Glomerulopathy And Glomerulonephritis

Front 1

What is the difference between a disease and a disorder?

Back 1

a disease usually comes from outside and something attacking the body whereas a disorder is an intrinsic malfunctioning of the body.

Front 2

What is the difference between a disease and a syndrome?

Back 2

a disease has a specific cause whereas a syndrome is a constellation of SYMptoms.

Front 3

Is the usage for disease, disorder, and syndrome strict?

Back 3

No not at all.

Front 4

How do I remember nephrOtic syndrome?

Back 4

Oedema
prOtein
Oh ****! (this is really bad)

Front 5

What are the 4 main symptoms of nephrotic syndrome?

Back 5

1. Massive proteinuria
2. Hypoalbuminemia
3. Edema
4. Hyperlipidemia/hyperlipiduria

Front 6

How do I remember nephrITIC syndrome?

Back 6

It is the one with the itis (inflammation)

Front 7

What is the difference between nephritic and nephrotic syndrome?

Back 7

nephrotic has normal GFR with membrane damage and nephritic has lower GFR due to inflammation and even more membrane damage.

Front 8

What is the difference between nephritic syndrome and glomerulonephritis?

Back 8

nephritic syndrome is the constellation of symptoms of glomerulonephritis.

Front 9

What do you get with minimal, moderate, or severe kidney injury?

Back 9

proteinuria --> nephrotic syndrome --> nephritic syndrome

Front 10

what is the difference between glomerulopathy and glomerulonephritis?

Back 10

glomerulonephritis is just inflammatory in nature.

Front 11

What is the SCAB mnemonic for collagen?

Back 11

1. Skin
2. Connective tissue
3. Arteries
4. Basement membrane

Front 12

How is collagen synthesized?

Back 12

It is procollagen and hydroxylated with vitamine C and copper in the ER. once the procollagen is secreted out of the cell, the ends are cleaved and it becomes collagen thanks to enzymes in the ECM and can start forming the triple helices

Front 13

Why is collagen only folded outside the cell?

Back 13

because you would damage the inside of the cell if it started folding there.

Front 14

Where is type 4 collagen located on the GBM?

Back 14

all over and throughout

Front 15

How do the antobodies attack non collagenous component of collagen type 4 in the GBM?

Back 15

in a linear fashion since they are everywhere

Front 16

What are megalins?

Back 16

They are proteins in the depressions of the podocytes.

Front 17

How are antibodies against megalin deposited?

Back 17

in a granular fashion following the distribution of the podocyte depressions between foot processes.

Front 18

Where are immune complexes formed in anti GBM and anti megalin attacks? Are they in circulation?

Back 18

No, the blood only has antibodies, but not antigens. These complexes are only in the glomerulus.

Front 19

What are the two main types of antibody attack on the glomerulus?

Back 19

In situ - antibodies attack antigens already in the glomerulus

Deposited - antigens get deposited into the glomerulus and then get attacked

Front 20

What are two types of in situ immune attacks on the glomerulus?

Back 20

1. Attacking the collagen heads in the basement memebrane (linear)
2. Attacking the megalins in the podocyte depressions (granular)

Front 21

What are the different places in which circulating antigens can deposit in the glomerulus? (4)

Back 21

1. sub endothelial
2. Intra basement membbrane
3. Subendothelial
4. intramesangial

Front 22

What will deposit in the sub endothelial layer?

Back 22

antigens that are large and negatively charged

Front 23

What are the two main types of antigens that can get deposited in the glomerulus?

Back 23

endogenous (lupus nuclear parts)
exogenous (microbial products, drugs, toxins, heavy metals)

Front 24

What you recognize the symptoms of nephrotic syndrome, what is the next stepo to diagnosis>

Back 24

You must ask what structure has changed to see where the damage is occurring.

Front 25

WHen two elephants are fighting (antigen and immune system), who loses?

Back 25

The grass (the tissue)

Front 26

What will endothelial cells do if the basement membrane is attacked?

Back 26

they will produce more basement membrane and it will thicken.

Front 27

What are the 4 steps to diagnosing and successfully treating glomerulonephritis?

Back 27

1. Identify the clinical presentation and check for symptoms
2. Find out what layer is being attacked
3. Find out the secondary immune mechanism (complement, etc)
4. Identify the antigen

Front 28

What is immune complex disease?

Back 28

when circulating immune complexes of antigen and antobodies get deposited in the glomeruli.

Front 29

Where will the circulating immune complexes get deposited? Why?

Back 29

Since they are large, they will be deposited subendothelially.

Front 30

What is a classic example of immune complex deposition in the globeruli?

Back 30

lupus complexes

Front 31

What qualifies something as a hypersensitivity reaction?

Back 31

It is ANY immune reaction in the body that damages tissue.

Front 32

What is glomerulonephritis?

Back 32

it is any number of diseases that are immunologically damaging the glomeruli.... so it is a hypersentivity reaction!

Front 33

In type I, what kind of antigen is there and who is the effector of the reaction?

Back 33

The antigen is always exogenous and IgE loaded mast cells are the effectors.

Front 34

In type II, what kind of antigen is there and who is the effector of the reaction?

Back 34

the antigen is intrinsic to the membrane of the tissue being attacked and the effectors are either complement or cell mediated that act on IgG or IgM.

Front 35

In type II, will any tissue other than the original cell be damaged?

Back 35

generally, no.

Front 36

What is the thief/police mnemonic that Najeeb makes for type i hypersensitivity?

Back 36

Type I - police is fixed and the exogenous thief wanders in (local damage)

Front 37

What is the thief/police mnemonic that Najeeb makes for type ii hypersensitivity?

Back 37

Type II - thief is fixed onto membrane and police finds it (local damage except with RBC's)

Front 38

What is the thief/police mnemonic that Najeeb makes for type iii hypersensitivity?

Back 38

Type III - thief and police meet on the road and fight. Can deposit anywhere. (damage to multiple tissues of deposition)

Front 39

how is type iv hypersensitivity different than the others?

Back 39

It is not mediated by antibodies.

Front 40

What are the three mechanisms of antigen/antibody injury to the glomeruli and what hypersensitivity are they?

Back 40

1. in situ antigen - type ii
2. planted antigen - may become type iii
3. immune complex deposition - type iii