I n t e r n a L medicine questions Bank

Glomerulonephritides

Knowing a few key facts is the best way to approach the difficult subject of glomerulonephritis:

Membranous glomerulonephritis

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  presentation: proteinuria / nephrotic syndrome / CRF
  
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  cause: infections, rheumatoid drugs, malignancy
  
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  1/3 resolve, 1/3 respond to cytotoxics, 1/3 develop CRF
  

IgA nephropathy - aka Berger's disease, mesangioproliferative GN

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  typically young adult with haematuria following an URTI
  

Diffuse proliferative glomerulonephritis

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  classical post-streptococcal glomerulonephritis in child
  
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  presents as nephritic syndrome / ARF
  

Minimal change disease

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  typically a child with nephrotic syndrome (accounts for 80%)
  
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  causes: Hodgkin's, NSAIDs
  
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  good response to steroids
  

Focal segmental glomerulosclerosis

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  may be idiopathic or secondary to HIV, heroin
  
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  presentation: proteinuria / nephrotic syndrome / CRF
  

Rapidly progressive glomerulonephritis - aka crescentic glomerulonephritis

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  rapid onset, often presenting as ARF
  
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  causes include Goodpasture's, ANCA positive vasculitis, SLE
  

Mesangiocapillary glomerulonephritis (membranoproliferative)

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  type 1: cryoglobulinaemia, hepatitis C
  
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  type 2: partial lipodystrophy
  

11. 
    Which one of the following is least recognised as a cause of membranous glomerulonephritis?
    

	A.	Malaria
	B.	Lymphoma
	C.	Hepatitis B
	D.	Cryoglobulinaemia
	E.	Gold