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Nephrology > All Histology > Flashcards

All Histology Flashcards

1
Q

Do nephrotic syndromes ever decrease complement?

A

no

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1
Q

What is a hallmark feature of nephritic syndrome?

A

dysmorphic RBCs / RBC casts

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2
Q

What 4 nephritic syndromes decrease serum complement?

A

Cryoglobulinemia
Membranoproliferative GN
Post-infectious GN
SLE

CMPS

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3
Q

What does light microscopy look like for Postinfectious GN?

A

mesangial proliferation which leads to lack of lumens

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4
Q

What does IF look like for postinfectious GN?

A

granular

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5
Q

What does electron microscopy look like for postinfectious GN?

A

hump-like subepithelial deposits

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6
Q

Difference between membranous nephropathy and PIGN if both have subendothelial deposits?

A

membranous nephropathy is a nephrotic syndrome

PIGN is a nephritic syndrome

which you can tell from question stem

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7
Q

Difference between IgA nephropathy and PIGN?

A

PIGN occurs weeks later when infection is already gone (immune reaction)

IgA nephropathy occurs at same time as infection

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8
Q

Is IgA nephropathy recurrent?

A

yes

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9
Q

IgA nephropathy and serum complement

A

normal levels

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10
Q

What are a defining features of RPGN? (2)

A

acute renal failure with quick GFR drop

crescents on biopsy

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11
Q

How do you determine the type of RPGN?

A

look at IF study

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12
Q

Linear IF study and RPGN indicates …

A

Goodpasture syndrome / anti-GBM syndrome

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13
Q

Goodpasture syndrome

A

associated with hemoptysis as well as RPGN

antibodies attacking the basement membrane (type IV collagen)

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14
Q

What is a common cause of membranoproliferative GN?

A

HBV and HCV

also mixed with cryoglubinemia

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15
Q

If someone is an IVDU, what should we be thinking about?

A

blood borne diseases

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16
Q

Serum complement and MPGN

A

decreased serum complement

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17
Q

How can you determine if something is a mixed disease? What 2 syndromes can be mixed?

A

MPGN and DPGN

look for proteinuria or fatty casts

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18
Q

What is the defining feature of membranoproliferative GN?

A

tram-track GBM on silver stain

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19
Q

What does silver stain show on membranous nephropathy?

A

membranous nephopathy is supposed to have “spikes”

hard to tell apart from MPGN!

look for clinical clues: membranous nephropathy is a nephrotic disorder

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20
Q

What is the most common type of nephritic lupus disease?

A

DPGN

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21
Q

How does DPGN appear on IF?

A

granular

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22
Q

What is the next step in a SLE patient with kidney symptoms?

A

renal biopsy

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23
Q

What 2 complement proteins are decreases in lupus?

A

C3 and C4

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24
Q

Which gene is associated with X-linked Alport syndrome?

A

COL4a5

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25
Q

Which gene is associated with autosomal Alport syndrome?

A

COL4a4 and COL4a3

can be dominant or recessive

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26
Q

Why is Alport syndrome more common in young men?

A

due to X-linked pattern of COL4a5

X-linked

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27
Q

What is Alport syndrome?

A

genetic condition associated with kidney disease, vision and hearing loss

problem with type IV collagen

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28
Q

What can Alport syndrome look like on light microscopy?

A

FSGS

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29
Q

What is a characteristic feature of Alport syndrome on EM?

A

thinning and splitting of GBM

basketweaving appearance

really look for the splitting

30
Q

What does ATN look like on light microscopy?

A

pigmented casts within tubules

looks like light pink within the tubules

31
Q

What does AIN look like on light microscopy?

A

eosinophils seen in the interstitium

32
Q

What is the most common cause of AIN?

A

allergic reaction to a drug

33
Q

What does lupus nephritis look like on light microscopy?

A

wire looping of glomerular capillaries

34
Q

What is the most common cause of MPGN in children?

A

idiopathic

35
Q

What are solid organ cancers associated with?

