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systems pathology > kidney > Flashcards

kidney Flashcards

1
Q

common clinical findings of somebody who has nephrotic syndrome

A 
proteinuria
hypoalbuminemia
edema
hyperlipidemia
lipiduria
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2
Q

what is the most common cause of nephrotic syndrome in children?

A

min. change syndrome

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3
Q

what are some microscopic changes that can be found in min. change syndrome

A

loss of foot processes

smeared look over GBM

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4
Q

how would you treat a child that you suspect might have min. change disease?

A

corticosteroids

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5
Q 
if child presence to clinic with 
proteinuria
hypoalbuminemia
edema
hyperlipidemia
lipiduria

what will you treat them with?
what do you suspect that they have?

A

min. change disease

treat with corticosteroids

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6
Q

membranous GN special lab findings?

A

spike like projections
sub-epithelial immune deposits
no cellular proliferations
thickening of GBM

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7
Q

which nephrotic syndromes have spike like projections?

A

MGN

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8
Q

what are some secondary causes of MGN?

A 
Hep. B
syphilis
malaria
malignant carcinoma of the lung
SLE
Drugs
NSAIDS
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9
Q

what is most common primary cause of MGN?

A

idiopathic

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10
Q

pt. comes in with nephrotic symptoms, you run a lab and find thickening of the GBM, sub-epithelial spikes, has no cellular proliferation…
what will be on the top of your differential dx.?

A

membranous GN

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11
Q

what are some special findings linked too FSGS?

A

sclerosis of focal spots of glomeruli involved and

segmental capillary tufts

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12
Q

what are some primary causes of FSGS?

A

nephrotic syndrome

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13
Q

what are some secondary causes of FSGS?

A

HIV

heroin

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14
Q

pt. has a history of heroin usage and nephrotic syndrome disorder, you do a lab test and find sclerosis of only some glomeruli and some capillary tufts what should be the top of you differential dx.?

A

FSGS

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15
Q

microscopically what are some findings of FSGS?

A

loss of foot processes
Cell detachment
Cytokines
blue collagen

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16
Q

which of the nephrotic syndromes can be caused by cytokines?

A

FSGS

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17
Q

which of the nephrotic syndromes uses trichome stain?

A

FSGS

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18
Q

which of the nephrotic syndromes can be seen as a final stage of pyelonephritis?

A

FSGS

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19
Q

which of the nephrotic syndromes has epithelial detachment?

A

FSGS

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20
Q

membranoproliferative GN (MPGN) involves which cells of the kidney?

A

mesangial cells

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21
Q

MPGN:

the proliferation of the mesangial cells split the GBM which leaves it looking like what microscopically?

A

tramtrack

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22
Q

what may be found microscopically in a pt. who has MPGN?

A 
double contour of subendothelial 
IgG and C3 --> immune complexes 
infiltrating leukocytes
lobular pattern
splitting of GBM
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23
Q

can children get MPGN?

A

yes

24
Q

what are some secondary causes of MPGN?

A

Hep c and b

SLE

25
Q

what do MPGN and MGN have in common?

A

they both have immune complexes

26
Q

which autoimmune disease has MPGN, increase of WBC’s in mesangium, IgA deposits and edema within the capillary lumen?

A

henoch schonlein purpura (HSP)

27
Q

what are some findings of alport nephritis?

A 
unexplained hematuria
Hx. of nephritis
B/L sensorineural hearing loss
ocular lesions
alterations of GBM
familial ESR
28
Q

what are the symptoms of pre eclampsia?

A

HEP =>
hypertension
edema
proteinuria

29
Q

Eclampsia symptoms

A

HEP + coma, convulsions –> death

30
Q

pregnant lady come to clinic with history of hypertension, you notice edema and proteinuria what should be on the top of your Dx.?

A

pre-eclampsia

31
Q

pt. comes into the clinic with unexplained hematuria, B/L sensorineural hearing loss and ocular lesions what is on the top of your Dx.?

