Glomerular Disease

Question 1

what is the glomerulus?

Answer 1

• network of capillaries

- filters blood through

Question 2

what are the 2 process of glomerulus that works toward making urine?

Answer 2

• ultrafiltration

- active reabsorption (need SELECTIVE permeability)

Question 3

what are the 4 categories of glomerular disease?

Answer 3

1. Acute nephritic syndromes
2. Nephrotic syndromes
3. asymptomatic protienuria & hematuria
4. acute & chronic glomerulonephritis

Question 4

Acute nephritic syndromes

Answer 4

-decrease in glomerular permeability(decrease in glomerular filtration rate)
(decrease filtration, retain more, keep fluids in with nitrogenous wastes, retaining nitrogenous wastes)
-fluid & nitrogen waste retention which then leads to edema and hypertension

Question 5

Nephrotic syndromes

Answer 5

• increase in glomerular permeability
• leads to fluid loss and electrolyte loss (leading to hypotension & hypovolemia
• which will then lead to an increase in proteinuria(increase permeability protiens, large pore sizes, proteins go through & loose) and Hypoalbumenia (loss of albumin, which is a protein)
• also hyperlipidemia & lipiduria

Question 6

why does hyperlipidemia & lipiduria occur with nephrotic syndromes?

Answer 6

secondary to proteinuria, secondary problem in liver, loosing proteins in urine, liver responds by synthesizing more proteins, as part of that synthesis more lipids produced, especially (triglycerides & LDLs)

Question 7

when hyperlipidemia & lipiduria occurs with nephrotic syndromes what are the lipids that are usually produced?

Answer 7

-triglycerides & LDL(low density lipids)

Question 8

asymptomatic proteinuria & hematuria

Answer 8

• asymptomatic because does not significantly affect renal function (DOES NOT AFFECT GFR)
• no impairment of kidney function
• level of proteinuria much lower than what is in nephrotic syndrome

Question 9

acute & chronic gomerulonephritis

Answer 9

• there are several forms of glomerulonephritis
• glomerular inflammation
• several types

Question 10

what is the type of golmerulonephritis we HAVE to KNOW and remember for this stupid exam?

Answer 10

acute post infectious (proliferative) glomerulonephritis

Question 11

what is Acute post infectious (proliferative) glomerulonephritis?

Answer 11

• common form of glomerulonephritis
• usually in children (has a 95% recovery rate)
• is a type 3 hypersensitivity reaction
• Immune complex traps in glomerulus and glomerular function impeded

Question 12

what is Acute post infectious (proliferative) glomerulonephritis usually preceded by?

Answer 12

Pharyngeal or Dermal infection (7-12 days after)

commonly from B hemolytic streptococcus (hemolytic is hemolysis so break down of erythrocytes during infection)

Question 13

what are the manifestations of Acute post infectious (proliferative) glomerulonephritis?

Answer 13

• oliguria (decreased urine output), proteinuria, hematuria
• azotemia
• fluid retention: causing hypertension & edema

Question 14

treatment of acute post infectious (proliferative) glomerulonephritis?

Answer 14

usually self limiting (recover in weeks)

symptomatic treatment

Question 15

how does this type 3 hypersensitivity play out in acute post infectious (proliferative) glomerulonephritis?

Answer 15

immunocomplex forms from infection (antigen) this immunocomplex is to small for enzymes to detect so avoids destruction. In both cases immunocomplex pressists & exisits in circulation until finds a vesesl small enough to attach to like a capillary for example the capillaries in the kidney . The immunocomplex arrives & deposits in glomerulus, impeded perfusion obstructing pores, macrophages will try to remove, when removing causing damage causing larger holes in membrane.

Question 16

what are the characteristics of cute post infectious (proliferative) glomerulonephritis?

Answer 16

• glomerular enlargement (substantial inflammation, inflammation causes swelling)
• hypercellularity (which is an increase in number cells)(leukocytes d/t inflm, mesangial & endothelial cells-dont really know why these cells increase)

Question 17

what are the mesangial cells

Answer 17

lie between capillary tufts, provide support for the glomerulus. mesengial cells produce an intracellular substance similar to that of basement membrane.