Pathology of Nephritic Disease

Question 1

A patient is diagnosed with rapidly progressing glomerulonephritis. There are no detectable anti-GBM antibodies or immune complexes. Tests for ANCAs are positive. What type of RPGN does this patient have?

Answer 1

Type III RPGN (Pacui-Immune)

Question 2

What is Henoch-Schonlein purpura?

Answer 2

Systemic deposits of IgA (aka IgA vasculitis)

Question 3

Goodpasture syndrome is an example of what type of hypersensitivity reaction?

Answer 3

Type II Hyper sensitivity

Question 4

This nephritic disease is associated with respiratory, GI, and urinary tract infections.

Answer 4

IgA Neuropathy (Berger Disease)

Question 5

A kidney biopsy is analyzed by a pathologist. They describe subendothelial dense deposits in the glomeruli and “wire loops.” What is the diagnosis?

Answer 5

Lupus Nephritis

Question 6

What symptoms present in Alport Syndrome?

Answer 6

Hematuria, nerve deafness, eye disorders

Question 7

What are the three types of rapidly progressing glomerulonephritis?

Answer 7

Anti-glomerular basement membrane antibody, immune complex, Pauci-immune

Question 8

“Hump-like” deposits in the subepithelium are most associated with what nephritic disease?

Answer 8

Acute proliferative glomerulonephritis

Question 9

A patient is diagnosed with a focal glomeruli disorder. How many glomeruli are involved?

Answer 9

Only some glomeruli - less than 50%

Question 10

What pathologic changes will be observed on a kdiney EM of a patient with Alport syndrome?

Answer 10

Irregular thickening of the basement membrane with thinning, “basket weave” appearance

Question 11

What antibodies are associated with systemic lupus?

Answer 11

Anti-smooth muscle and dsDNA antibodies

Question 12

What bacteria are most associated with acute proliferative glomerulonephritis?

Answer 12

Streptococcal infections

Question 13

What is the primary symptom associated with nephritic disorders?

Answer 13

Hematuria

Question 14

Alport Syndrome is an X-linked genetic disease. What mutation is present?

Answer 14

Mutation affecting collagen IV

Question 15

What is the most common type of Lupus Nephritis?

Answer 15

Diffuse Nephritis

Question 16

What is the most common type of glomerulonephritis worldwide?

Answer 16

IgA Nephropathy (Berger Disease)

Question 17

Goodpasture Syndrome most often presents in teens and young adults who smoke. What triad is characteristic of this syndrome?

Answer 17

Alveolar hemorrhage, glomerulonephritis, anti-GBM antibodies

Question 18

An entire glomerulus is involved in a patient with a nephritic disorder. What is this termed?

Answer 18

Global

Question 19

True/False. Plasmapheresis is an effective treatment option for Type II Rapidly Progressive Glomerulonephritis.

Answer 19

False - Plasmapheresis is ineffective in Type II RPGN. It is effective in Type I

Question 20

Most cases of acute proliferative glomerulonephritis are seen in what patient population?

Answer 20

Children

Question 21

Type II RPGN is due to immune complex deposition. What disorders are associated with this type of RPGN?

Answer 21

Postinfectious glomerulonephritis, systemic lupus erythematosus

Question 22

What histologic finding is characteristic of Rapidly Progressing Glomerulonephritis (RPGN)?

Answer 22

Cellular crescent in Bowman’s space

Question 23

In cases of IgA nephropathy, where are glomerular deposits found?

Answer 23

Mesangial Matrix

Question 24

What antibodies are present in Type I rapidly progressing glomerulonephritis?

Answer 24

Anti-GBM (glomerular basement membrane)

Question 25

A patient is diagnosed with a nephrotic disorder. In observing a glomerulus under microscopy, only a portion is involved. What term describes this involvement?

Answer 25

Segmental

Question 26

How many glomeruli are involved with a diffuse disorder?

Answer 26

Most glomeruli - more than 50%

Question 27

What patient population is most often affected by Henoch-Schonlein purpura and IgA nephropahthy?

Answer 27

Children, 3-8yo

Question 28

True/False. Damage in lupus nephritis is limited to the glomeruli.

Answer 28

False - changes and the interstitium and tubules may be involved

Question 29

What materials make up crescents in rapidly progressive glomerulonephritis?

Answer 29

Fibrin & macropahges

Question 30

Linear immunoflorescene in a renal biopsy is most associated with what disorder?

Answer 30

Goodpasture Syndrome - antibodies against the GBM