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Undeleted > Exam 1 Path/Clinical > Flashcards

Exam 1 Path/Clinical Flashcards

1
Q

Azotemia

A

increased serum BUN/creatinine

decreased GFR

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2
Q

Cause of prerenal azotemia

A

kidney hyoperfusion

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3
Q

Nephritic sx

A 
<3.5 protein loss per day
azotemia
HTN
hematuria
inflammatory process
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4
Q

Nephrotic sx

A

> 3.5 protein loss per day
hypoalbuminemia
hyperlipidemia

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5
Q

Cause of hyalinosis

A

accumulation of eosinophilic material

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6
Q

Acute proliferative GN characteristics

A

post-strep GN, 1-4wks after
6-10y/o
immune complex deposition
glomerular proliferation

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7
Q

Acute proliferative GN histo

A

hypercellularity
red cell casts
mesangial/GBM deposition of IgG/IgM/C3

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8
Q

Sx of acute proliferative GN

A

young child post sore throat
red cell casts in urine
periorbital edema
decreased serum C3

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9
Q

Rapidly progressive GN characteristics

A

crescentic GN
loss of renal fxn
epithelial proliferation
oliguria/nephritic syndrome

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10
Q

Types of rapidly progressive GN

A

Anti-GBM (Goodpastures)
immune complex deposition (HSP)
Pauci-immune (c-ANCA)

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11
Q

Fluorescence of RPGN types

A

anti-GBM- linear
immune complex- granular
pauci-immune- no deposition

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12
Q

Clinical sx of rapidly progressive GN

A

hematuria
HTN/edema
anti-GBM/ANA/ANCA abs depending on type

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13
Q

Membranous nephropathy characteristics

A

irregular immune complex deposition
granular on IF
nephrotic syndrome in adult whites
assc with SLE/tumors/infections

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14
Q

Clinical sx of membranous nephropathy

A

nephrotic syndrome
hematuria
mild HTN
sclerosis of glomeruli

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15
Q

Minimal change disease characteristics

A

ages 2-6
follow infection or vaccine
nephrotic syndrome in children
response to corticosteriods

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16
Q

Minimal change disease sx

A

massive proteinuria
good renal fxn
assc with Hodgkin lymphoma in adults

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17
Q

Focal segmental glomerulosclerosis characteristics

A

nephrotic syndrome

ass with Sickle Cell/HIV/heroin use/blacks

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18
Q

Focal segmental glomerulosclerosis histo

A 
lipid droplets/foam cells
hyalinosis of afferent arterioles
retraction/collapse of glomeruli
effacement of foot processes (flattening)
IgM/C3 in mesangium
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19
Q

Membranoproliferative GN characteristics

A

nephrotic/nephritic combo
hypercellular glomeruli
crescents
tram track appearance with silver stain

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20
Q

Type 1 MPGN

A

subendothelial deposits

granular C3 deposition, some IgG

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21
Q

Type II MPGN

A

ribbon like, irregular GBM
granular or linear
C3 in mesangium in circular ring
no IgG/Cl4/C4

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22
Q

IgA nephropathy characteristics

A

Berger disease
IgA deposition in mesangium
hematuria
nephritic/sometimes nephrotic

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23
Q

Microscopy of IgA nephropathy

A

mesnagial IgA deposition

C3/properdin

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24
Q

Henoch-Schonlein purpura characteristics

A 
purpuric skin lesions on arm/legs
nonmigratory arthralgias
hematuria
nephritic/nephrotic syndromes
3-8y/o
follows URT infection
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25
Q

Morphology of HSP

A

crescentic glomerulonehpritis
mesangial proliferation
deposition of IgA in mesangial regions

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26
Q

Alport syndrome characteristics

A 
hematuria/red cell casts
nerve deafness
eye disorders
X-linked
5-20y/o
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27
Q

Alport syndrome morphology

A

GBM thinning
splitting of lamina dense (basket weave appearance)
glomerulosclerosis

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28
Q

Chronic glomerulonephritis characteristics

A

crescentic glomerulonephritis
contraction of kidneys
thin cortex
atrophy of tubules

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29
Q

Micro and macroabluminuria levels

A

micro: 30-300mg/day
macro: >300mg/day

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30
Q

Urinalysis measurement

A

only albumin

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31
Q

Nephrotic syndrome in children

A

minimal change disease

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32
Q

Nephrotic syndrome with adults

A

membranous and focal sclerosis

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33
Q

Complications of nephrotic syndrome

A

hyperlipidemia

hypercoagulability

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34
Q

Tubular proteinuria protein loss

A

no albumin loss

500-2000mg/day

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35
Q

Orthostatic proteinuria protein loss

A

daytime urine has higher proteinuria

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36
Q

Overflow proteinuria protein loss

A

light chains/small MW proteins lost

multiple myeloma assc

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37
Q

False (+) for hematuria

A

foods/drugs

myoglobing-rhabdomyolysis (no RBC’s)

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38
Q

What are red blood cell casts?

