Glomerulonephropathies Flashcards

1
Q

5 characteristics of nephrotic syndrome

A
  1. proteinuria > 3.5 g/day
  2. hypoalbuminemia
  3. hypogammaglobulinemia
  4. hypercoagulable state
  5. hyperlipidemia and hypercholesterolemia
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2
Q

Most common cause of nephrotic syndrome in children

A

Minimal change disease

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3
Q

Cancer associated with minimal change

A

Hodgkin lymphoma

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4
Q

Minimal change findings on H&E stain, EM, and IF

A

H&E: normal glomeruli

EM: effacement of foot processes due to production of cytokines

IF: negative

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5
Q

Symptoms of minimal change disease

A

Selective loss of albumin, periorbital edema following an upper respiratory tract infection or vaccination

Has an excellent response to steroids

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6
Q

Populations most likely to have focal segmental glomerulosclerosis

A

Hispanics and African Americans, also associated with HIV, heroin use and sickle cell disease

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7
Q

Focal segmental findings on H&E stain, EM, and IF

A

H&E: focal (some glomeruli) and segmental (involving only part of the glomerulus) sclerosis

EM: effacement of foot processes

IF: negative

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8
Q

Populations most likely to have membranous nephropathy

A

Caucasian adults, also associated with HBV and HCV, solid tumors (lung, breast, colon), SLE or drugs (NSAIDS and pencillamine, gold)

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9
Q

Membranous nephropathy findings on H&E stain, EM, and IF

A

H&E: thick glomerular basement membrane

EM: subepithelial deposits with spike and dome appearance

IF: immune complex deposition giving a granular appearance

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10
Q

Membranoproliferative, type I findings on H&E stain and IF

A

H&E: thick glomerular basement membrane often with tram track appearance due to basement membrane splitting by mesangial ingrowth

IF: immune complex deposition giving a granular appearance

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11
Q

Diseases associated with membranoproliferative, type I

A

HBV and HCV

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12
Q

Membranoproliferative, type II findings on IF

A

IF: intramembranous dense deposits

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13
Q

Association with membranoproliferative, type II

A

C3 nephritic factor: autoantibody that stabilizes C3 convertase, leading to over activation of complement, inflammation and low levels of circulation C3

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14
Q

Microscopic findings in diabetic glomerulonephropathy

A

Sclerosis of the mesangium with formation of Kimmelstiel-Wilson nodules

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15
Q

Microscopic findings in systemic amyloidosis affecting the kidney

A

Amyloid deposits in the mesangium, characterized by apple-green birefringence under polarized light after staining with Congo Red

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16
Q

4 characteristics of nephritic syndrome

A
  1. limited proteinuria < 3.5 g/day
  2. oliguria and azotemia
  3. periorbital edema and hypertension
  4. RBC casts and dysmorphic RBCs in urine
17
Q

Acute poststreptococcal glomerulonephritis findings on H&E stain, EM, and IF

A

H&E: glomeruli enlarged and hypercellular

EM: subepithelial immune complex humps

IF: granular appearance due to IgG, IgM, and C3 deposition along GBM and mesangium

18
Q

Symptoms of PSGN

A

Peripheral and periorbital edema, dark urine, and hypertension usually 2-3 weeks following infection

19
Q

RPGN findings on EM, and IF

A

EM: crescents in Bowman’s space composed of fibrin and macrophages

IF: varies on disease

20
Q

RPGN condition with linear IF pattern

A

Goodpasture syndrome: antibody against collagen in glomerular and alveolar basement membranes

21
Q

RPGN conditions with granular IF pattern

A

PSGN or diffuse proliferative glomerulonephritis

22
Q

RPGN conditions with negative IF pattern (pauci immune)

A

Wegener’s, microscopic polyangiitis, and Churg-Strauss

23
Q

Differentiate between microscopic polyangiits and Churg-Strauss

A

Both are p-ANCA+

Granulomatous inflammation, eosinophilia, and asthma are only associated with Churg-Strauss

24
Q

Berger’s disease findings on H&E stain, EM, and IF

A

H&E: mesangial proliferation

EM: mesangial IC deposits

IF: IgA-based IC deposits in mesangium

25
Symptoms of Berger's disease
Usually presents in childhood with episodic gross or microscopic hematuria with RBC casts usually following mucosal infections
26
Mutation found in Alport syndrome and inheritance pattern
Inherited defect in type IV collagen, most commonly X-linked
27
Symptoms of Alport syndrome
Isolated hematuria, sensory hearing loss, and ocular disturbances
28
Diffuse proliferative glomerulonephritis findings on H&E stain, EM, and IF
H&E: "wire looping" of capillaries EM: subendothelial and sometimes intramembranous IgG-based ICs often with C3 deposition IF: granular appearance