Pathology high yield Flashcards
buzz words, pathognomonics, from every lecture with a nichols handout
Foot process effacement
Minimal change disease
Spike and dome
Membranous nephropathy (new GBM represent the spikes that project between the subepithelial immune complexes (domes))
Subepithelial humps
Post infectious glomerulonephritis
Tram tracks
MPGN
Basketweave
Alport syndrome
Wire loops
Lupus nephritis
Onion skin appearance
Hypertensive nephropathy (glomeruli) OR scleroderma (glomeruli) OR thrombotic microangiopathies (vessels)
Proteinuria
Nephrotic syndrome
RBC casts
Glomerular inflammation (nephritic syndrome)
Fatty casts
Nephrotic syndrome (due to hyperlipidemia)
Flea bitten kidney
malignant hypertension
mutations in Apolipoprotein L1 (APOL1)
increased risk for hypertensive nephropathy, FSGS, HIV nephropathy
provides resistance to Trypanosoma b. rhodesiense (african sleeping sickness)
antibodies to noncollagenous (NC) domain of alpha3 chain of type 4 collagen in the GBM
Goodpasture’s syndrome (anti-GBM)
how to treat anti-GBM disease
plasmapheresis
rapidly progressive glomerulonephritis
crescentic glomerulonephritis
proliferation of parietal epithelial cells
crescentic glomerulonephritis
nephrin and podocin mutations
congenital nephrotic syndromes
glomerular cells that provide structural support and have phagocytic and contractile properties
mesangial cells
immune complex deposition in mesangium
IgA nephropathy
subendothelial deposition of immune complexes against the GBM with a linear IF pattern
Goodpastures (anti-GBM)
antibodies against podocyte cell membranes
membranous nephropathy
granular deposits on IF
Any disease with immune complex formation
example of a subendothelial deposition of immune complexes
Lupus
no IF detection
pauci-immune GN
advanced glycation end-products (AGE)
diabetic nephropathy
arterionephrosclerosis
globally sclerotic glomeruli seen in hypertensive nephropathy
fibrinoid necrosis of arterioles
malignant hypertension (fibrinoid necrosis is characteristic but not specific for malignant HTN)
hyperplastic arteriosclerosis
malignant HTN/onion skin appearance (hyperplastic arteriosclerosis is characteristic but not specific for malignant HTN)
muddy brown casts
ATN
maltese cross, oval fat bodies
nephrotic syndrome due to hyperlipidemia
xanthelesma
nephrotic syndrome due to hyperlipidemia
first clinical sign in diabetic nephropathy?
microalbuminuria
overflow proteinuria
multiple myeloma
albuminuria
glomerular disease
low MW proteinuria
tubular disease
values for nephrotic range proteinuria?
> 3.5 g/day and spot urine protein/creatinine ratio >3.5
elevated suPAR
FSGS
hyalinosis
FSGS
FSGS subtype with rapid onset of nephrotic syndrome and rapid progression to renal failure
collapsing glomerulopathy type (e.g. HIV)
steroid-sensitive nephrotic syndrome
MCD
steroid-resistant nephrotic syndrome
FSGS
antibodies against neural endopeptidase (NEP)
congenital MN
antibodies against M-type PLA2 receptor
primary (idiopathic) MN
in primary MN, PLA2R co-localizes with ___ and deposits in ____
IgG4, subepithelial layer
smoky urine, low C3
post-streptococcal GN
Hepatitis C
think MPGN (type 1) or cryoglobulinemia (mixed)
dysregulation of complement system
dense deposit disease
C3 nephritic factor
dense deposit disease
ribbons of dense material in GBM
dense deposit disease
IgA nephropathy has _____ deficient IgA deposition in mesangium
galactose-deficient IgA
use ___ to differentiate IgA nephropathy from other forms of glomerulonephritis
IF
use ____ to differentiate DDD from other forms of glomerulonephritis
EM
what distinguishes anti-GBM from Goodpastures
pulmonary involvement in Good-pastures but essentially the same thing
mutation in alpha5 chain of collagen type 4
alport syndrome
nephritis + deafness + lens disorders
alport syndrome
defects in alpha3 or alpha4 of type 4 collagen
thin basement membrane disease
nocturia
indicated tubular damage due to inability to concentrate urine
BUN:creatinine >20
pre-renal issue (most sensitive marker)
abnormal fundoscopic exam
malignant hypertension, diabetic nephropathy
crescentic formation associated with?
RPGN
septic shock and ischemia
ATN
K+ > ____ is a medical emergency
> 7 mmol/L
most vulnerable portions of the kidney to hypoxic injury?
straight portion of PT and TALH
loss of brush border and blebbing
ATN
myoglobin casts
rhabdomyolysis, releases myoglobin which can contribute to ATN
ATN with vacuolization and formation of oxalate crystals in tubular lumen due to?
ethylene glycol poisoning
tx when K+> 7mmol/L
IV calcium gluconate
OR insulin + glucose
most common cause of acute pyelonephritis
E. coli
neutrophil infiltration with liquefactive necrosis and abscess formation
acute pyelonephritis
pyonephrosis
when infected pus fills and distends the renal calyces, pelvis and ureter (seen in acute pyelonephritis)
thyroidization
acute pyelonephritis (tubules become atrophic and distended with urine causing them to resemble thyroid follicles)
classic triad of interstitial nephritis
fever, rash, eosinophilia
new onset azotemia with oliguria, fever, skin rash, and eosinophilia think…
interstitial nephritis
polycystin1 or 2 mutations
adult polycystic kidney disease (autosomal dominant)
fibrocystin mutation
childhood polycystic kidney disease (autosomal recessive)
medullary cystic disease complex that is the most common genetic cause of ESRD in children
Nephronophthisis
C-ANCA
Granulomatosis with polyangiitis (Wegener’s)
anti-proteinase 3 antibodies
C-ANCAs, seen in granulomatosis with polyangiitis (Wegener’s)
anti-myeloperoxidase antibodies
microscopic polyangiitis
sinopulmonary renal syndrome
granulomatosis with polyangiitis (Wegener’s)
shiga toxin
HUS
inactivation of factor H
HUS
sudden onset of irritability, lethargy, weakness, pallor and oliguria in a small child, 5-10 days following gastroenteritis
HUS
ADAMTS13
TTP
tx of TTP
plasmapheresis
tx of HUS
plasmapheresis
ANAs
Lupus
class 1 lupus
minimal mesangial (rare)
class 2 lupus
mesangial proliferative
class 3 lupus
focal proliferative
class 4 lupus
diffuse proliferative (severe, most common), wire loop lesions and hyaline thrombi
class 5 lupus
membranous
class 6 lupus
advanced sclerosing
full house immunoflourescence
Lupus (IF staining for IgG, IgM, IgA, C3, C4)
scleroderma renal crisis
new onset of accelerated arterial hypertension and/or rapidly progressive oliguric renal failure
non-proliferative, non-inflammatory glomerulopathy
amyloidosis
apple green birefringence
amyloidosis
hemosiderin depositis
sickle cell nephropathy
what type of amyloidosis is the main target for the kidney? presentation?
AA, nephrotic syndrome
what kind of amyloidosis do you get with long-term dialysis?
AB2microglobulin
collapsing form of focal segmental glomerulosclerosis
HIV nephropathy
syncytium formation
seen in AL amyloidosis as tubular epithelial cells can form a syncytium around the bence jones proteins
deposition of material that looks like “silt” on EM
light chain disease
Most common cause of ESRD?
Diabetic nephropathy