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PSBIM 2023 Nephro > Glomerular Diseases > Flashcards

Glomerular Diseases Flashcards

1
Q

Renal biopsy findings in post streptococcal glomerulonephritis

A

Hypercellularity of mesangial and endothelial cells, glomerular infiltrates of polymorphonuclear leukocytes, granular subendothelial immune deposits of IgG, IgM, C3, C4 and C5-9 and subepithelial deposits (which appears as “humps”)

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2
Q

Renal pathology of Subacute Bacterial Endocarditis

A

Subcapsular hemorrhages, with a “flea-bitten” appearance, and microscopy on renal biopsy reveals focal proliferation around foci of necrosis associated with abundant mesangial, subendothelial, and subepithelial immune deposits of IgG, IgM, and C3

  • commonly present with a clinical picture of RPGN and have crescents on biopsy
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3
Q

Most common clinical sign of renal disease in lupus nephritis

A

Proteinuria

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4
Q

Antibodies that correlate best with the presence of renal disease

A

Anti-dsDNA

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5
Q

Only reliable method of identifying the morphologic variants of lupus nephritis

A

Renal biopsy

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6
Q

Lupus nephritis that has normal glomerular histology by any technique or normal light microscopy with minimal mesangial deposits on immunoflourescent or electron microscopy

A

Class I (Minimal mesangial)

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7
Q

Lupus nephritis that designates mesangial immune complexes with mesangial proliferation

A

Class II (Mesangial proliferation)

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8
Q

Lupus nephritis that describes focal lesion with proliferation or scarring, often involving only a segment of the glomerulus

A

Class III (Focal nephritis)

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9
Q

Lupus nephritis that describes global, diffuse, proliferative lesions involving vast majority of the glomeruli

A

Class IV (Diffuse nephritis)

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10
Q

Class of lupus nephritis that has the worst renal prognosis without treatment

A

Class IV

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11
Q

Lupus nephritis lesion that describes subepithelial immune deposits producing a membranous pattern

A

Class V Lesion (Membranous nephritis)

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12
Q

Lupus nephritis class that is predisposed to renal-vein thrombosis and other thrombotic complications

A

Class V

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13
Q

Lupus nephritis that have >90% sclerotic glomeruli and ESRD with interstitial fibrosis

A

Class VI (Sclerotic nephritis)

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14
Q

A pulmonary renal syndrome that present with lung hemorrhage and glomerulonephritis, targets Type IV collagen

A

Goospasture’s syndrome

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15
Q

Renal biopsy show focal or segmental necrosis that later with aggressive destruction of the capillaries by cellular proliferation, leads to crescent formation in Bowman’s space

A

Anti-GBM disease

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16
Q

Recognized on biopsy by linear immunoflourescent staining for IgG

A

Anti-GBM disease

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17
Q

Treatment of Goodpasture syndrome patients with advanced renal failure who present with hemoptysis

A

Plasmapheresis

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18
Q

One of the most common forms of glomerulonephritis worldwide

A

IgA nephropathy

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19
Q

An immune complex-mediated glomerulonephritis defined by the presence of diffuse mesangial IgA deposits often associated with mesangial hypercellularity

A

IgA nephropathy

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20
Q

Two most common presentations of IgA nephropathy

A
  1. Recurrent episodes of macroscopic hematuria during or immediately following a URTI often accompanied by proteinuria
  2. Persistent asymptomatic microscopic hematuria
21
Q

ANCA Small-vessel vasculitis

A

Granulomatosis with polyangiitis
Microscopic polyangiitis
Churg strauss Syndrome
Renal limited Vasculitis

22
Q

ANCA that is more common in granulomatosis with polyangiitis

A

Anti-PR3

23
Q

ANCA that is more common in microscopic polyangiitis or Churg-Strauss

A

Anti-MPO

24
Q

Classically present with fever, purulent rhinorrhea, nasal ulcers, sinus pan, polyarthralgias/arthritis, cough, hemoptysis, shortness of breath, microscopic hematuria, and 0.5-1 g/24h of proteinuria