A

Tamm Horsfall protein + RBC’s in tubules

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39
Q

Demographic for minimal change disease

A

children

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40
Q

Demographic for focal segmental GN

A

black
HIV
heroin users

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41
Q

Demographic for membranous nephropathy

A

caucasian adults

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42
Q

Demographic for IgA nephropathy

A

Asian
Hispanics
American Indian

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43
Q

Microscopy of minimal change disease

A

fusion of foot processes

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44
Q

Microscopy of focal segmental GN

A

focal/segmental damage

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45
Q

Microscopy of membranous nephropathy

A

subepithelial immune deposits (PLA2R)

thick basement membrane

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46
Q

Microscopy of IgA nephropathy

A

mesangial IgA deposition

47
Q

Nephrotic syndromes

A

minimal change disease
focal segmental GN
membranous nephropathy

48
Q

Postinfection GN characteristics

A

2-3wks post infection
nephritic
low complement
subepithelial humps

49
Q

Membranoproliferative GN

A

assc with Hep C
cryoglobulinemia
nephritic syndrome/sometimes nephrotic

50
Q

Types of cryoglobulinemia

A

I-monoclonal IgM, multiple myeloma/Waldenstrom assc
II-monoclonal IgM against IgG
III-polyclonal IgM against IgG, Hep C/rheumatoid factor assc

51
Q

Glomerulonephritis diseases with low serum complement

A

post infection
membranoproliferative
cryoglobulinemia
lupus nephritis

52
Q

Membranoproliferative GN microscopy

A

splitting of thick membranes
tram tracking
cryoglobulin precipitates in capillaries
subendothelial immune complex deposition

53
Q

Hyperacute transplant rejection cause

A

preformed Abs react with allo-Ags

thrombosis/necrosis results

54
Q

Membranoproliferative GN type 1

A

C3 and IgG/IgM
classic C pathway
rail track appearance

55
Q

Membranoproliferative GN type 2

A

C3 nephritic factor, C3 convertase stabilized
alternative C pathway
ribbon appearance

56
Q

Focal segmental GN asscs

A

HIV
heroin use
Sickle cell disease
Hispanics/blacks

57
Q

Membranous nephropathy assc

A 
white adult male
Hep B/C
tumors
SLE
drugs (NSAIDS/penicillamine)
58
Q

Diabetes mellitus characteristics on kidneys

A

nonenzymatic glycosylation
results in hyaline arteriolosclerosis
Kimmelstiel-Wilson nodules

59
Q

Systemic amyloidosis characteristics on kidneys

A

amyloid deposits in mesangium
nephrotic syndrome
Congo red/apple green birefringence

60
Q

Nephrotic syndrome groupings

A

FSGS/MCD- foot process effacement
MN/MPGN-deposits of immune complexes
DM/amyloidosis-nodular glomerulosclerosis

61
Q

Ischemic acute kidney injury sign

A

hyaline/granular casts

from Tamm Horsfall protein

62
Q

Toxic acute kidney injury causes

A

HgCl-acidophilic inclusions
CCl4-neutral lipids in cells
Ethylene glycol-vacuolar degeneration/calcium oxalate crystals

63
Q

Acute pyelonephritis immune cells present

A

neutrophils

64
Q

Chronic pyelonephritis morphology

A

thyroidization-flat epithelium/dilated tubules

fibrosis

65
Q

Analgesic nephropathy clinical picture

A

women with muscle pain

hypochondriac

66
Q

Urate nephropathy types

A

uric acid crystals/lymphoma
monosodium urate crystals/Tophus
uric acid stones/gout

67
Q

Types of urolithiasis

A

calcium oxalate/phosphate, most common
Mg/ammonium/phosphate, bacterial/staghorn stone
uric acid, radiolucent
cystine, congenital defect

68
Q

AD polycystic kidney disease

A

bilateral enlarged kidneys
cysts filled with serous/red-brown fluid
from tubules

69
Q

AR polycystic kidney disease

A 
PKHD1/2 gene mutation
childhood onset
smooth external surface of kidney
spongelike appearance with small cysts
portal fibrosis/liver cysts
70
Q

Medullary sponge kidney

A

dilation of medullary collecting ducts
assc with Marfans/Carolis/Ehlers-Danlos
sponge like appearance of medulla

71
Q

Renal papillary adenoma

A

branching/papillomatous structure

metastasizes over 3cm

72
Q

Angiomyolipoma

A

hamartoma
assc with tuberous slcerosis
spontaneous hemorrhage assc

73
Q

Oncocytoma

A

tan/mahogany brown color
well encapsulated
lg eosinophilic cells

74
Q

Renal cell carcinoma

A

yellow color
60-70’s
tobacco increases risk
from tubular epithelium

75
Q

Clear cell carcinoma

A

most common renal cell carcinoma
orange/yellow color
upper pole of kidney
chromosome 3p deletion

