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Emma Renal > Pathology > Flashcards

Pathology Flashcards

1
Q

nephrotic syndromes

A
  • minimal change disease
  • FSGS
  • membranous nephropathy
  • diabetic nephropathy
  • amyloidosis
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2
Q

nephritic syndromes

A

-post-strep
glomerulonephritis
-berger’s (IgA) nephropathy
-diffuse proliferative glomerularnephritis
-crescentic GN (RPGN)
-Alport syndrome
-Membranoproliferative glomerulonephritis (MPGN)

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3
Q

nephrotic w/ foot process effacement

A

minimal change disease

FSGS

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4
Q

immune complex deposition

A

membranous nephropathy

membranoproliferative glomerulonephritis

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5
Q

mesangium deposition

A

diabetic nephropathy

amyloidosis

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6
Q

SLE related nephrotic syndrome

A

membranous nephropathy

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7
Q

SLE related nephritic syndrome

A

diffuse proliferative glomerulonephritis

*MOST COMMON SLE SYNDROME

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8
Q

thin/split BM

eye/ear disturbances

A

ALPORT SYNDROME

type IV collagen defect, nephritis

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9
Q

selective proteinuria

A

minimal change disease

loss of albumin due to heparin sulfate loss

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10
Q

exquisite sensitivity to steroids

A

minimal change disease

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11
Q

minimal change sx but no response to steroids

A

FSGS

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12
Q

HIV, sickle cell, heroin

A

FGSG

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13
Q
  • thick BM
  • subEPITHELIAL IC deposits (spike and dome)
  • absence of hypercellularity
  • (good prog in child, bad prog in adults
A

membranous nephropathy

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14
Q

anti-phospholipase A2 receptor Abs

A

membranous nephropathy

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15
Q

FSGS response to steroids

A

POOR, prog to chronic renal failure

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16
Q

membranous nephropathy response to steroids

A

POOR, prog to chronic renal failure

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17
Q
  • recurrent hematuria
  • thick BM, focal sclerosis (mesangial)
  • nodular sclerosis (KIMMELSTIEL-WILSON BODIES)
  • preferential hyaline arteriosclerosis in EFF a.
A

diabetic nephropathy

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18
Q

diabetic nephropathy MOA

A

hyperglycemia –> nonenzymatic glycation of tissue proteins –> mesangial expansion

GBM thickening/inc perm

hyperfiltration (glomerular HTN and inc GFR) –> glomerular hypertrophy and scarring

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19
Q

most comm cause ESRD in US

A

diabetic nephropathy

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20
Q

deposits in mesangium (B-pleated sheets)

- congo red –> apple-green birefringence

A

amyloidosis

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21
Q

SLE
solid tumors
Hepatitis (B/C)

nephrotic syndrome

A

membranous nephropathy

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22
Q

nephrOtic sx

A
  • proteinuria (>3.5 g/dl) –> FROTHY urine
  • hypOalbuminemia
  • hyperlipidiemia (fatty casts/oval bods)
  • hypercoaguability (AIII loss)
  • dec plasma oncotic P so fluid leaks into tissues –> dec ECV/GFR, inc RAAS –> EDEMA (LE, peri-orbital)
  • infections (loss of Ig)
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23
Q

tx of which nephritic syndrome is usu supportive bc IC dissipate out

A

post-strep glomerulonephritis

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24
Q

M protein virulence fx
peripheral/periorbital edema
HTN
cola urine

A

post-strep glomerulonephritis

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25
Q

2-3 weeks post infection

A

post-strep glomerulonephritis

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26
Q 
subEPITHELIAL humps ("lumpy-bumpy"), deposition
capillary loops w/ neutrophils
A

post-strep glomerulonephritis

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27
Q

dec complement levels (C3) due to infection

A

post-strep glomerulonephritis

type II membranoproliferazive glomerulonephritis

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28
Q

nephrITIC syndrome

A
  • INFLAMM process damaging ENTIRE glomeruli
  • damaged filtration barrier –> dec GFR –> inc BUN/Cr
  • oliguria
  • inc hydrostatic P –> HTN, edema
  • filtration barrier to RBCs/protein lost (HEMATURIA)
  • ->salt retention (periorbital edema +HTN)
  • EM: hypercellular (neutrophils)
  • UA: RBC casts (glomerular bleeding), dysmorphic RBCs
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29
Q

all nephritic syndrome have sub_____ deposition, except _______, which has sub_____ deposition.

