Glomerular Disease Overview

by Carlo Raj, MD

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    Moving to the glomerular region. Up until this point, what we have done over and over again is giving you an overview as far as laying down the foundation and then we build upon well. With glomerular diseases, first and foremost, think about where you are, you are in the glomerulus and there are numerous issues or factors that may then result in glomerular disease. Let us begin. First and most importantly at this point, is the fact that your operative word here is biopsy. So the fact that you are taking a biopsy specimen based on the symptoms of your patient. Remember once again. Do you remember when we did our session with urinalysis? And with urinalysis, you used information that you had derived based on the history that you got from the patient, either through a clinical vignette or from the attending or what not, and you put all this together so that you can arrive at the proper diagnosis. Well, with the biopsy, there are a couple of important imaging studies that you will have to conduct. You can do an H &E stain and with this, we mean hematoxylin and eosin. And with this, this then allows us to classify the type of glomerular disease. This, for the most part, will be light microscopy. What does light microscopy mean to you? Well, as we go to the various diseases, when it is relevant and pertinent, we will then take a look at diseases in which it is best to classify them through light microscopy. Well, let us say that you don't find exactly as to which you need to or perhaps there is further investigation that is warranted and then you are going to other types of stains and this includes something like immunofluorescence. This is...

    About the Lecture

    The lecture Glomerular Disease Overview by Carlo Raj, MD is from the course Glomerulonephritis. It contains the following chapters:

    • Glomerular Disorders
    • Electron Microscopy
    • Pathogenesis of Glomerular Disease
    • Mechanisms Producing Glomerular Disease

    Included Quiz Questions

    1. It involves the deposition of immune complexes.
    2. It is a type II hypersensitivity disorder.
    3. It is not visible with light microscopy until severe kidney damage has ensued.
    4. It shows a linear pattern on immunofluorescence.
    5. It involves anti-glomerular basement membrane antibodies.
    1. Immunofluorescence
    2. Electron microscopy
    3. All answers are correct
    4. Two answers are correct
    5. Light microscopy
    1. Identifies patterns and type of immunodeposition.
    2. Classifies type of glomerular disease.
    3. Allows better visualization of structures compared to light microscopy.
    4. To show the structure of the glomerulus.
    5. Allows for visualization of filtration barriers.
    1. Between the glomerular basement membrane and the cells lining the lumen containing blood.
    2. Between the glomerular basement membrane and the cells lining the lumen containing urine.
    3. Within the glomerular basement membrane.
    4. Subendothelial deposits are the result of type II hypersensitivity reactions, so there would be no immune complexes.
    5. Between the cells lining the lumen containing urine and the cells lining the lumen containing blood.
    1. They both can detect immune complex deposition.
    2. They both can detect the site of complex deposition.
    3. They both show submicroscopic defects in the glomerulus.
    4. They both may aid in the diagnosis of minimal change disease.
    5. They both rely on the recognition of immune complexes by chemical tests.
    1. Epithelial
    2. Subendothelial
    3. Mesangial
    4. Intramembranous
    5. Subepithelial
    1. Immune complex deposits may be mesangial, subepithelial or subendothelial.
    2. It shows a linear pattern on immunofluorescence.
    3. It involves antibodies directed against the glomerular basement membrane.
    4. It is a type II hypersensitivity reaction.
    5. Activated T-cells are primarily responsible for glomerular damage.
    1. It is visible with immunofluorescence of biopsy specimens.
    2. It involves fusion of the podocytes of visceral epithelial cells.
    3. It is associated with T-cell activation.
    4. It is a type of nephrotic syndrome.
    5. Cytokines are responsible for the lose of the negative charge of the glomerular basement membrane.

    Author of lecture Glomerular Disease Overview

     Carlo Raj, MD

    Carlo Raj, MD

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