30 Questions
Describe two mechanisms, apart from anti-GBM antibodies, that can lead to the development of characteristic findings in Type II RPGN.
Immune complex deposition and pauci-immune mechanisms.
What specific disease exemplifies immune complex deposition in Type II RPGN?
SLE
What specific disease exemplifies pauci-immune mechanisms in Type II RPGN?
Granulomatosis with polyangiitis (Wegener's)
What is the diagnosis based on the findings of diffuse thickening of the basement membrane, prominent capillary loops, but no increased cellularity in light microscopy, along with subepithelial deposits and basement membrane reaction in electron microscopy?
Membranous glomerulopathy
What is the significance of the 5.5 g of protein in the 24-hour urine test and serum albumin of 29g/L in the clinical presentation?
Indicates significant proteinuria and hypoalbuminemia.
How does the appearance of spikes on Jones silver stain relate to the diagnosis of membranous glomerulopathy?
They arise from subepithelial deposits and basement membrane reaction.
What is the characteristic location of deposits in poststreptococcal glomerulonephritis?
Subepithelial (between the GBM and the podocytes)
What is the main complication associated with rapidly progressive glomerulonephritis?
Rapid and progressive loss of renal function
What differentiates postinfectious glomerulonephritis due to staphylococcal infections from streptococcal infections?
Sometimes produces immune deposits containing IgA rather than IgG
What are the 3 types of Rapidly Progressive (Crescentic) Glomerulonephritis?
Type 1 RPGN (Anti-GBM), Type 2 RPGN (Immune complex-mediated), Type 3 RPGN (Pauciimmune)
What is the hallmark feature of Renal limited Goodpasture syndrome?
Crescent formation
What diagnostic tools are used to diagnose poststreptococcal glomerulonephritis?
Clinical findings, Antistreptolysin O level, Urinalysis, Biopsy
What are the key structures highlighted in a normal glomerulus in a H + E stain?
Green line: Bowman's capsule; Blue circles: Capillary loops; Red lines: Red blood cells; Yellow areas: Mesangium
How can glomerular disorders be classified based on the extent of organ involvement?
Primary (idiopathic) when the kidney is the only or predominant organ involved, Secondary when glomeruli may be injured due to systemic diseases.
List three techniques used to evaluate glomeruli in glomerular disorders.
Light microscopy, Immunofluorescence, Electron microscopy
What are the main manifestations of glomerular disorders?
Nephritic syndrome, Nephrotic syndrome, Mixed, Asymptomatic hematuria/urinary abnormalities, Chronic renal failure
Define 'Segmental' involvement in glomerular disorders.
A portion of a glomerulus is involved.
Explain the term 'Global' in the context of glomerular disorders.
All of a glomerulus is involved.
What are the clinical features of nephritic syndrome?
Acute renal failure, haematuria, red cell casts, proteinuria, hypertension
Describe the clinical features of nephrotic syndrome.
Proteinuria (>3.5g/day), hypoalbuminaemia, generalised oedema
What is the glomerular reaction pattern seen in crescentic glomerulonephritis?
Crescentic glomerulonephritis
Which glomerular disease is associated with matrix accumulation in mesangium and GBM with glomerulosclerosis?
Membranous glomerulonephritis
What are the clinical features of post-infectious glomerulonephritis?
Proteinuria + gradual decline in GFR
Which glomerular disease is associated with minimal change glomerulopathy?
Minimal change glomerulopathy
What is the pathophysiological basis of massive proteinuria in nephrotic syndrome?
Changes in physicochemical properties of GBM and fusion of foot processes of podocytes result in loss of regulatory barrier, permitting massive protein loss in the urine.
How does hypoalbuminemia develop in nephrotic syndrome?
When loss of albumin in urine exceeds the capacity of the liver to produce more, hypoalbuminemia will occur.
Explain the mechanism behind the development of edema in nephrotic syndrome.
Decreased plasma oncotic pressure secondary to hypoalbuminemia leads to the transudation of fluid into the interstitium.
What are some common causes of secondary membranous glomerulopathy?
Drugs (NSAID, penicillamine, captopril, gold), malignant tumors (lung and colorectal carcinomas, melanomas), systemic lupus erythematosus (SLE), infections (chronic hepatitis B, hepatitis C, syphilis, schistosomiasis, malaria).
What clinical features were observed in the 2-year-old Malaysian male with nephrotic syndrome?
Facial swelling, runny nose, cough, normal blood pressure, and nephrotic range proteinuria.
What is the significance of proteinuria ++++ in the urinalysis of the 2-year-old Malaysian male?
It indicates a very high level of protein in the urine, which is characteristic of nephrotic syndrome.
Join Dr. Suja Pillai in this Zoom pathology lectorial to learn about renal diseases like glomerular, vascular, and cystic diseases including Nephritic Syndrome, Nephrotic Syndrome, Membranoproliferative Glomerulonephritis, Vascular Diseases, and Cystic Diseases. Explore topics like renal artery stenosis, polycystic kidney disease, and more.
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