Nephrotic Syndrome

Question 1

Minimal Change Disease (demographic, associated disease, microscopy, treatment)

Answer 1

Children
Hodgkin’s Lymphoma can cause because cytokine-mediated
Effacement of foot processes on electron, H&E and IF generally normal
Responds well to steroids, unique for nephrotic syndromes

Question 2

Focal Segmental Glomerulosclerosis (demographic, 3 risk factors, microscopy)

Answer 2

Hispanics and AAs
HIV, heroin, and sickle cell
Focal and segmental sclerosis on H&E, Effacement of foot processes on EM

Question 3

Membranous Nephropathy (demographic, associations, microscopy)

Answer 3

Caucasian adults
SLE, notable bc can cause nephritic or nephrotic. Also hepatitis and shit. Also NSAIDs
Thick glomerular BM on H&E
Granular BM IC deposits on IF
Subepithelial deposits with “spike and dome” on EM

Question 4

Membranoproliferative Glomerulonephritis microscopy

Answer 4

Thick BM on H&E with “tram-track” appearance - mesangial cell proliferation cuts through IC deposit
Granular IF

Question 5

Type I MPGN (deposit location, important microscopy, disease association)

Answer 5

Subendothelial - tram tracking more common

Associated with HBV and HCV

Question 6

Type II MPGN (deposit location, cause/association)

Answer 6

Intramembranous deposit
Associated with C3 nephritic factor, AutoAb that stabilizes C3 convertase leading to overactivation of complement and inflammation

Question 7

Diabetes Mellitus (what happens, pathopneumonic finding, treatment)

Answer 7

Hyaline arteriolosclerosis affects efferent arteriole more, causing increased GFP and hyperfiltration -> microalbuminuria
Sclerosis of mesangium with Kimmelstiel-Wilson nodules
ACE inhibitors slow progression (bc prevent ATII activity increasing glomerular pressure more)

Question 8

Systemic Amyloidosis

Answer 8

Kidney most commonly affected organ, so deposits in mesangium causing nephrotic syndrome and visible via Congo red