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Pathology II Exam 1 > Renal 2 > Flashcards

Renal 2 Flashcards

1
Q

Name 3 features of nephritic sydnrome

A
  1. dark colored urine
  2. erythrocytes in urine microscopically
  3. The patient may also have renal failure (Increase in Serum creatinine and blood urea nitrogen/BUN) in which case this is called acute nephritic syndrome
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2
Q

name 2 diseases that cause asymptomatic isolated hematuria

A
  1. IgA nephropathy

2. Alport syndrome

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3
Q

Whats the most common type of primary glomerulonephritis worldwide?

A

IgA nephropathy

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4
Q

Who does IgA nephropathy typically affect?

A

-children and young adults

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5
Q

Upon staining, what would you see microscopically for IgA nephropathy?

A

mesangial proliferation/hypercellularity (>3 cells per mesangial region)

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6
Q

T/F- although most patients with IgA nephropathy have a good prognosis, proteinuria is a predictor of progressive disease

A

true

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7
Q

How do you treat IgA nephropathy?

A

No specific treatment available, in progressive cases steroids and other immunosuppressive agents may be tried with variable success rates.

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8
Q

What is the “vasculitic variant” of IgA nephropathy?

A

Henoch Schonlein purpura

-usually seen in children

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9
Q

name 3 symptoms associated with Henoch Schonlein purpura

A
  1. arthritis
  2. abdominal pain
  3. rashes
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10
Q

If you biopsied the vessels in someone with HSP, what would you find?

A

IgA in subdermal vessels

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11
Q

What are the characteristics of alport syndrome?

A
  • mutation in alpha-5 chain of type IV collagen (X linked dominant)
  • deafness
  • eye abnormalities
  • GBM thickening, splitting, and lamination
  • “basket weave” pattern upon staining
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12
Q

Which two conditions (not diseases per say but descriptive pathological changes seen in the glomerulus) cause acute nephritic syndrome?

A
  1. crescentic glomerulonephritis

2. diffuse proliferative glomerulonephritis

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13
Q

T/F- crescentic glomerulonephritis has a low morbidity

A

False, Severe renal failure and death can result if untreated.

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14
Q

What forms the crescents?

A

Crescents are proliferation of cells lining the Bowman’s space
along with incoming inflammatory cells as result of glomerular
capillary fibrinoid necrosis

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15
Q

Describe the expected IF stain, lab values, and causes of Type 1 crescentic glomerulonephritis

A
  • IF: linear capillary loop IgG
  • Labs: elevated serum anti-GBM antibody
  • Cause: Anti-GBM disease (aka Goodpasture’s disease)
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16
Q

Describe the expected IF stain, lab values, and causes of Type II crescentic glomerulonephritis

A
  • IF: granular deposits in mesangium or capillary loops
  • Labs: elevated Antinuclear antibodies (ANAs), anti-dsDNA etc.
  • Cause: lupus nephritis, IgA nephropathy
17
Q

Describe the expected IF stain, lab values, and causes of Type III crescentic glomerulonephritis

A
  • IF: no deposits
  • Labs: ANCA
  • cause: ANCA diseases (wegeners granulomatosis, microscopic polyarteritis)
18
Q

Anti-GBM disease is caused by abnormal production of antibodies against what?

A

collagen IV basement membrane of glomerulus and lung

19
Q

How do you treat crescentic glomerulonephritis? What do you add for anti-GBM disease?

A
  • treat all with corticosteroids, cytotoxic agents (cyclophosphamide)
  • add plasmapharesis for anti-GBM
20
Q

ANCA associated glomerulonephritis is also known as what?

A

Pauci-immune crescentic glomerulonephritis

21
Q

Crescents imply what?

A

vasculitis

22
Q

Name 2 causes of diffuse proliferative glomerulonephritis (DPGN)?

A
  1. acute-post streptococcal glomerulonephritis

2. proliferative (active) lupus nephritis

23
Q

How long after a group A strep infection would you see DPGN?

A

-about 2 weeks

24
Q

Acute post-streptococcal GN would present with what findings?

A
  • acute nephritic syndrome
  • renal failure
  • hypertension
  • low C3
  • elevated ASO titer
25
Q

What immune deposits would be seen on IF (immunoflourescence) in post strep glomerulonephritis?

A

-C3 and IgG deposits in capillary loops (subepithelial deposits “humps”)

26
Q

if you see SUBEPITHELIAL HUMPS what is it?

A

acute post infectious glomerulonephritis

27
Q

What would provide serological evidence of lupus (suggesting proliferative lupus nephritis)?

A
  • anti-nuclear antibody, anti-dsDNA

- low complements c3 and c4

28
Q

A “full house pattern” IF stain suggests what?

A

IgG, IgA, IgM, C3, C1q all present suggesting proliferative lupus nephritis

29
Q

In contrast to subEPIthelial deposits seen in acute post infectious glomerulonephritis, what would you see in acute lupus nephritis?

A

subENDOthelial deposits (+full house pattern)

Pathology II Exam 1 (8 decks)

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