Puthoff Lecture 1 Flashcards
What is Berger disease?
Damage is limited to where?
Renal IgA nephropathy
Glomerulus
What is an IgG plasma malignancy with Kappa light chains?
What are the light chain deposits called?
Multiple myeloma
Bence-Jones
HIV patients with FSGS most likely to develop what?
More common in who?
Collapsing variant
Blacks
What disease shows a tri chrome stain (blue) with replacement of virtually all glomeruli?
Chronic glomerulonephritis
Membranous Glomerulopathy has involvement with what?
MAC
IgG4
Morphology of Membranous Glomerulopathy?
Spike and dome appearance on Silver stain
People with CKD have a high prevalence of what?
Associated with what?
Increased risk for what?
Hyperhomocysteinemia
Folate deficiency
Stroke
What disease is characterized IgA nephropathy and systemic disease?
What symptoms?
Henoch-Schonlein purpura (HSP)
Purpura, abdominal viscera
What is the Pathogenesis of MPGN type II?
Means what?
C3NeF nephritic factor
Decreased serum C3
Increased C1q and C4
What is described by uremia, persistent albuminuria, that may be clinically silent?
Chronic kidney disease
What is the most common cause of ESRD?
2nd?
Diabetes
HTN
What clinical finding characterizes MPGN type I?
Type II?
Proteinuria
Hematuria
Name the 3 types of RPGN and give examples
1 - anti-GBM antibody (Goodpasture)
2 - immune complex (lupus)
3 - Pauci-immune (ANCA)
What disease has characteristic “tram tracking”?
MPGN type I
What disease shows Mesangial cellular proliferation and IgA deposition on IF?
IgA nephropathy
What disease is characterized by in situ immune complex formation of PLA2R antigen?
Membranous nephropathy
Morphology of RPGN?
3 main things
Crescent shape of visceral and parietal epithelial cells
Obliteration of urinary space
Infiltrates of macrophages and leukocytes
DDD occurs how?
What type is it?
Primary renal disease in children
MPGN type II
What are the 3 major pathologic responses of the glomerulus to injury?
Hypercellularity
BM thickening/deposition
Hyalinosis and sclerosis
What is the most common cause of Nephro sclerosis in U.S. Adults?
Who is there a greater incidence in?
primary FSGS
Hispanics, Blacks
What defines uremia?
Azotemia plus clinical findings
What characterizes ESRD?
GFR
3 major characteristics of nephritic syndrome
Hematuria
HTN
Mild-moderate proteinuria
What disease is subepithelial humps found in?
Acute glomerulonephritis
Treatment for anti-glomerular BM disease?
Plasmapheresis
what does EM of RPGN show?
GBM disruption
Fibrin
What disease occurs mostly in older children and younger adult males with a family history component that has hematuria following a uri?
Know associations with gluten enteropathy and liver disease?
IgA nephropathy
Diffuse proliferative GN is characterized by what?
Hypercellularity
Leukocyte infiltration
What are the 2 most common etiologies of nephrotic syndromes in systemic diseases?
DM
SLE
What are the 6 main nephrotic syndromes?
Think of groups of 2 like in pathoma
MCD and FSGS
Membranous and Membranoproliferative GN
DM and systemic amyloidosis
Membranous Glomerulopathy changes to the structure of the kidney?
Effaced foot processes
thickened GBM
Subepithelial deposits (IgG)
MPGN type I has what clinical presentation?
EM shows what?
Light microscopy shows what?
Mixed - hematuria and proteinuria
Subendothelial deposits
Mesangial cell proliferation
Acute proliferative GN occurs in who and because of what?
Children ages 6-10
Due to Group A beta-hemolytic strep infection
1-4 weeks following pharyngitis
What are common causes of secondary MPGN type I?
Prognosis?
Hep C
SLE endocarditis
Malignancy
Dismal
What is characterized by the following morphology?
Mesangial cell proliferation
BM thickening and splitting
Increased lobular architecture
Influx of neutrophils?
MPGN type I
What are the EM findings of acute proliferative GN?
IF findings?
Subepithelial humps
Granular deposits of IgG, IgM, and C3
Idiopathic FSGS displays what?
What kind of progression?
Higher incidence of hematuria, reduced GFR
Proteinuria is nonselective
CKD (50% w/in 10 years)
What disease are Mesangial deposits found in?
IgA nephropathy
Where do Bence-Jones deposit?
Tubules
Acute proliferative GN may be due to what bacterial infections?
Group A beta-hemolytic
Staphylococcal
3 major characteristics of nephrotic syndrome?
Proteinuria (>3.5 g/day)
Hypoalbuminemia
Edema
Also lipiduria
What disease is epimembranous deposits found in?
Membranous nephropathy
Heymann glomerulonephritis
What disease is subendothelial deposits found in?
Lupus nephritis
MPGN
What is described by a rapid decline in GFR, oliguria/anuria, and may result from glomerular, interstitial, vascular, or tubular injury?
Acute kidney injury
What manifestations are present in RPGN?
Acute nephritis
Proteinuria
Acute renal failure
Hematuria can be caused by what?
SCHITTT
Slide 26 if you forget the mneumonic
mutation of NPHS1 is on what chromosome?
Encodes for what protein?
Causes what?
19
Nephrin
Congenital nephrotic syndrome of the Finnish type (FSGS)
Increased risk to FSGS caused by what mutation on chromosome 22?
Common in whom?
APOL1
African American