A

Granulomatosis with Polyangiitis

25
Q

CXR finding of Granulomatosis with Polyangiitis

A

Nodules and persistent infiltrate, sometimes with cavities

26
Q

Renal biopsy during active disease demonstrate segmental necrotizing glomerulonephritis as focal, mixed, crescenteric or sclerotic without immune deposits

A

Granulomatosis with Polyangiitis

27
Q

Disease that is more common in patients exposed to silica dust and thosewith a1 antitrypsin deficiency

A

Granulomatosis with Polyangiitis

28
Q

ANCA positive vasculitis with no granulomas on kidney biopsy

A

Microscopic polyangiitis

29
Q

Associated with peripheral eosinophilia, cutaneous purpura, mononeuritis, asthma and allergic rhinitis

A

Churg-strauss syndrome

30
Q

Commonly associated with persistent hepatitis C infections, autoimmune diseases like lupus or cryoglobulinemia or neoplastic diseases

A

Type I MPGN

31
Q

The most proliferative of the three types of MPGN

A

Type 1 MPGN

32
Q

Shows mesangial proliferation with lobular segmentation on renal biopsy and mesangial interposition between the capillary basement membrane and endothelial cells producing a double contour sometimes called “tram tracking”

A

Type 1 MPGN

33
Q

Low serum C3 and a dense thickening of the GBM containing ribbons of dense deposits and C3

A

Type 2 MPGN (Dense deposit disease)

34
Q

Treatment of MPGN in the presence of proteinuria

A

RAAS inhibitors

35
Q

Characterized by expansion of the mesangium, sometimes associated with mesangial hypercellularity; thin , single contoured capillary walls, and mesangial immune deposits

A

Mesangioproliferative glomerulonephritis

36
Q

Shows no obvious glomerular lesion by light microscopy and is negative for deposits by immunofluorescent microscopy or occasionally shows small amounts of IgM in the mesangium

A

Minimal change disease

37
Q

Presents clinically with abrupt onset of edema and nephrotic syndrome accompanied by acellular urinary sediment

Light and immunoflourescent microscopy: negative findings
Electron microscope - effacement of foot processes

A

Minimal change disease

38
Q

Treatment of minimal change disease

A

Steroids

39
Q

MCD patients who have a complete remission after a single course of prednisone

A

Primary responders

40
Q

MCD patients who have two or more relapses in the 6 months following taper

A

Frequent relapsers

41
Q

Refers to a pattern of renal injury characterized by segmental glomerular scars that involve some but not all glomeruli , clinically manifests as proteinuria

A

Focal segmental glomerulosclerosis

42
Q

Most common cause of nephrotic syndrome in the elderly

A

Membranous glomerulonephritis

43
Q

Characterized by uniform thickening of the basement membrane along the peripheral capillary loops.

Electron microscopy reveals electron-dense subepithelial deposits

A

Membranous glomerulonephritis

44
Q

Risk factors for the development of diabetic nephropathy

A

Hyperglycemia
Hypertension
Dyslipidemia
Smoking
Family history of diabetic nephropathy
Genetic polymorphisms affecting the activity of the RAAS

45
Q

Timeline when morphologic changes appear in the kidney after the onset of clinical diabetes

A

Within 1-2 years

46
Q

Eosinophilic , PAS+nodules which develop in some patients with diabetic nephropathy

A

Nordular glomerulosclerosis or Kimmelstiel-Wilson nodules

47
Q

A potent risk factor for cardiovascular events and death in patients with Type 2 Diabetes

A

Microalbuminuria

48
Q

How long does it take for diabetic nephropathy to reach ESRD from the earliest stages of microalbuminuria

A

10-20 years

PSBIM 2023 Nephro (8 decks)

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