Histopathology

Question 1

Nephrotic syndrome clinical features

Answer 1

Over 3g of protein per 24 hr
Hypoalbuminemia less than 30g/L

Question 2

Causes of nephrotic syndrome

Answer 2

Intrinsic causes:
- Minimal change disease
- Membranous disease
- FSGS

Systemic causes:
- Diabetes
- Amyloidosis

Question 3

Would you do a biopsy for someone with nephrotic syndrome?

Answer 3

Yes you have to

Question 4

Would you do a biopsy in a child with nephrotic syndrome?

Answer 4

No - we assume it will be minimal change disease

Question 5

What does a silver stain look like?

Answer 5

Has a black outline

If there are large areas of the glomerulus which don’t turn black, they are silver negative

Question 6

Amyloidosis staining

Answer 6

Apple green birefringence on congo red stain

Question 7

What do you see on EM staining with amyloidosis?

Answer 7

Fibrills

Question 8

What do you do next after apple green birefringence?

Answer 8

Stain the tissue for kappa / lambda

Question 9

Myeloma work up

Answer 9

BM biopsy
Imaging for lymph nodes

Question 10

How do you treat for AL myeloma?

Answer 10

Chemo

Question 11

Which organ is most affected in AL amyloidosis?

Answer 11

Heart failure

Question 12

In AKI, when do you do a biopsy?

Answer 12

Only after you’ve excluded prerenal and postrenal causes

Question 13

Give pre renal causes of an AKI

Answer 13

Sepsis, hypovolemia

Question 14

Give post renal causes of an AKI

Answer 14

Stones, obstruction

Question 15

What are some renal causes of AKI?

Answer 15

Glomerular - GN, thrombotic microangiopathy
Tubular interstitum - ATN, acute interstitial nephritis
Arteries - cholestrol emboli

Question 16

Give a key cause of acute interstitial nephritis

Answer 16

PPIs

Question 17

Mx of someone with acute interstitial nephritis caused by PPI

Answer 17

Stop PPI
Give steroids