Glomerular Diseases EC

Question 1

Proteinuria (>3.5g/day), Hyperlipidemia, fatty casts in urine, and edema.

Answer 1

Nephrotic syndrome

Associated with thromboembolism (ATIII loss)
Increased risk of infections

Question 2

Segmental sclerosis and hyalinosis on LM
Effacement of foot processes on EM
Associated with HIV

Answer 2

Focal segmental glomerulosclerosis

Most common cause of nephrotic syndrome in adults

Question 3

Diffuse capillary and GBM thickening on LM
“Spike and dome” appearance with subepithelial deposits on EM
Granular appearance on IF

Answer 3

Membranous nephropathy

Idiopathic, drugs, infections, SLE) (granular appearance on IF, and solid tumors

Question 4

Normal glomeruli on LM
Foot process effacement on EM
Selective loss of albumin, not globulins

Answer 4

Minimal change disease

May be triggered by a recent infection or immune stimulus
Most common in CHILDREN
responds to corticosteroids

Question 5

Congo red stain shows apple-green birefringence under polarized light
Associated with multiple myeloma, TB, RA

Answer 5

Amyloidosis

Question 6

Subendothelial IC deposits with granular IF

“tram-track” appearance due to GMB splitting caused by mesangial growth

Answer 6

Type I Membranoproliferative Glomerulonephritis

Associated with HBV and HCV

Question 7

Intramembranous IC deposits: “dense deposits”

Answer 7

Type II Membranoproliferative Glomerulonephritis

Associated with C3 and nephritic factor

Question 8

Nonenzymatic glycosylation of GBM (increased permeability and thickening)
NEG of efferent arterioles (Increased GFR, mesangial expansion)
Eosinophilic nodular glomerulosclerosis (Kimmelstiel-Wilson lesions)

Answer 8

Diabetic Glomerulonephropathy

Question 9

Hematuria, RBC casts in urine. Associated with azotemia, oliguria, hypertension, and proteinuria (<3.5g/day)

Answer 9

Nephritic syndrome = Inflammation

Question 10

Glomeruli enlarged and hypercellular, neutrophils, “lumpy-bumpy” appearance on LM
Subepithelial immune complex humps on EM
Granular appearance due to IgG, IgM, and C3 deposits along GMB and mesangium on IF
Peripheral and periorbital edema, dark urine, hypertension

Answer 10

Acute Poststreptococcal Glomerulonephritis

Most often in children

Question 11

Crescent-moon shape consisting of fibrin and C3b with glomerular parietal cells, monocytes, and macrophages

Answer 11

Rapidly progressive glomerulonephritis

Goodpasture’s = type II hypersensitivity, antibodies to GBM and alveolar basement membrane. LINEAR IF and hemoptysis/hematuria

Granulomatosis with polyangitis (c-ANCA)

Microscopic polyangitis (p-ANCA)

Question 12

“Wire looping” of capillaries
Subendothelial IgG-based immune complexes with C3
Granular upon IF

Answer 12

Diffuse proliferative glomerulonephritis

Due to SLE (most common cause of death) or MPGN

Question 13

Henoch-Schonlein purpura
Mesangial proliferation on LM
Mesangial IC deposits on EM
IgA based IC deposits in mesangium on IF

Answer 13

Berger’s Disease (IgA nephropathy)

Often presents with a UTI or gastroenteritis

Question 14

Mutation in type IV collagen
Split basement membrane
Glomerulonephritis, deafness, and eye problems

Answer 14

Alport syndrome