Goodpasture Syndrome: Summary (Nursing)

00:01 Okay, now this one's kind of fun.

00:02 I know this is nerd version of fun, but knowing what these names mean are really important.

00:08 So anti glomerular basement membrane antibody disease Got that? So let's break that down.

00:16 We've got anti glomerular basement membrane and that is referring to the basement membrane in the glomerulus.

00:24 Now the basement membrane is kind of what keeps everything intact you have basement membranes throughout your body.

00:30 Yeah, but in the glomerulus, they're really important to help keep things intact and we're talking about the glomerulus because we're talking about goodpasture's syndrome or anti glomerular basement membrane antibody disease.

00:45 Now so we've got anti being against glomerular basement membrane is in the glomerulus and antibody disease.

00:53 We've got the antibodies there for you.

00:56 So we're thinking about a basement membrane.

00:57 I didn't want to just skip over this point.

00:59 I wanted to make sure that you understood how important these are because take a look at our graphic.

01:06 This is a section of a small blood vessel.

01:09 Now the inner surface of the vessel is lined by endothelial cells now they sit on a really thin membrane that we call the basement membrane.

01:19 Okay, so take a look at our drawing you can see we have the round circle on the top and then we have a cross section of the blood vessel on the bottom.

01:27 So are you with me? Okay, cool.

01:29 Now look at the endothelial cell see those little shapes there and they're labeled endothelial cells.

01:36 Look they are lining your blood vessels.

01:39 You have endothelial cells all throughout your body lining your blood vessels.

01:44 Now, you've got the basement membrane see it there.

01:47 Yeah. We've got it labeled for you.

01:49 See what the basement membrane is.

01:51 So you've got endothelial cells and they sit on this really thin membrane, for really thin but it's really important.

02:00 So keep an eye on that we'll talk about what happens in this disease.

02:04 So in anti GBM disease antibody start to attack the collagen in the basement membranes of the lungs and the kidneys.

02:14 That's how we end up with hemorrhaging lungs and kidneys.

02:17 They get all clogged up.

02:19 Now before you go on, let's let that sink in for just a little bit.

02:24 Look at the top, you're looking as if we took a slice of a blood vessel on the bottom as if we dissected It down the middle and laid it open in half.

02:33 Find the endothelial cells find the basement membrane.

02:38 Cool. Okay, you've got those so you can see how the basement membrane kind of keeps everything together.

02:44 Now what's flowing through that, Look how we have those labeled for you, got some other wbc's, those are the blue ones you've got red blood cells.

02:53 Remember those are just stacks that carry oxygen right, as adults they carry four hemoglobins as little tiny infants, they 6 when you're a newborn, I think that's super cool.

03:03 And super weird about babies at the same time And you've got neutrophil types of white blood cells.

03:10 So in this bloodstream, you see two of our five kinds of white blood cells.

03:14 You see red blood cells, endothelial cells and the basement membrane.

03:20 Now I need you to really slow down here and make sure this makes sense to you because basement membranes are also throughout your body just like endothelial cells.

03:30 So this is an important concept that you're gonna be able to apply in lots of other places.

03:35 And we have a beautiful graphic here for you to be able to understand it.

03:40 So in anti GBM disease antibody start attacking what? Right.

03:47 The basement membrane.

03:48 Okay, cool.

03:48 You're getting it now you're with us.

03:50 That's awesome.

03:51 But I want you to do is draw some notes on here.

03:54 So you can have that solid in your brain that in anti GBM disease antibodies attack the collagen in the basement membrane.

04:02 So write that in your notes antibodies attack collagen in the basement membrane.

04:09 All right, let's keep going.

04:11 So let's do a quick review of antibodies.

04:13 I know you've probably looked at them before but it's kind of helpful sometimes to have a review of what they do.

04:19 So antibodies are large y-shaped proteins and that's why we draw them like this there for you to help you remember.

04:26 So whenever you're reading and you're seeing things about antibodies, this is a great visual for you to remember.

04:32 They're also called immunoglobin see those things like IG, that's what we're talking about.

04:38 So antibodies are large y-shaped proteins.