A

all nephritic syndrome have subENDOTHELIAL deposition, except POST-STREP GN, which has subEPITHELIAL deposition.

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30
Q

repeated mucosal (resp/GI) infec –> Ig deposition in. mesangium –> repeated hematuria

slowly worsening renal func (BUN/Cr) over time

A

IgA nephropathy

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31
Q

nephritic syndrome days after infec

A

IgA nephropathy

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32
Q

cirrhosis
celiac
HIV

A

IgA nephropathy

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33
Q

IgA nephropathy w/ extra renal involvement

A

Henoch-Scholein Purpura
(HSPI)

deposition occurs outside kidney (GI, skin)

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34
Q

IgA nephropathy - glomeruli only

A

Berger disease

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35
Q

capillary loops THICKENED

subendothelial deposition

A

diffuse proliferative glomerulonephritis

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36
Q

fever/rash/arthritis

immune complex deposition (subendo)+thickened capillary loops

A

IgA nephropathy

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37
Q

post strep glomerulonephritis can progress to

A

crescentic GN (RPGN)

38
Q

finding of inflammatory debris (FIBRIN + macrophages)

A

crescentic GN (rapidy progressive glomerulonephritis)

39
Q

lupus nephritis

A

“full house deposition” (IgG/M/A, complement)

dx: ANA and anti-dsDNA

40
Q

crescentic GN

Crescents composition/location

A

crescents in Bowman’s space

fibrin + macrophages

41
Q

crescents + ribbon like IgG deposition

A

anti-GBM

Goodpasture

42
Q

crescents + granular IgG deposition

A

PSGN
SLE
IgA
MPGN (idiopathic)

43
Q

crescents + negative IF, ANCA+

A 
pauci-immune
Werger granulomatosis (c-ANCA), microscopic polyangitis or Churg-Strauss (p-ANCA)
44
Q

type IV collagen defect (alpha 3,4,5)

A

alport syndrome

45
Q 
thick BM
prolif mesangial cell matrix
varying renal func
chronic deposition of immune complexes
double contours, hyper cellular, subendoethelial or within BM deposition
A

membranoproliferative glomerulonephritis (MPGN)

46
Q

MPGN (types !, II)
membranous nephropathy

location of deposits?

A

MPGN I –> subENDOthelial
MPGN II –> w/i BM
membranous nephropathy –> subEPIthelial

47
Q

tram track GBM

A

membranoproliferazive glomerulonephritis (MPGN)

48
Q 
thick BM
prolif mesangial cell matrix
tram tracks
hepatitis B/C or idiopathic
sub endothelial Ig depsoits w/ granular IF
A 
membranoproliferazive glomerulonephritis (MPGN) 
type I
49
Q 
thick BM
prolif mesangial cell matrix
tram tracks
low levels of circulating C3
IF: no IgG
A 
membranoproliferazive glomerulonephritis (MPGN) 
type II
50
Q

cyroglobulins

A

sign of active hep C

think MPGN

51
Q 
membranoproliferazive glomerulonephritis (MPGN) 
type II MOA
A

assoc w/ C3 nephritic factor (AutoAb) –> stabilizes C3 convertase –> alternative path –> overactive complement –> buildup in GBM + inflammation

LOW circulating C3 levels

52
Q

palpable abd mass
hematuria
flank pain

usu clear cell histo

A

renal cell CA

53
Q

loss of VHL (tumor suppressor)

A

renal cell CA

*can also be sporadic (male, smokers)

54
Q

renal cell CA origin

A

PCT cells

55
Q

yellow mass

highly vascular. often hemorrhage

A

renal cell CA

56
Q

most common renal malignancy young child

A

Wilm’s tumor

nephroblastoma

57
Q

epithelium, storm, blastema on histo

A

wilms tumor

58
Q

WT1 tumor suppressor mut

A

Wilms tumor

59
Q

assoc w/ wilms

A

wagr syndorme
beckwith wiedmann syndrome
denys-drash syndrome

60
Q

WAGR

A 
wilms tunmor
aniridia (iris absence)
genital anomalies
mental retardation
deletion of WT1 gene chrom 11
61
Q

ped overgrowth disorder

  • wilms
  • neonatal hypoglycemia
  • macrosomia
  • muscular hemihypertrophy
  • organomegaly (tongue)
A

beck with wiedemann

62
Q

diffuse mesangial sclerosis
dysgenesis of gonads (male pseudohermaphroditism)
WT1 mut

