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What is the filtering part of the kidneys called?
What is the filtering part of the kidneys called?
Glomerulus
What is the primary mechanism of glomerular injury?
What is the primary mechanism of glomerular injury?
Anti-glomerular basement membrane nephritis is an example of antibody-mediated glomerular injury.
Anti-glomerular basement membrane nephritis is an example of antibody-mediated glomerular injury.
True
What is the name of the syndrome where anti-GBM antibodies cross-react with the basement membrane of the lungs?
What is the name of the syndrome where anti-GBM antibodies cross-react with the basement membrane of the lungs?
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What is the main mechanism behind immune complex-mediated glomerular injury?
What is the main mechanism behind immune complex-mediated glomerular injury?
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Name the type of hypersensitivity responsible for immune complex-mediated glomerular injury.
Name the type of hypersensitivity responsible for immune complex-mediated glomerular injury.
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What is the main effect of released cytokines in cell-mediated glomerular injury?
What is the main effect of released cytokines in cell-mediated glomerular injury?
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What is the primary characteristic of nephrotic syndrome?
What is the primary characteristic of nephrotic syndrome?
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Which of the following is NOT a primary glomerular cause of nephrotic syndrome?
Which of the following is NOT a primary glomerular cause of nephrotic syndrome?
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What is the most common cause of nephrotic syndrome in children?
What is the most common cause of nephrotic syndrome in children?
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What is the most common cause of nephrotic syndrome in adults?
What is the most common cause of nephrotic syndrome in adults?
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Immunofluorescence is a technique that utilizes antibodies linked to a fluorophore to stain proteins.
Immunofluorescence is a technique that utilizes antibodies linked to a fluorophore to stain proteins.
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What is the most common cause of nephrotic syndrome in children known for its unknown cause and increased cytokines (Type IV hypersensitivity)?
What is the most common cause of nephrotic syndrome in children known for its unknown cause and increased cytokines (Type IV hypersensitivity)?
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What type of glomerular pathology involves sclerosis affecting some but not all glomeruli?
What type of glomerular pathology involves sclerosis affecting some but not all glomeruli?
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What is the most common cause of nephrotic syndrome in adults characterized by in situ antibody-mediated (AB mediated against planted Ag) Type II hypersensitivity?
What is the most common cause of nephrotic syndrome in adults characterized by in situ antibody-mediated (AB mediated against planted Ag) Type II hypersensitivity?
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In the early stages, membranous glomerulonephritis often appears normal under a light microscope.
In the early stages, membranous glomerulonephritis often appears normal under a light microscope.
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What is the primary feature of membranoproliferative glomerulonephritis (MPGN) type I that distinguishes it from other glomerular diseases?
What is the primary feature of membranoproliferative glomerulonephritis (MPGN) type I that distinguishes it from other glomerular diseases?
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Which types of glomerulonephritis are associated with immune complex-mediated/circulating immune complex (type III hypersensitivity)?
Which types of glomerulonephritis are associated with immune complex-mediated/circulating immune complex (type III hypersensitivity)?
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What is the most common manifestation of nephritic syndrome?
What is the most common manifestation of nephritic syndrome?
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What is the main pathological process underlying nephritic syndrome?
What is the main pathological process underlying nephritic syndrome?
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Which of the following is NOT a common cause of acute glomerulonephritis?
Which of the following is NOT a common cause of acute glomerulonephritis?
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What is the primary characteristic of acute diffuse proliferative glomerulonephritis (ADPGN)?
What is the primary characteristic of acute diffuse proliferative glomerulonephritis (ADPGN)?
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Which type of infection is often associated with post-streptococcal glomerulonephritis?
Which type of infection is often associated with post-streptococcal glomerulonephritis?
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The immune complex in ADPGN is primarily composed of IgG and IgM antibodies deposited in the basement membrane.
The immune complex in ADPGN is primarily composed of IgG and IgM antibodies deposited in the basement membrane.
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Which of the following is a clinical feature of ADPGN?
Which of the following is a clinical feature of ADPGN?
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What is the most prominent microscopic finding in post-streptococcal glomerulonephritis?
What is the most prominent microscopic finding in post-streptococcal glomerulonephritis?
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The subepithelial humps seen in post-streptococcal glomerulonephritis are pathognomonic, meaning they definitively indicate this specific condition.
The subepithelial humps seen in post-streptococcal glomerulonephritis are pathognomonic, meaning they definitively indicate this specific condition.
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What is the prognosis for children with post-streptococcal glomerulonephritis?
What is the prognosis for children with post-streptococcal glomerulonephritis?
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What is the main characteristic that defines rapidly progressive glomerulonephritis?
What is the main characteristic that defines rapidly progressive glomerulonephritis?
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What is the primary histological feature of rapidly progressive glomerulonephritis?
What is the primary histological feature of rapidly progressive glomerulonephritis?
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Which of the following conditions is NOT a common cause of rapidly progressive glomerulonephritis?
Which of the following conditions is NOT a common cause of rapidly progressive glomerulonephritis?
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What is the main difference between Goodpasture's syndrome and other types of glomerulonephritis?
What is the main difference between Goodpasture's syndrome and other types of glomerulonephritis?
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Goodpasture's syndrome is a common and readily treatable condition.
Goodpasture's syndrome is a common and readily treatable condition.
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What is the most common cause of glomerulonephritis worldwide?
What is the most common cause of glomerulonephritis worldwide?
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Primary IgA nephropathy is associated with autoimmune responses and often develops following a streptococcal infection.
Primary IgA nephropathy is associated with autoimmune responses and often develops following a streptococcal infection.
