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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
Which gene is associated with X-linked Alport syndrome?
COL4a5
25
Which gene is associated with autosomal Alport syndrome?
COL4a4 and COL4a3 can be dominant or recessive
26
Why is Alport syndrome more common in young men?
due to X-linked pattern of COL4a5 X-linked
27
What is Alport syndrome?
genetic condition associated with kidney disease, vision and hearing loss problem with type IV collagen
28
What can Alport syndrome look like on light microscopy?
FSGS
29
What is a characteristic feature of Alport syndrome on EM?
thinning and splitting of GBM basketweaving appearance really look for the splitting
30
What does ATN look like on light microscopy?
pigmented casts within tubules looks like light pink within the tubules
31
What does AIN look like on light microscopy?
eosinophils seen in the interstitium
32
What is the most common cause of AIN?
allergic reaction to a drug
33
What does lupus nephritis look like on light microscopy?
wire looping of glomerular capillaries
34
What is the most common cause of MPGN in children?
idiopathic
35
What are solid organ cancers associated with?
secondary membranous glomerulopathy
36
Large PAS-positive acellular nodules is another description for ...
KW nodules
37
What is the most common cause of glomerulonephritis worldwide?
IgA nephropathy
38
What is most important factor in establishing an IgA nephropathy diagnosis?
mesangium deposition of IgA (don't care about serum IgA levels)
39
Is RPGN always associated with glomerular crescents on biopsy?
yes
40
Is nephrotic or nephritic syndrome more associated with hypoalbuminuria?
nephrotic syndrome due to proteinuria
41
Where is the only place you see minimal change disease?
on EM (effacement of foot processes)
42
How do you treat minimal change disease?
steroids
43
Which disease is associated with the APOL1 gene?
FSGS
44
What are 2 common causes of FSGS?
heroin and HIV
45
What is the most common cause of nephritic syndrome?
IgA nephropathy
46
What type of tumor do patients with VHL normally have? What does it look like on light microscopy?
normally have clear cell RCC looks like adipose tissue in the glomerulus
47
What are the "triphasic" parts of Wilm's tumor?
1) blastema (dark purple) 2) stroma (other, lighter) 3) epithelial (tubules)
48
What is a disease that can be secondary to chronic dialysis?
acquired CKD
49
What is the spike and dome pattern on subepithelium ?
membranous nephropathy (a nephrotic syndrome!)
50
Subepithelium is where ...
podocytes are
51
What are the humps on subepithelium ?
PIGN a nephritic syndome
52
What are the 2 diseases that have deposits in subepithelium?
PIGN (nephritic) membranous nephropathy (nephrotic)
53
Maltese cross on urine microscopy indicates which glomerular nephritis?
nephrotic syndrome in general
54
When is complement syndrome never decreased?
in nephrotic syndrome (only decreased in select 4 diseases)
55
What non-specific finding happens anytime you have proteinuria?
effacement of foot processes
56
Most common nephrotic disease in children?
minimal change disease
57
What disease can anabolic steroid use predispose you to?
FSGS
58
What is the most common primary and secondary causes of nephrotic syndrome?
primary: FSGS secondary: diabetes
59
What nephrotic syndrome are NSAIDs associated with?
membranous nephropathy
60
What nephrotic and nephritic syndrome is SLE associated with?
nephrotic: membranous nephropathy nephritis: DPGN
61
High serum calcium in the setting of nephrotic syndrome indicates ...
amyloidosis
62
Back pain in the setting of nephrotic syndrome indicates ...
amyloidosis skeletal lesions from amyloidosis causing pain (myeloma)
63
What do you see in diabetic kidney disease on light microscopy?
KW nodules expansion of mesangial cells
64
How can you tell if hydronephros is occuring in calyces?
they are all connected with fluid
65
What nephrotic syndrome is associated with HBV infection?
membranous glomerulopathy
66
What is the most common cause of membranous glomerulopathy?
autoantibodies to podocyte antigen (phospholipase A2 receptor)
67
What response can FSGS trigger?
HTN
68
If you have pyelonephritis, what will be in the urine?
WBC casts
69
Hypersensitivity reactions in the kidney are manifested by what findings?
interstitial edema with eosinophilic and neutrophilic inflammatory infiltrate
70
In which sex does ureterovesical AND urteroplevic junction obstruction occur more?
males
71
In what sex do ureteroceles occur more frequently?
females
72
Posterior urethral valves occur more in which sex?
males

Nephrology (6 decks)

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