Renal 2 Flashcards
Clinical scenarios of AA amyloid
chronic inflammation
RA
“skin-poppers”
Most common light chain related renal dz
light chain cast nephropathy
2nd most common light chain related renal dz
AL amyloid nephropathy
Most patients with AL amyloid do/do not have myeloma
do not
most patiets with light chain cast nephropathy do/do not have myeloma
do
fracutred eosinophilic casts surrounded by multinucleated cells
light chain cast nephropathy
Amyloid is more often kappa or lambda?
lambda
Light chain deposition dz is more often kappa or lambda?
kappa
LM in light chain deposition dz
nodular mesangial (like K-W nodules)
IF in light chain deposition dz
linear kappa or lambda tubular nad GBM staining
Linear kappa or lambda tubular and GBM staining
light chain deposition disease
EM: Granular deposits on tubular and glomerular BM
light chain depostion dz
Vessels with “onion-skinning” and mucoid intimal hyperplasia
scleroderma and malignant HTN
arteral lumen occluded by plaque with cholesterol clefts
atheroembolic dz
diffuse glomerulonephritis (4)
Post-infectious,
Membranoproliferative,
Lupus,
bacterial endocarditis
Focal glomerulonephritis (5)
IgA, Lupus, HSP, Systemic vasculitis, Bacterial endocarditis
Crescentic glomerulonephritis (4)
Idiopathic,
Systemic vasculitis,
Anti-GBM,
Severe manisfestation of any focal or diffuse
Most frequent cauase of post-infectious GN
Group A Beta hemolytic strep (pyogenes)
LM of post-infectious GN
diffuse, exudative GN with many PMNs
EM of post-infectious GN
subepithelial humps
Clinical of MPGN
mixed nephritis/nephrotic
LM in MPGN
hypercelular and hyperlobated glomeruli
IF of post-infectious GN
granular “lumpy-bumpy” IgG and C3 on capillaries and mesangium
PAS or silver stain of MPGN
“tram-tracking”
IF of MPGN
granular IgG, IgM, and C3 on capillary loops and mesangium
Dense deposit dz is also called
Type II MPGN
EM of MPGN
subendothelial and mesangial deposition with GBM duplication
EM of dense deposit dz
long intramembranous deposits “sausage”
LM looks like MPGN with PAS+ pseudothrombi
cryoglobulinemia
EM of cryoglobulinemia
cylindical, “comma-shaped”
