GN

Question 0

Categories of hematuria?

Answer 0

1. Intrarenal (Kidney trauma, renal stones, GN, pyelonephritis, RCC, vascular injury)
2. Extrarenal (Foley trauma, infections, nephrolithiasis, prostate/bladder cancer)

Question 1

Patient with red dark urine – causes?

Answer 1

1. True hematuria (RBCs)

2. pigmented urine (myoglobin, hemoglobin)

Question 2

RBC casts indicate?

Answer 2

Glomerular origin

Question 3

Nephritis versus nephrosis?

Answer 3

Inflammatory (hematuria, edema, hypertension) verses noninflammatory (no active sediment in the urine)

Question 4

Mechanisms for nephritic findings?

Answer 4

Hematuria – ruptured capillaries of the glomerulus
Proteinuria – altered permeability of the capillary walls
Edema – salt andwater retention
Hypertension – disturbed homeostasis of BO

Question 5

Secondary renal disorders?

Answer 5

1. Lupus (+ANA)
2. Postinfectious GN (+ASO)
3. Hepatitis C/B (cryo- GM)
4. Medium/small vessel vasculitis related (polyarteritis nodosa; Wegner, Chrug-Strauss, microscopic polyangiitis, Henoch-Schonlein purpura)
5. Infective endocarditis related

Question 6

Types of immune mediated injury to the glomeruli? Tx?

Answer 6

1. Complement mediated.
2. Ab-mediated - plasmapheresis
3. ANCA Mediated (pauci-immune) - Steroids/cyclophosphamide

Question 7

Differentiating between the ANCAs?

Answer 7

Wegner’s – c-ANCA

P-ANCAs

1. Microscopic polyangiitis - No granulomas
2. Churg-Strauss - Granulomas, asthma, eosinophilia
3. Polyateritis nodosa

Question 8

GNs positive anti-GBM antibodies?

Answer 8

1. no lung involvement - Anti-GBM GN

2. Lung involvement – Goodpasture’s

Question 9

Complement mediated GN?

Answer 9

1. Lupus (+ANA)
2. Postinfectious GN (+ASO)
3. Hepatitis C/B (cryo- GM)
4. Infectious endocarditis (+blood culture)
5. RPGN