04:42 So when they clog things up, they really clog things up.

04:45 They're big they're y-shaped their proteins.

04:48 They also go by another name of immunoglobins, and they're found in our blood and some of our other body fluids.

04:54 Okay so antibody quick review, giant proteins shaped like a Y.

05:00 They're also called immunoglobins and they're found in our blood and some other body fluids.

05:06 That is an awesome summary slide about antibodies so mark that if you're doing some other reading about your immune system, but wait, there's more just like they say on late-night TV.

05:18 Let's talk a little bit more about antibodies because these are critical players in our adaptive immune system.

05:24 Now, if you don't mind go ahead and underline adaptive immune system.

05:28 This is the bad a part of antibodies.

05:31 This is so cool that they can recognize bad guys and fight them off.

05:36 These antibodies recognize a unique part of a foreign thing.

05:41 We call it an antigen.

05:43 So if a foreign thing is in our body and its trying to attack us, the antigens will remember that's part of the adaptive part of our immune system.

05:52 So we've got these antibodies they have a memory and they recognize this unique part of the antigen, right.

05:59 So what they do, in autoimmune diseases is instead of recognizing a foreign thing autoimmune mistakenly looks at my own body part and starts to attack that.

06:12 So in autoimmune disease, it looks at self instead of a foreign thing and attacks it It mistakes me as an antigen and then I have an autoimmune problem.

06:25 So we need antibodies to survive.

06:27 We definitely need an adaptive immune system.

06:30 But in autoimmune, it starts to recognize me as an antigen mistakenly and attacks my own body.

06:38 That's what happens.

06:39 That's how the basement membrane is attacked.

06:42 So back to our blood slides See that we've got the slice of it for you there.

06:46 If we open it up in half you got the different, two different types of white blood cells.

06:52 You've got the red cells got the endothelial cells and the basement membrane.

06:57 All right, were you able to identify those with me as I walked through? Well an anti GBM, anti glomerular basement membrane antibody disease, the antibodies bind to the capillary basement membrane.

07:10 Whoohoo! Good reading on my part, right? Well, I wanted to walk you through that really slowly because I want you to see take the chance now just charter walkthrough in your brain what that would look like pause and read that statement again and see if it gives you an idea of how that disease works.

07:28 Then we'll come back and I'll show you graphically how the illustration.

07:35 Okay, ready? I bet you're pretty close just from the name and what you've done with medical terminology, but let's look at what happens.

07:43 See those antibodies.

07:45 Now, we've got those antibodies are those large y-shaped proteins right there floating in the bloodstream similar blood and in some other tissues.

07:54 Now what's going on is they're starting to attach themselves to that basement membrane see that there? So notice how they're starting to attach to that basement membrane.

08:04 Danger Will Robinson.

08:06 We've got a problem because that basement membrane is really thin, pretty fragile.

08:12 So if you start attaching yourself to this, this is going to be a problem because when those antibodies bind to the capillary basement membranes this starts attracting white blood cells, the neutrophils.

08:25 Okay. Normally, this is a good idea.

08:27 Because the antibodies like, Hey guys, we got a problem come help us but here it's mistakenly identifying me.

08:34 It's identifying make basement membrane.

08:36 So when those antibodies attach to my basement membrane, their job is to attract white blood cells specifically the neutrophils, Oh, no, it is on like Donkey Kong because the idea is you're supposed to be fighting off infection.

08:50 But instead it's attacking me.

08:53 So neutrophils attack the vessel walls and cause inflammation.

08:57 That's what leads to the glomerulonephritis and in the of alveolar capillaritis.

09:03 So that's we end up with bleeding in the lungs and glomerulonephritis in the kidneys.

09:10 So see the picture there walk back through it again.

09:13 What happens is those antibodies right? Their job is to attract the white cells.

09:18 The antibodies attach to the capillary basement membrane when they attach to the capillary basement membrane that attracts the neutrophils the neutrophils job, they cause this major inflammatory response and we end up with bleeding in the lungs, because I see everything leaking out through there and glomerulonephritis in the kidneys.