Nephropathies

Question 1

Focal Segmental glomerulosclerosus

Answer 1

LM - segmental sclerosis, hyalinosis
EM - sim. to Min. Change

Most common nephrotic syndrome in adults

Assoc: HIV, Heroine abuse, massive obesisty, IFN rx, CKD

Question 2

Membranous Nephropathy

Answer 2

LM - capillary and GMB thickening
EM - Spike and dome, sub EPITHELIAL
IF - granular
SLE's nephrotic presentation
2nd most common in adults

Question 3

Minimal Change Disease

Answer 3

LM-normal
EM- effacement of podocytes

Selective albumin loss
Most common in KIDS
triggered by infection, responds to steroids

Question 4

Amyloidosis

Answer 4

LM-Congo red stain shows apple green birefringence

Question 5

Membranoproliferative glomerulonephritis

Answer 5

Type I - subENDO IC depo, granular IF, “Tram-Track” due to GBM splitting by mesangial growth – HBV, HCV

Type II - intramembranous IC “dense deposits” – C3 Nephritic factor

Question 6

Diabetic glomerulonephropathy

Answer 6

NEG of GBM, increased perm and thickening
Arteriolosclerosis of efferent arteriole

LM - mesangial expansion, GBM thickening, Kimmelstiel Wilson bodies

Question 7

Acute Poststreptococcal glomerulnephritis

Answer 7

LM - enlarged glomeruli, hypercellular, PMNs
EM - sub EPI thelial IC depos

Children, post strep, dark urine periorbital edema

Question 8

RPGN

Answer 8

Crescent moon fibrin and plasma proteins with glomerular parietal cells, monocytes and macrophages

Goodpastures, WeCeners, Microscopic polyangiitis

Question 9

DPGN

Answer 9

SLE or MPGN
Most common CAUSE OF DEATH in SLE
Wire Looping of capillaries
EM- sub ENDO deposits

Question 10

Berger’s disease

Answer 10

IgA nephropathy, Henoch-Schonlein purpura

LM- mesangial proliferation

presents as flares after URI or acute gastroenteritis

Question 11

Alport Syndrome

Answer 11

Mutation in Type IV collagen
X linked
Glomerulonephritis, deafness, eye problems