A

secondary membranous glomerulopathy

36
Q

Large PAS-positive acellular nodules is another description for …

A

KW nodules

37
Q

What is the most common cause of glomerulonephritis worldwide?

A

IgA nephropathy

38
Q

What is most important factor in establishing an IgA nephropathy diagnosis?

A

mesangium deposition of IgA

(don’t care about serum IgA levels)

39
Q

Is RPGN always associated with glomerular crescents on biopsy?

A

yes

40
Q

Is nephrotic or nephritic syndrome more associated with hypoalbuminuria?

A

nephrotic syndrome due to proteinuria

41
Q

Where is the only place you see minimal change disease?

A

on EM (effacement of foot processes)

42
Q

How do you treat minimal change disease?

A

steroids

43
Q

Which disease is associated with the APOL1 gene?

A

FSGS

44
Q

What are 2 common causes of FSGS?

A

heroin and HIV

45
Q

What is the most common cause of nephritic syndrome?

A

IgA nephropathy

46
Q

What type of tumor do patients with VHL normally have? What does it look like on light microscopy?

A

normally have clear cell RCC

looks like adipose tissue in the glomerulus

47
Q

What are the “triphasic” parts of Wilm’s tumor?

A

1) blastema (dark purple)
2) stroma (other, lighter)
3) epithelial (tubules)

48
Q

What is a disease that can be secondary to chronic dialysis?

A

acquired CKD

49
Q

What is the spike and dome pattern on subepithelium ?

A

membranous nephropathy

(a nephrotic syndrome!)

50
Q

Subepithelium is where …

A

podocytes are

51
Q

What are the humps on subepithelium ?

A

PIGN

a nephritic syndome

52
Q

What are the 2 diseases that have deposits in subepithelium?

A

PIGN (nephritic)

membranous nephropathy (nephrotic)

53
Q

Maltese cross on urine microscopy indicates which glomerular nephritis?

A

nephrotic syndrome in general

54
Q

When is complement syndrome never decreased?

A

in nephrotic syndrome

(only decreased in select 4 diseases)

55
Q

What non-specific finding happens anytime you have proteinuria?

A

effacement of foot processes

56
Q

Most common nephrotic disease in children?

A

minimal change disease

57
Q

What disease can anabolic steroid use predispose you to?

A

FSGS

58
Q

What is the most common primary and secondary causes of nephrotic syndrome?

A

primary: FSGS

secondary: diabetes

59
Q

What nephrotic syndrome are NSAIDs associated with?

A

membranous nephropathy

60
Q

What nephrotic and nephritic syndrome is SLE associated with?

A

nephrotic: membranous nephropathy

nephritis: DPGN

61
Q

High serum calcium in the setting of nephrotic syndrome indicates …

A

amyloidosis

62
Q

Back pain in the setting of nephrotic syndrome indicates …

A

amyloidosis

skeletal lesions from amyloidosis causing pain (myeloma)

63
Q

What do you see in diabetic kidney disease on light microscopy?

A

KW nodules

expansion of mesangial cells

64
Q

How can you tell if hydronephros is occuring in calyces?

A

they are all connected with fluid

65
Q

What nephrotic syndrome is associated with HBV infection?

A

membranous glomerulopathy

66
Q

What is the most common cause of membranous glomerulopathy?

A

autoantibodies to podocyte antigen (phospholipase A2 receptor)

67
Q

What response can FSGS trigger?

A

HTN

68
Q

If you have pyelonephritis, what will be in the urine?

A

WBC casts

69
Q

Hypersensitivity reactions in the kidney are manifested by what findings?

A

interstitial edema with eosinophilic and neutrophilic inflammatory infiltrate

70
Q

In which sex does ureterovesical AND urteroplevic junction obstruction occur more?

A

males

71
Q

In what sex do ureteroceles occur more frequently?

A

females

72
Q

Posterior urethral valves occur more in which sex?

A

males

Nephrology (6 decks)

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