CIS - Amyloids

Question 1

Normal renal function entails filtration by the ________ to preserve overall volume and electrolyte balance.

Answer 1

Glomeruli

Question 2

Normal glomeruli have evenly dispersed ________, like blooms on flowering bush.

Answer 2

Nuclei

Question 3

What does an abnormal renal glomerulus look like?

Answer 3

Has large pink patches, like blobs of bubblegum, with no nuclei.

Question 4

A patient walks in with edema in legs, why is checking his urine important?

Answer 4

Normal urine does not have a lot of protein in it, because the protein is in the blood. However, this patients urine came out foamy and has a lot of protein in it. More protein in urine and less in blood means more swelling.

Question 5

In renal dysfunction, the loss of _______ in urine makes fluid leak out of blood vessels and accumulate in tissues (edema).

Answer 5

Protein

Question 6

What are the AA amyloids made up of?

Answer 6

Beta-pleated fibrils

Question 7

Chronic, long-lasting inflammation and infection can cause the liver to overproduce _________ protein. When the inflammation lasts a long time, then this protein will get separated and form _____ protein and this will accumulate in tissues as _______ _______.

Answer 7

Serum amyloid A (SAA)
AA
AA amyloid

Question 8

Chronic, long-lasting inflammation and infection can cause the liver to overproduce _________ protein. When the inflammation lasts a long time, then this protein will get separated and form _____ protein and this will accumulate in tissues as _______ _______.

Answer 8

Serum amyloid A (SAA)
AA
AA amyloid

Question 9

The most common tissue that develops AA amyloids is the _______.

Answer 9

Kidney

Question 10

What are additional tests for amyloid that can be performed in the lab?

Answer 10

Congo red stain

Electron microscopy

Question 11

When pink deposits are identified in tissues, a Congo Red stain can be applied. The stain will bind between the stable fibrils. A polarized light filter will show characteristic ________ ________ if amyloid is present.

Answer 11

Apple-green birefringence

Question 12

How do we determine what KIND of amyloid is present?

Answer 12

By applying extra stains in lab, targeted against particular amyloid proteins.

Question 13

What type of stain can determine if AA amyloid is present?

Answer 13

Brown stain (if stains brown then it’s positive)

Question 14

AA amyloid is a secondary phenomenon, must find the initial cause of the inflammation/infection to stop it. What are some conditions that could cause this?

Answer 14

Rheumatologic disease 
Inflammatory disease of GI 
Chronic infections (i.e., Tuberculosis, AIDS) 
Hematologic malignancies 
Hereditary disorders (i.e., FMF)

Question 15

Put the following steps in order:

A. Inadequate breakdown and/or excessive accumulation.
B. Accumulation of AA amyloid
C. Inflammation
D. Hepatic production of SAA protein.

Answer 15

1) C.
2) D.
3) A.
4) B.