Renal Pathology 1

Question 1

Nephritic syndrome is associated with ____________ while nephrotic is associated with __________

Answer 1

hematuria
proteinuria

(think O in phrOtic and O in prOtein)

Question 2

What is the hallmark of nephritic syndrome?

Answer 2

hematuria

Question 3

What characterizes nephritic syndrome?

Answer 3

1) hematuria w/ dysmorphic RBCs
2) oliguria and azotemia
3) hypertension

Question 4

What is a cast?

Answer 4

a structure which is a negative impression of the renal tubule (a mold)

Question 5

What is the most common demographic for acute postinfectious glomerulonephritis?

Answer 5

children (6-10 years)

Question 6

What is the most common cause of acute postinfectious glomerulonephritis?

Answer 6

GABHS (Group A B-Hemolytic Strep)

Question 7

What is the pathogenesis of acute postinfectious glomerulonephritis?

Answer 7

immune complexes deposit in capillary wall, activating complement C5a which attracts neutrophils and mediates damage

Question 8

What does acute postinfectious glomerulonephritis look like histologically?

Answer 8

endocapillary proliferation obliterates capillaries, PMNs come in

Question 9

Name 4 lab tests for acute postinfectious glomerulonephritis?

Answer 9

1) tea color urine
2) hematuria
3) ASO titer up
4) complement levels down

Question 10

What is the prognosis for acute postinfectious glomerulonephritis?

Answer 10

total recovery (for kids)
can become chronic for adults

Question 11

What is Berger disease?

Answer 11

IgA nephropathy (too much IgA made - likely in response to infection - so immune complexes deposit in mesangium)

Question 12

What happens if too much IgA is produced?

Answer 12

can get Berger disease (IgA nephropathy)

Question 13

Why is there a difference in world-wide risk for IgaN?

Answer 13

because it is genetically linked - more common in Africa

Question 14

What does IgAN look like histologically?

Answer 14

mesangial proliferation (IgA ICs are diagnostic)

Question 15

What is the disease called when IgAN gets extra-renal symptoms?

Answer 15

Henoch-Schoenlein purpura

Question 16

In IgAN, complement involvement is via the __________ complement pathway

Answer 16

alternative

Question 17

What do lab tests look like for IgAN?

Answer 17

hematuria

normal complement

Question 18

What is hereditary nephritis?

Answer 18

mutations in glomerular basement membrane proteins

Question 19

Hereditary nephritis commonly comes with a mutation in ________________

Answer 19

collagen type IV

Question 20

What is the triad of hereditary nephritis?

Answer 20

nephritis
nerve deafness
various eye disorders (due to collagen defect)

Question 21

What kidney disease is associated with hearing abnormalities?

Answer 21

hereditary nephritis

Question 22

What is the method of inheritance for hereditary nephritis?

Answer 22

X-linked

Question 23

What form of microscopy is the most diagnostic for hereditary nephritis?

Answer 23

electron microscopy

see a “basket weave” of the lamina dense splitting and lamination

Question 24

What does hereditary nephritis look like histologically?

Answer 24

no immune complexes

EM diagnostic

Question 25

What is the prognosis for hereditary nephritis?

Answer 25

renal failure between 20-50 years of age (need transplant)