Renal Flashcards
Nephrotic syndrome in children
Foot process fusion on EM
Minimal change GN
Treatment for minimal change GN
Oral steroids
2nd line - cyclophosphamide, retuximab
Most common cause of nephrotic syndrome in adults
LM shows mesangial collapse / sclerosis
EM shows podocyte process fusion
IF shows Ig/complement deposition
Focal segmental glomerulonephritis
Treatment for FSGN
long term steroids +/- immunosuppression
2nd most common cause of nephrotic syndrome in adults
Anti-PLAr antibodies
LM shoes thickened BM, spikes on silver stain
IF shows granular IgG + C3 deposits
EM shows electron dense sub-epithelial deposits
Membranous Nephropathy
Treatment of Membranous Nephropathy
Rituximab + ACEi/ARB
Common form of GN in the world
Associated with genetics, coeliac, post infection (days), HSP
Nephritic syndrome
LM shows mesanginal proliferation + IgA deposition
IF shows IgA + C3 in mesangium
EM shows deposits in mesangium
IgA nephropathy
Treatment of IgA nephropathy
BP control with ACEi/ ARBs
Caused by vasculitis, Goodpasture’s, HSP, SLE
Nephritic
Renal biopsy shows glomerular crescents
Rapidly progressive glomerulonephritis
Treatment of RPGN
steriods, cyclophosphomide/azathioprine, plasmapharesis if haemorrhage, dialysis
Nephrotic and Nephritic syndrome
LM shows train tracks (big glomeruli with thick membranes)
IF shows granular C3 deposits
EM shows electron dense deposits
Membranoproliferative
Treatment of membranoproliferative GN
ACEi/steroids/cyclophosphomide
7-14 days post step pyogenes infection
immune complexes in glomeruli (IgG, IgM, C3)
EM shows subepithelial humps
IF shows granular/starry sky appearance
Post-streptococcus GN
Management of post-streptococcus GN
Supportive
Painless, hard testicular lump. Potato appearance and arise in the seminiferous tubule
Seminoma
Produce alpha-feto protein
Yolk-sac
Aggressive, high grade testicular tumor that frequently metastases
Embryonal cell carcinoma
testicular lump and beta-HCG +ve
choriocarcinoma
Investigations of testicular lumps
USS
CT chest/abdomen for mets
bloods for tumor markers
FBC, LFTs, RFTs
Management of testicular tumors
sperm preservation
radical inguinal orchidectomy
recheck tumor markers 1 week post op
adjuvant chemo
Benign renal tumor. Mahogany brown with central stellate scar
Oncocytoma
Uncommon, malignant renal cell tumor.
Raisin-like nuclei, perinuclear haloes and prominent cell membranes
Chromophobe renal cell carcinoma
2nd most common malignant renal tumor.
Finger like projections
good prognosis
Papillary renal cell carcinoma
Least common malignant renal tumor.
high grade - very desmoplastic stroma
poor survival
Collecting duct carcinoma
