Renal patho 1

Question 1

Waxy casts

Answer 1

CKD/ESRD

Question 2

Hyaline casts

Answer 2

► via solidification of Tamm–Horsfall mucoprotein

► Reflects concentrated urine

Question 3

Dipstick test for the presence of ____

Affected by ____

Answer 3

►heme
proteins

►urine concentration

Question 4

Gold standard for protein evaluation in urine

Answer 4

24h urine sample

Question 5

Spot urine test:

Purpose:

Answer 5

►Urine protein to Cr ratio
►To find out the presence or absence of protein in the urine. This may be used as a screening test for kidney disease particularly to screen diabetic nephropathy.

Question 6

Nephritic syndrome etiology:

Answer 6

Glomerular inflammation → GBM damage → ↓filtrarion barrier → ↓GFR

Question 7

Nephrotic syndrome- disruption of

Answer 7

Podocyte → impaired charge barrier

Question 8

Affect of nephrotic syndrome on lymphatics

Answer 8

↑ lymphatic drainage → net plasma filtration into the interstitium (↑interstitial pressure → edema) → ↓effective circulatory volume → RAAS activation

Question 9

MCD- immune dyregulation leads to overproduction of _____

Answer 9

glomerular permeability factor (IL-13) that directly damages podocytes

Question 10

Focal segmental glomerulosclerosis- LM:

Answer 10

—segmental sclerosis and hyalinosis

Question 11

Membranous nephropathy:
LM—
IF
EM

Answer 11

►diffuse capillary and GBM thickening

►granular due to immune complex (IC) deposition ►“Spike and dome” appearance of subepithelial deposits

Question 12

_____ is the most commonly involved organ (systemic amyloidosis).

Answer 12

Kidney

Question 13

Most common cause of death in diabetes with ESRD is

Answer 13

1. Cardiovascular

2. Infection

Question 14

Acute poststreptococcal glomerulonephritis

ƒ IF—

Answer 14

(“starry sky”) granular appearance (“lumpy-bumpy”) due to IgG, IgM, and C3 deposition along GBM and mesangium

Question 15

In PSGN levels of C4 compliment is normal because compliment activation occurs via ________

Answer 15

Alternative pathway

Question 16

In good pasture syndrome antibodies are formed against _____

Answer 16

α3 chain of type IV collagen

Question 17

Rapidly progressive (crescentic) glomerulonephritis 
 ƒ LM—

Answer 17

crescent moon shape. Crescents consist of fibrin and plasma proteins (eg, C3b) with glomerular parietal cells, monocytes, macrophages

Question 18

Diffuse proliferative glomerulonephritis

EM-

Answer 18

subendothelial, sometimes subepithelial or intramembranous IgG-based ICs often with C3 deposition

Question 19

in membranous nephropathy spikes and domes are seen on LM by?

Answer 19

Silver staining

Question 20

Membranoproliferative glomerulonephritis
► Type II is associated with ______
► Deposits

Answer 20

► C3 nephritic factor (IgG autoantibody that stabilizes C3 convertase→ persistent complement activation →↓C3 levels).
► Intramembranous deposits, also called dense deposit disease

Question 21

mixed cryoglobinemia presents as __________

Answer 21

Membranoproliferative glomerulonephritis

Question 22

D/D of lupus nephritis

How different from lupus nephritis?

Answer 22

Anemia, bone pain, kidney damage
Multiple myeloma
Waxy casts, No RBC casts
No oral ulcers
Extremely rare in young age

Question 23

Causes of calcium oxalate stones

Answer 23

►ethylene glycol (antifreeze) ingestion (↑Oxalate formation)
►vitamin C abuse (metabolized to oxalate)
►hypocitraturia (associated with ↓urine pH) , ►malabsorption (eg, Crohn disease).
► Gastric bypass surgery
► High oxalate diet green leafy vegetables, chocolates, nuts

Question 24

Lowest pH in which part of nephron

Answer 24

DCT and collecting duct

Question 25

Uric acid stone Risk factors

Answer 25

►urine volume,
►arid climates,
►acidic pH.

Question 26

Test for cystine stone

Answer 26

Sodium cyanide nitroprusside test

Question 27

Cr is elevated in obstruction _______

Answer 27

if obstruction is bilateral or if patient has an obstructed solitary kidney

Question 28

Hydronephrosis leads to

Answer 28

compression and possible atrophy of renal cortex and medulla