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What is the primary histological finding in primary IgA nephropathy?
What is the primary histological finding in primary IgA nephropathy?
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Primary IgA nephropathy typically progresses rapidly and leads to severe renal failure within a short period.
Primary IgA nephropathy typically progresses rapidly and leads to severe renal failure within a short period.
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What is the primary defining characteristic of chronic glomerulonephritis?
What is the primary defining characteristic of chronic glomerulonephritis?
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Chronic glomerulonephritis is often irreversible and leads to a gradual decline in kidney function.
Chronic glomerulonephritis is often irreversible and leads to a gradual decline in kidney function.
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What is the primary characteristic of chronic glomerulonephritis in terms of gross morphology?
What is the primary characteristic of chronic glomerulonephritis in terms of gross morphology?
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What is the most common microscopic finding in the glomeruli of chronic glomerulonephritis?
What is the most common microscopic finding in the glomeruli of chronic glomerulonephritis?
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Diabetic nephropathy is a common complication of diabetes mellitus that affects only the kidneys and does not involve other organs.
Diabetic nephropathy is a common complication of diabetes mellitus that affects only the kidneys and does not involve other organs.
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What is the primary mechanism by which hyperglycemia damages the kidneys in diabetic nephropathy?
What is the primary mechanism by which hyperglycemia damages the kidneys in diabetic nephropathy?
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Which of the following is NOT a common glomerular complication of diabetic nephropathy?
Which of the following is NOT a common glomerular complication of diabetic nephropathy?
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Which type of diabetic nephropathy is characterized by the formation of hyaline deposits within mesangial areas of the glomeruli?
Which type of diabetic nephropathy is characterized by the formation of hyaline deposits within mesangial areas of the glomeruli?
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Long-term diabetic nephropathy can lead to a contracted kidney, indicating significant loss of renal tissue.
Long-term diabetic nephropathy can lead to a contracted kidney, indicating significant loss of renal tissue.
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Study Notes
Glomerular Disease I
- Kidney components are divided into four: damage to one affects the others, ending in end-stage kidney.
- Nephron is the kidney's functional unit.
- Glomerulonephritis is inflammation and damage to the glomerulus (filtering part of the kidneys).
- Glomerular injury is mainly immunologically mediated, either secondary to another disease or primary.
Mechanisms
-
Type II Hypersensitivity (Antibody-mediated): Antibodies directly react with tissue antigens (anti-glomerular basement membrane nephritis).
- Antibodies target the glomerular basement membrane (BM) along its whole length, showing a diffuse, linear pattern on immunofluorescence.
- Example: Goodpasture syndrome (antibodies react with both lung and kidney BM).
-
Type II Hypersensitivity (In Situ Immune Complex): Antibodies against planted non-glomerular antigens.
- Viral, parasitic, bacterial products, or drugs act as antigens.
- These antigens bind to the anionic glomerular basement membrane (GBM) and become trapped.
- Example: Membranous glomerulonephritis (granular heterogeneous pattern on immunofluorescence).
Glomerular Disease II (Nephritic Syndrome)
- Kidney disease with acute onset of hematuria (blood in the urine), hypertension (high blood pressure), mild to moderate proteinuria (protein in the urine), edema, and oliguria (low urine output).
- Pathogenesis – either immunological or non-immunological damage to glomerular capillary endothelial cells causes increased permeability.
- Focal Increase in Permeability leads to proteinuria, hematuria, and casts (protein, red blood cells, and epithelial cells) in the urine.
Acute Diffuse Proliferative Glomerulonephritis (GN)
- Characterized by diffuse inflammation affecting all glomeruli in both kidneys.
- Post-streptococcal GN is common, following infection with group A beta-hemolytic streptococci (2-4 weeks later).
- Other causes include: bacterial (Staph aureus, meningiococci), viral (Hepatitis B, C, A, EBV, mumps), parasitic (malaria, toxoplasmosis), and other infectious agents.
- Pathogenesis is immune-complex mediated.
- Antigens (e.g., streptococcal) trigger antibody production that leads to mesangial/subepithelial immune complex deposition.
- Leads to glomerular injury and inflammation.
Rapidly Progressive (Crescentic) Glomerulonephritis
- Clinically progressive decline in kidney function (weeks to months).
- Histologically, it's marked by crescent formation in Bowman's space.
- Causes include idiopathic, post-streptococcal, SLE, and Goodpasture's syndrome.
Chronic Glomerulonephritis
- End-stage of glomerulonephritis.
- Early symptoms include increased urine volume (polyurea), decreased urine concentration ability, mild proteinuria, and presence of hyaline and granular casts in urine.
- Late symptoms include progressively worsening oliguria, uremia, anemia, and hypertension.
- Pathological features include loss of demarcation between cortex and medulla, uniformly reduced kidney size, and sclerosis of glomeruli.
Diabetic Nephropathy
- Glomerular injury due to prolonged hyperglycemia.
- Glucose attaches to proteins in blood vessels (collagen, basement membrane).
- Thickened glomerular basement membrane, mesangial cell activation and mesangial matrix expansion occur.
- Leads to glomerulosclerosis and other complications such as non-nephrotic proteinuria, chronic renal failure, nephrotic syndrome, and increased susceptibility to pyelonephritis and papillary necrosis.
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Description
Test your knowledge on glomerular diseases, including the functional unit of the kidney and the mechanisms of damage such as glomerulonephritis and hypersensitivity reactions. This quiz covers key topics related to immunologically-mediated kidney injury and specific conditions such as Goodpasture syndrome.
