deposits?
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What distinguishes Acute Glomerulonephritis from Rapidly Progressive Glomerulonephritis in terms of prognosis?
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Which of the following is NOT a characteristic of a telescoped urine sediment?
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Which of the following conditions is most likely associated with a telescoped urine sediment?
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In the progression of chronic renal failure, at which stage does metabolic acidosis, edema, and hyperkalemia develop?
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Which of the following is a prerenal cause of acute renal failure?
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At which stage of chronic renal failure does the GFR drop to about 50% of normal?
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Which of the following is a renal cause of acute renal failure?
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Study Notes
Glomerulonephritis
- Membranous Glomerulonephritis: characterized by pronounced thickening of the glomerular basement membrane due to IgG immune complex deposition
- Associated disorders: systemic lupus erythematosus, Sjögren syndrome, secondary syphilis, hepatitis B, gold and mercury treatments, malignancy
- Disease progression: slow, with possible remission, and frequent development of nephrotic syndrome symptoms
Membranoproliferative Glomerulonephritis
- Type 1: increased cellularity in the subendothelial cells of the mesangium, causing thickening of the capillary walls
- Type 2: extremely dense deposits in the glomerular basement membrane
- Laboratory findings: hematuria, proteinuria, decreased serum complement levels
- Associated with autoimmune disorders, infections, and malignancies
Chronic Glomerulonephritis
- Examination of the urine reveals: hematuria, proteinuria, glucosuria, and various casts
- Markedly decreased glomerular filtration rate, increased BUN and creatinine levels, and electrolyte imbalance
Acute Glomerulonephritis
- Sterile, inflammatory process affecting the glomerulus
- Associated with blood, protein, and casts in the urine
- Multiple types, which may change over time and become chronic
Acute Poststreptococcal Glomerulonephritis
- Caused by infection with group A streptococcus
- Symptoms: fever, edema, fatigue, hypertension
- Laboratory diagnosis: urinalysis findings include hematuria, proteinuria, oliguria, and elevated ASOT
Rapidly Progressive Glomerulonephritis (RPGN)
- Aka Crescentic Glomerulonephritis
- Accumulation of cells in Bowman's space, forming "crescents"
- Initiated by deposition of immune complexes
- Complication of another form of glomerulonephritis or immunologic disorder
- Lab results similar to acute glomerulonephritis, but becomes more abnormal as it progresses
Goodpasture's Syndrome
- Presence of antiglomerular basement membrane antibody (anti-GBM)
- Attachment of autoantibody to basement membrane, followed by complement activation, producing capillary destruction
- More likely in young males between 18-35 years old
- Rapidly progresses to renal failure, with a mortality rate of up to 50%
Wegener's Granulomatosis
- A small-vessel vasculitis
- Granuloma-producing inflammation of the small blood vessels of the kidney and respiratory system
- Laboratory diagnosis: serum antineutrophilic cytoplasmic antibody (ANCA), hematuria, proteinuria, RBC casts, elevated serum creatinine and BUN
Henoch-Schönlein Purpura
- A small-vessel vasculitis
- Vasculitis with IgA-dominant immune deposits, affecting small vessels
- Disease occurs primarily in children following upper respiratory infections
- Clinical manifestations: raised, red patches on the skin, respiratory and gastrointestinal symptoms
- Renal involvement, with complete recovery in >50% of patients
Renal Failure
- Acute Renal Failure: sudden loss of renal function, often reversible
- Primary causes: prerenal (sudden decrease in blood flow), renal (acute glomerulonephritis), postrenal (renal calculi, tumors)
- General characteristics: decreased glomerular filtration rate, oliguria, edema, and azotemia
- Telescoped urine sediment: simultaneous occurrence of elements of glomerulonephritis and nephrotic syndrome
Chronic Renal Failure
- Rate of progression varies from several months to many years
- Progression occurs in four stages:
- Diminished renal reserve (GFR drops to 50% of normal)
- Renal insufficiency (GFR drops from 20 to 50%, azotemia, anemia, and hypertension begin)
- Renal failure (GFR <20%, kidneys cannot regulate volume and solute concentration)
- End-stage renal disease
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Description
Learn about acute glomerulonephritis, an inflammatory condition affecting the glomerulus and characterized by blood, protein, and casts in the urine. Understand its association with group A streptococcus infection and immune complex deposition in the glomerular membrane.
