Glomerulonephritis and Immune Responses Quiz

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Questions and Answers

What type of immune response is primarily involved in Goodpasture syndrome?

Type IV hypersensitivity

Type II hypersensitivity (correct)

Type I hypersensitivity

Type III hypersensitivity

Which of the following is a common secondary cause of glomerulonephritis?

Hypertension

Goodpasture syndrome

Diabetes Mellitus (correct)

Post-streptococcal infections

In glomerulonephritis, what is the role of complement proteins following immune complex deposition?

They bind directly to the glomeruli.

They initiate renal blood flow.

They recruit immune cells that release inflammatory cytokines. (correct)

They cause recessive genetic mutations.

Which type of hypersensitivity involves T-cell mediated injury in glomerulonephritis?

Type IV hypersensitivity Signup and view all the answers

Which of the following conditions is NOT considered a primary cause of glomerulonephritis?

Diabetes Mellitus Signup and view all the answers

What is the common characteristic of acute glomerulonephritis?

Immediate immune response to an infection Signup and view all the answers

Which of the following best describes the pathophysiology involved in post-streptococcal glomerulonephritis?

Immune complexes depositing in the glomerular basement membrane Signup and view all the answers

Chronic kidney disease (CKD) is closely associated with which one of the following conditions?

Chronic glomerulonephritis Signup and view all the answers

What triggers the immune response leading to Type II hypersensitivity in Goodpasture syndrome?

Antibodies targeting glomerular structures Signup and view all the answers

What is a consequence of endothelial cell injury in the glomeruli?

Proteinuria and hematuria Signup and view all the answers

What effect does damage to the glomerular capillaries have on the glomerular filtration rate (GFR)?

Reduces the GFR Signup and view all the answers

Which of the following is a risk factor specifically for acute glomerulonephritis?

Recent streptococcal infection Signup and view all the answers

Which autoimmune disease is specifically associated with increased risk of glomerulonephritis?

Goodpasture syndrome Signup and view all the answers

Which statement correctly describes glomerulonephritis transmission?

Infections can lead to glomerulonephritis, but are not transmissible Signup and view all the answers

How does chronic inflammation impact kidney function in glomerulonephritis?

Causes fibrosis and scar tissue formation Signup and view all the answers

Which risk factor is most closely associated with chronic glomerulonephritis?

Diabetes mellitus Signup and view all the answers

What is a likely consequence of immune injury to the glomerular filtration barrier?

Loss of endothelial integrity Signup and view all the answers

Which of the following is NOT a risk factor for nephritic syndrome?

Family history of diabetes Signup and view all the answers

What common clinical manifestation is associated with nephritic syndrome?

Swelling of the face Signup and view all the answers

How do infections like streptococcal pharyngitis relate to nephritic syndrome?

They are transmissible and trigger nephritic syndrome Signup and view all the answers

Which of the following can lead to chronic glomerulonephritis?

Rheumatoid arthritis Signup and view all the answers

Which condition is classified under nephritic syndrome?

IgA nephropathy Signup and view all the answers

What primary cause of nephrotic syndrome is most common in children?

Minimal Change Disease Signup and view all the answers

Which of the following is NOT considered a risk factor for chronic nephrotic syndrome?

Multiple sclerosis Signup and view all the answers

What is a possible pathophysiological change in chronic glomerulonephritis?

Capillary obstruction Signup and view all the answers

Which statement about nephrotic syndrome is true?

It results in hypoalbuminemia and edema. Signup and view all the answers

What is the mechanism by which Minimal Change Disease leads to proteinuria?

Damage to podocytes resulting in loss of negative charge on GBM Signup and view all the answers

Which of the following conditions can lead to secondary nephrotic syndrome?

Lupus Signup and view all the answers

How are streptococcal infections related to glomerulonephritis?

They can lead to post-streptococcal glomerulonephritis. Signup and view all the answers

Which of the following infections are linked to nephrotic syndrome?

HIV and hepatitis B Signup and view all the answers

What drug categories are considered modifiable risk factors for nephrotic syndrome?

NSAIDs and antibiotics Signup and view all the answers

Which group is more likely to develop minimal change disease (MCD)?

Infants and toddlers Signup and view all the answers

Which of the following is a non-modifiable risk factor for nephrotic syndrome?

Age Signup and view all the answers

What is a potential consequence of glomerular filtration barrier injury in nephrotic syndrome?

Massive proteinuria Signup and view all the answers

Which autoimmune disease is associated with an increased risk of nephrotic syndrome?

Systemic lupus erythematosus (SLE) Signup and view all the answers

Which of the following is NOT considered a modifiable risk factor for nephrotic syndrome?

Genetic mutations Signup and view all the answers

What factor is likely to increase glomerular capillary pressure, contributing to nephrotic syndrome?

Obesity Signup and view all the answers

What characterizes Nephritic Syndrome?

Decreased glomerular filtration rate Signup and view all the answers

Which condition is commonly linked to Nephritic Syndrome due to immune-mediated injury?

Glomerular Capillary Injury Signup and view all the answers

What is a likely cause of nephritic syndrome associated with throat infection?

Post-Streptococcal Glomerulonephritis Signup and view all the answers

Which autoimmune disorder is characterized by immune complexes depositing in the glomerulus?

Systemic Lupus Erythematosus Signup and view all the answers

What is a feature of the pathophysiology of nephritic syndrome?