A

alport neohritis

32
Q

you use a jones silver stain and notice IgA deposits, capillary lumina edema and increase of WBC’s along with the pt. having nephrotic findings.. what should be on the top of Dx.?

A

henoch schontein purpura (HSP) MPGN

33
Q

what are common clinical findings of acute proliferative GN?

A 
azotemia
hematuria
oliguria
hypertension
some proteinuria and edema
34
Q

what is an example of an endogenous cause of acute proliferative GN>

A

SLE

35
Q

what is an example of an exogenous cause of acute proliferative GN?

A 
streptococcus
HEP b
mumps
measels
checkenpox
36
Q

what are some pathological findings of acute proliferative GN?

A

increase of glomerular tufts
proliferation of mesangial and endothial cells
neutrophilic and monocytic infiltration

37
Q

in acute proliferation GN where are the immune complex deposits located?

A

subendothelial and intramembranous

38
Q

what special appearance does acute proliferative GN appear like under microscope?

A

‘lumpy bumpy’

39
Q

what kind of immune complexes can you find in the capillary loops?

A

IgG

40
Q

clinical:
an infant comes into the clinic and the mother says they got over ‘strep’ about 4 weeks ago and now she notices the child is barely peeing, he is lethargic and notices the pee is brown
what should you suspect as a Dx.?

A

acute proliferative GN (post streptococcus)

41
Q

what are some findings of somebody that has rapidly progressive glomerulonephritis?

A
  • severe oliguria
    *crescence of glomeruli (ruptured GBM)
    presence of monocytes and macrophages
    fibrin
42
Q

if a person has good pastures disease what kind of nephritic syndrome can you assume they are presenting with if have the common symtoms?

A

rapidly progressive glomerulonephritis

43
Q

what type of HSR is goodpasture syndrome?

A

type 2

44
Q

what might be a 2ry cause of rapidly progressive GN?

A

SLE

45
Q

you run a lab on somebody who is presenting with azotemia
hematuria
oliguria
hypertension and you find macrophages and focal spots of ruptured GBM and crescence parietal cells what would be on the top of differential Dx.?

A

rapidly progressive GN

46
Q

what is the leading cause of acute pyleonephritis?

A

ecoli

47
Q

what are the two routes somebody can get pyelonephritis?

A

blood stream or ascending infection

48
Q

what are some other organisms that cause acute pyelonephritis?

A

strep, staph, pseudomonas, klebsiella

49
Q

what are some predisposing factors of acute pyelonephritis?

A 
cytoscopy
catheterization
female
outflow obstruction
incompetent vesicoureteral orifice
diabetic
50
Q

what are the pathological findings of a kidney that has acute pyelonephritis

A

enlarged
yellow abcesses
deeply congested between abcesses

51
Q

you are dissecting a kidney are realize suppurative inflammation of renal pelvis and interstitium and yellow abscesses.. what did the person suffer from?

A

acute pylonephritis

52
Q

what are the two causes of chronic pyelonephritis?

A

chronic obstructive pyelonephritis

chronic reflux associated with pylenophritis

53
Q

what is the most common form of chronic pyelonephritis?

A

chronic reflux associated with pyelonephritis

54
Q

what are some pathological findings of chronic pyelonephritis?

A 
1.diffuse patches of fibrin and scarring
of pelvis and calyces
2.papillary blunting
3.interstitial fibrosis
4. contraction and dilation of tubules
5. arteriosclerosis
55
Q

you do a dissection of kidney and your lab findings include:
glossy pink colloid appearance
contraction and dilation of tubules (cast filled)
scarring of pelvis and calyces &
arteriosclerosis

what is at the top of your Dx.?

A

chronic pyelonephritis

56
Q

pt. presents to clinic with nocturia, polyuria and hypertension what should suspect?
especially if they have history of infection

A

chronic pyelonephritis

systems pathology (4 decks)

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