Path buzz words Flashcards
Lumpy bumpy/humps
Post streptococcal glomerulonephritis
+ serum antistreptolysin (ASO) titers and streptozyme test
Post streptococcal glomerulonephritis
What strains are seen in Post streptococcal glomerulonephritis?
Beta hemolytic: types 12, 4, or 1
IF shows IgM, IgG, and C3
Post streptococcal glomerulonephritis
- Glomerular hypercellularity
2. Leukocyte infiltration
Post streptococcal glomerulonephritis
- Capillary basement membrane thickening
- Diffuse Mesangial sclerosis
- Nodular glomerulosclerosis
Diabetic glomerulosclerosis/nephropathy
Malignant nephrosclerosis
Diabetic glomerulosclerosis/nephropathy
Renal disease associated with malignant or accelerated hypertension
Will have fibrinoid necrosis in the afferent arteriole
and hyperplastic arteriolitis “onion-skin” lesion
early findings of microalbuminuria and elevated GFR
Diabetic glomerulosclerosis/nephropathy
Fatty casts
Minimal Change disease
Anti-phospholipase A2 receptor Abs
membranous glomerulonephropathy
Spikes
membranous glomerulonephropathy
- Effaced foot processes
- Thickening of the basement membrane
- Accumulation of immunoglobulin deposits
membranous glomerulonephropathy
HIV positive pts
Collapsing glomerulosclerosis, a type of FSGS
large cysts surrounded by mesenchyme
Cystic renal dysplasia
Medullary cysts concentrated to the corticomedullary junction
Nephronophthisis- medullary cystic disease complex
Types of RPGN
Type I: Anti-GBM. Linear
Type II- Immune complex. Granular.
Type III- pauci immune. None
EM- wrinkled and ruptured BM
RPGN
nephritic nephrotic syndrome
Membranoproliferative glomerulonephritis
Tram track
Membranoproliferative glomerulonephritis
Membranoproliferative glomerulonephritis types
Type I: immune complex IgG + C3. Subendothelial. Occurs with hepatitis C with cryoglobulinemia
Type II: C3 nephritic factor. Intramembranous.
35% of pts develop acute nephritic syndrome
Effectively treated my corticosteroids
minimal change disease
Alternating thickening and thinning
Alports
Urea-splitting bacteria
Struvite stones made of magnesium phosphate
VHL gene
Renal cell carcinoma
Thyroidization
chronic pyelonephritis
Inflammatory infiltrate of lymphocytes and plasma cells, and no neutrophils
chronic cystitis
Shistocytes
HUS
40% of this is associated with step pneumo
atypical HUS
ADAMTS
TTP
factor H
atypical HUS
Fibrocystin
autosomal recessive polycystic disease
mesangial proliferation
MPGN
granulomatous vasculitis
RPGN Type III
Chronic immune complex deposition disease
Membranous glomerulonephropathy
nephrin
FSGN
papillary necrosis
analgesic nephropathy
leukemia
uric acid stone
Stage 3 GFR
30-59
Signs of chronic renal disease
- HTN, edema, CHF
- Bone disease
- Anemia
- Isosthenuria and broad waxy casts
- Acidosis
- Hyperkalemia
- Progressive azotemia over months to years
a. End stage: fatigue, weakness, malaise, nausea, vomiting - Paresthesias
- B/l small kidneys
ventriculoperitoneal shunt
post streptococcal glomerulonephritis
What do the humps contain?
IgG and C3. Deposited on subepithelial side
Diseases that IgA deposits can also be seen in
hepatic cirrhosis
HIV
CMV
Celiac disease
Hepatitis C is associated with…
- Immune complex mediated MPGN (nephritic, type I)
- Mixed Cryoglobulinemic GN (nephritic)
- Membranous Nephropathy (nephrotic)
Low C3
MPGN
Dense ribbon-like deposits
MPGN
Treatment for nephritic diseases
- Treat hypertension and proteinuria with ACE inhibitor
- Add methylprednisolone for proteinuria > 1gm/d and GFR > 70 mL/min
- Add cyclophosphamide or mycophenolate mofetil for GFR
APOL1 gene
Focal segmental glomerulosclerosis
Kimmelstiel-Wilson
Diabetic nephropathy
Chronic tubulointerstitial disease characterized by
o Isosthenuria with polyuria o Moderate proteinuria o Very few cells o Type I, II, or IV RTA o Broad waxy casts o Small kidneys
Causes of tubulointerstitial disease
o Prostate (obstructive uropathy) o Analgesics (NSAIDs) o VU reflux o Lead (heavy metals) o Gout o Myeloma
Renal disease of myeloma
Myeloma kidney Hypercalcemia Hyperuricemia Amyloidosis B cell infiltration Hyperviscosity
Tests for renovascular hypertension
- Captopril test
- DSA
- MRI-angiography
- Arteriography
- Renal vein renin ratio >1.5
2 main causes of renovascular hypertension
- Atherosclerosis-males
2. Fibromuscular dysplasia- females