"Be able to identify" - AP

Question 1

Describe what MCD looks like on EM

Answer 1

• Podocytes flattened out on the BM due to the effacement of the podocytes = “condensation of the actin-based cytoskeleton against the sole of the foot process”
• No change in the podocyte number, but an altered phenotype of the podocyte
• Recall: MCD looks normal on LM

Question 2

Describe FSGS on H&E and PAS

Answer 2

• Engagement of apoptotic pathways –> podocytopenia
• LM: glomerular capillary obliteration (sclerosis, scarring, collapse)
• PAS: hyaline PAS-positive material (hyalinosis)
• Tubular atrophy, interstitial fibrosis, lymphocytic infiltrates

Question 3

Describe MGN on silver stain

Answer 3

• Spikes and holes on silver stain b/c see the ICs coming up btwn the large electron dense immune deposits in the subepithelial space
• When it’s primary, these ICs will be bound to PLA2R