Renal GN problems

Question 1

Minimal change - nephrotic or nephritic, on biopsy

Answer 1

Nephrotic
Normal biopsy on LM and IF, foot process fusion on EM

Question 2

Focal segmental GN - nephrotic or nephritic, on biopsy

Answer 2

Nephrotic
LM - areas of mesangial collapse and sclerosis
EM - diffuse podocyte process fusion

Question 3

Membranous GN - nephrotic or nephritic, on biopsy

Answer 3

Nephrotic
LM - spikes on silver stain
IF - granular IgG and C3 deposits

Question 4

Membranoproliferative - nephrotic or nephritic, on biopsy

Answer 4

Mix or nephrotic and nephritic
LM - tram tracks
IF - C3 deposits

Question 5

IgA - nephrotic or nephritic, on biopsy

Answer 5

Nephritic
IF - IgA and C3 deposits in mesangium

Question 6

Post strep GN - nephrotic or nephritic, on biopsy and effect on complement levels

Answer 6

Nephritic
LM - Sub-epithelial humps
IF - IgG and C3 sub-epithelial deposits
Lowered complement

Question 7

Goodpastures - antibodies, nephrotic or nephritic and on biopsy

Answer 7

anti-GBM antibodies
linear IgG/C3 at GBM
Necrosis and epithelial cell crescents
Mainly nephrotic

Question 8

ATN - whats seen in urine, response to fluid challenge
- what are some causes

Answer 8

Brown granular casts in urine
Poor response to fluid challenge
Causes - Gent, shock, trauma, surgery, NSAIDs, Chemo drugs, statins, ARBs and ACEs

Question 9

Amyloidosis on biopsy (what staining to use)

Answer 9

Congo red staining gives apple green bifringence under polarised light

Question 10

Myeloma affect on glomeruli and tubules

Answer 10

Glomerular - AL amyloidosis, monoclonal immunoglobulin deposition (light-heavy chain)
Tubular - light chain cast nephropathy