Increased permeability of the filtration barrier Signup and view all the answers

In which condition do immune complexes primarily involving IgA lead to inflammation in the glomeruli?

IgA Nephropathy Signup and view all the answers

What mechanism contributes to glomerular damage in nephritic syndrome due to immune complex deposition?

Complement system activation Signup and view all the answers

Which of the following conditions can lead to rapidly progressive glomerulonephritis?

ANCA-associated vasculitis Signup and view all the answers

Study Notes

Glomerular Disorders

Glomerulonephritis involves inflammation of the glomeruli, often leading to chronic kidney disease (CKD) and end-stage renal disease (ESRD).
Primary causes are those affecting the glomeruli directly
Secondary causes are systemic diseases affecting the glomeruli.
Immunological responses are a leading cause, including type II (antibodies attack components of the glomerular basement membrane) and type III (immune complex deposition) hypersensitivities.
Infections, like post-streptococcal glomerulonephritis (PSGN), can cause glomerulonephritis.
Ischemia, medications, toxins, free radicals, and vascular disorders like hypertension can also damage glomeruli.
Diabetes mellitus is a common cause of chronic glomerulonephritis, leading to diabetic nephropathy.
Systemic lupus erythematosus (SLE) can cause lupus nephritis.

Pathophysiology

Immune-mediated attack on the glomeruli is the key process, varying depending on the underlying cause.
Immune complex deposition in the glomerular basement membrane triggers inflammation, often following an infection like PSGN.
Complement proteins are activated, leading to recruitment of neutrophils and macrophages which release inflammatory cytokines further injuring the glomeruli.
Cell-mediated injury (type IV hypersensitivity) can also contribute to inflammation and glomerular damage.
Direct antibody attack (type II hypersensitivity) can damage glomerular structures, as seen in Goodpasture syndrome.
Endothelial injury leads to increased permeability of the glomerular capillaries allowing proteins to leak into urine.
Reduced glomerular filtration rate (GFR) occurs due to damage and swelling of glomerular capillaries.
Chronic inflammation can lead to fibrosis & scarring, further impairing kidney function.

Disease Transmission

Glomerulonephritis is generally not directly transmissible between individuals.
However, infections that trigger the immune response, like those causing PSGN, can be transmitted.

Risk Factors

Acute glomerulonephritis: Recent streptococcal infection, other bacterial/viral/parasitic infections, autoimmune conditions (like SLE and rheumatoid arthritis), medications/toxins, and vascular disorders (like hypertension).
Chronic glomerulonephritis: Diabetes, chronic infections, family history of autoimmune diseases, and genetic predisposition.

Nephrotic Syndrome

Nephrotic syndrome is characterized by massive protein loss (proteinuria), hypoalbuminemia, edema, and hyperlipidemia.
This occurs due to damage to the glomerular filtration barrier increasing its permeability to proteins.
Primary causes include minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and membranous nephropathy which occur predominantly in children compared to secondary causes such as diabetic nephropathy.
Secondary causes include diabetic nephropathy, lupus, infections, medications, and amyloidosis.

Nephrotic Syndrome Pathophysiology

Damage to the three filtration layers (fenestrated endothelium, glomerular basement membrane, and podocytes) results in increased glomerular capillary permeability.
Increased proteinuria leads to hypoalbuminemia, decreased oncotic pressure, resulting in fluid leakage into interstitial spaces.
This leads to edema and compensatory activation of the RAAS, promoting sodium and water retention which worsens the edema.
Loss of proteins stimulates hepatic production of lipoproteins causing hyperlipidemia, and some lipids appear in the urine (lipiduria).
Loss of anticoagulant proteins increases the risk of thrombosis including renal vein thrombosis.

Nephrotic Syndrome Transmission

Nephrotic syndrome itself is not contagious
Nevertheless, infections that trigger it, like HIV, hepatitis B/C, are infective

Nephrotic Syndrome Risk Factors

Modifiable risk factors include infections, drug use (NSAIDs, antibiotics), obesity, hypertension, and diabetes.
Non-modifiable risk factors include age, gender, genetics, and autoimmune diseases.

Nephritic Syndrome

Nephritic syndrome is characterized by hematuria (blood in urine), oliguria (reduced urine output), decreased glomerular filtration rate (GFR), and hypertension.
Causes include post-streptococcal glomerulonephritis (PSGN), systemic lupus erythematosus (SLE), IgA nephropathy, Goodpasture syndrome, and other conditions like rapidly progressive glomerulonephritis (RPGN), and Henoch-Schönlein purpura (HSP) .

Nephritic Syndrome Transmission

Nephritic syndrome itself is not transmitted, but underlying infections (e.g., streptococcal infections ) that cause it can be transmitted.

Nephritic Syndrome Risk Factors

Infections (like strep throat or skin infections), autoimmune diseases (SLE), age (children more susceptible to PSGN, adults to other types), genetic factors associated with autoimmune disorders, and family history of IgA nephropathy are important risk factors.

Clinical Manifestations (Nephritic/Nephrotic Syndrome)

Kidney function changes including hematuria (blood in urine), oliguria (decreased urine output), hypertension, edema, and proteinuria (protein in urine) are symptoms of both glomerular disorders.

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Description

Test your knowledge on glomerulonephritis and its connection to immune responses, including Goodpasture syndrome and related hypersensitivity mechanisms. Explore the causes, symptoms, and pathophysiology of glomerulonephritis through a series of targeted questions.