A

Denys drash syndrome

63
Q

hamartoma (vessels/smc/adipose)
benign tumor (young children)
cardiac rhabodomyomas
ash-leaf patches

A

angiomyolipma

64
Q

tumor assoc w/ tuberous sclerosis

A

angiomyolipoma

65
Q

benign epithelial neoplasm arising from CD
tumor oncocytic cells (eos+ granular cytoplasm)
NESTS/CORDS, myxoid stroma

A

oncocytoma

66
Q

tan, well-circumscribed tumor

A

oncocytoma

67
Q

malignancy assoc w/ L sided varicocele

A

renal cell CA

68
Q

bladder (urothelial carcinomas)

A

older adults
infiltrative, difficult to completely excise
recurring
UA: hematuria w/o casts

69
Q

transitional cell CA

A

most common
multifocal/recurrent (“field defect”) damage to entire urothelium

old/white/smoker

NO casts in urine

flat or papillary

tx: chemo (platinum), surgery, radiation

70
Q

tumor that is ideally tx w/ surgery (non-responsive to chemo)

A

renal cell CA

71
Q

rare, need chronic inflammation of BLADDER

risk fx:
mult kidney stones
UTI (schisto)

A

squamous cell CA( metaplasia –> dysplasia –> squamous cell CA)

72
Q

rare, glandular prolif of bladder

risk fx:
urachal remnant (dome of bladder-umbilicus)
long hx cystitis
exstrophy

A

adenocarcinoma

73
Q

types of urothelial CA

A

transitional cell CA
squamous cell CA
adenocarcinoma

74
Q

tumor with large eos cells with abundant mitochondria without perinuclear clearing

A

oncocytoma

75
Q

ATN histo

A

dilated, denuded tubules (lacking cells)

occasional mitotic figures

76
Q

acute interstitial nephritis

A

tubular atrophy
thickened BM
lymphocytes/eos/macrophages

77
Q

mononuclear cell infiltration

mild inc BUN/Cr

A

chronic interstitial nephritis

78
Q

ESRD histo

A

diffuse and global glomerulosclerosis
inc glomerular mesangial cellularity/matrix
collapse of capillary tufts and capillary luminal closure
tubular atrophy

79
Q

gross hematuria
normal renal function
sloughing of tissue
if in isolation–> no WBC casts

A

papillary necrosis

coagulative necrosis of renal papillae
^where pyramids empty into CD system –> ureter

80
Q

ischemia of renal cortex
acute onset severe renal failure
seen in very sick patients
oliguria–> anuria

A

cortical necrosis

81
Q

inc doses of phenacetin, aspirin, coffee
lg calcified scars, sloughed papilla –> obstruction
chronic inflammation

A

analgesic nephropathy

82
Q

tumor lysis syndrome can lead to ____ nephropathy

A

urate nephropathy

83
Q

yellow blue birefringent crystals

A

urate nephropathy; gout

84
Q

distended tubules w/ pus (neutrophils and cellular debris)

interstitial microabsesses

A

acute pyelonephritis

UA: pyuria, WBC casts, hematuria

85
Q

Vesicoureteral reflex is a risk fx for

A

chronic pyelonephritis

86
Q

thyroidization

A

chronic pyelonephritis

87
Q 
atrophic tubules
eos protein material
fibrosis
sclerosed glomeruli
cortical atrophy 
distorted pelvocalyceal system
A

chronic pyelonephritis

88
Q

beads on a string

A

fibromusclular dysplasia

89
Q

thickened intimal layer

hyalinzed arteriole

A

benign hyaline arteriolosclerosis

90
Q

concentric arteriolopathy (vasculopathy)

A

arterioles w/ concentric hyperplasia of media

91
Q

punctuate small holes under renal capsule

A

flea bite kidney

benign arteriosclerosis

92
Q

fibrinoid necrosis of arterial wall
thromboses
irreversible

A

malignant HTN

Emma Renal (7 decks)

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