76
Q

Asscs with clear cell carcinoma

A

von Hippel-Lindau

tuberous sclerosis

77
Q

Papillary carcinoma

A

fibrous capsule

foamy macrophages/intracellular hemosiderin

78
Q

Genetics of papillary carcinoma

A

sporadic: trisomy 7,16.17, loss of Y
familial: trisomy 7

79
Q

Chromophobe renal carcinoma

A

tan brown/well circumscribed
compact architecture of nests
halo around nuclei
(+) Hale’s colloidal iron stain

80
Q

Collecting duct carcinoma

A

Bellini duct carcinoma
infiltrative borders
hobnail cell lined
mucin producing/desmoplastic response

81
Q

Acute transplant rejection

A

5-7 days after transplant
HS type IV
immunosuppression helps
lymphocytes predominant cell type

82
Q

Benign nehproslcerosis

A

caused by HTN
hyaline arteriosclerosis
assc with diabetes and fibromuscular dysplasia

83
Q

Malignant nephrosclerosis

A

from malignant HTN
uremia causes death
fibrinoid necrosis/hyperplastic arteriosclerosis
angiotensin II released, perpetuates damage

84
Q

Renal artery stenosis

A

number 1 cause-atheromatous plaque

number 2-FMD, women 20-40y/o

85
Q

Factors with thrombotic microangiopathy

A

endothelial injury-vasoconstriction

platelet aggregation-von Willebrand factor/ADAMTS-13

86
Q

Childhood hemolytic uremic syndrome

A

follows EHEC infection
shigella like toxin
assc with petting zoos/undercooked meats
Verocytotoxin causes platelet aggregation

87
Q

Adult (atypical) hemolytic uremic syndrome causes

A 
SLE
pregnancy
malignant HTN
immunosuppressants
factor H complement defect
88
Q

Thrombotic thrombocytopenic purpura

A

hemolytic anemia
purpura
neuro sx
caused by defect of ADAMTS-13 (thins blood)

89
Q

ANCA (+) disease

A

Wegener’s granulomatosis
microscopic polyangitis
Churg-Strauss syndrome

90
Q

Wegener’s granulomatosis

A

chronic sinusitis
ANCA (+)
noncaseating granulomas
nephritic syndrome

91
Q

Microscopic polyangitis vs Wegener’s granulomatosis

A

similar to Wegener’s but no granulomas

92
Q

Isolated pauci-immune GN vs Wegener’s granulomatosis

A

Wegener’s but limited to the kidney (no lung involvement)

93
Q

Churg-Strauss syndrome

A 
allergic rhinitis
worsening asthma
rash with palpable purpura
peripheral neuropathy
nephritic syndrome
ANCA (+)
eosinophilia with small vessel vasculitis
94
Q

Goodpasture’s disease

A

anti-GBM against lungs and kidneys
nephritic syndrome
crescentic, necrotizing GN
linear deposition of IgG on IF

95
Q

Lupus nephritis

A

young women with SLE
can mimic any glomerular disease
“full house” on IF

96
Q

SLE sx

A

photosensitive rash
Raynaud’s
alopecia
anti-dsDNA and ANA (+)

97
Q

Diabetic nephropathy

A

Kimmelstiel-Wilson nodules

nonenzymatic glycosylation

98
Q

Amyloidosis on kidneys

A

primary-light chains assc with multiple myeloma
secondary-amyloid
Congo red/apple green birefringence

99
Q

Sickle cell disease on kidneys

A

hematuria/proteinuira from sickled cells

decreased renal conc mechanism

100
Q

Diffuse cortical necrosis causes

A

OB emergency
septic shock
extensive surgery

101
Q

Henoch-Schonlein purpura

A

small vessel vasculitis
palpable purpura with IgA deposits on bx
children/young adults following URT infection

102
Q

HIV assc nephropathy

A

increased in blacks
FSGN
collapsing glomeruli

103
Q

Minimal change disease findings

A

foot process effacement

104
Q

Membranous GN findings

A

granular IF

subepithelial deposits

105
Q

Focal segmental GN findings

A

no deposits on EM

segmental GS

106
Q

IgA nephropathy findings

A

mesangial proliferation

IgA deposits in mesangium

107
Q

Post strep GN/acute proliferative GN findings

A

garland on IF

subepithelial deposits

108
Q

ANCA diseases findings

A

crescentic, necrotizing GN

no deposits/IF

109
Q

Goodpasture’s findings

A

crescentic, necrotizing GN
linear IF
no deposits

110
Q

Membranoproliferative GN findings

A

granular IF
subendothelial/mesangium deposits
tram track appearance (membrane splitting)

111
Q

Lupus findings

A

“full house” on IF

any histo of other diseases

112
Q

Diabetes mellitus findings

A

nodular GS

thick basement membrane

113
Q

Amyloidosis findings

A

nodular GS
Congo red (+)
fibrils

114
Q

HIV assc nephropathy findings

A

collapsing FSGN

reticular inclusion bodies

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