Renal Pathology 2

Question 1

What is the Gross appearance of the kidneys in Chronic Renal Failure?

Answer 1

Kidneys small
Cortex Thinned
Increased pelvic Fat

Question 2

What is the Micro appearance of the kidneys in Chronic Renal Failure?

Answer 2

Glomerular Sclerosis
Interstitial Fibrosis
Tubular atrophy

Question 3

What are the causes of nephrOTIC Syndrome?

Answer 3

Primary: Minimal Change disease
Focal Segmental Glomerulosclerosis
Membranous Nephropathy
Secondary: Diabetic Nephropathy

Question 4

What are the charicteristics of Minimal Change disease? AKA Lipoid Nephrosis

Answer 4

DIFFUSE EPITHELIAL FOOT PROCESS EFFACEMENT
Normal glomeruli on light microscopy an IMF microsc
Lipid in tubular cells
Responds to steroids

Question 5

What are the traits of Focal Segmental Glomerulosclerosis?

Answer 5

Proteinuria
PROGRESSIVE GLOMERULAR SCARRING
Starts focal and segmental becomes more global

Question 6

What are the causes of FSGS?

Answer 6

1^ idiopathic
2^ Virus associated: HIV
Drug induced: HEROIN
Familial
Adaptive: Systemic HTN

Question 7

What is the Clinical presentation of FSGS?

Answer 7

NephrOTIC Synd
Hypertension
Common in African Americans
Var degree of Dec Renal funct
Micro Hematuria

Question 8

What is seen Microscopically in FSGS?

Answer 8

LM- Segmental sclerosis
IF- Mild IgM and C3 or neg
EM- Diffuse epithelial cell injury

Question 9

What is the Clinical course of FSGS?

Answer 9

Sometimes responds to steroids

Question 10

What is seen on micro imaging of Membranous Glomerulopathy?

Answer 10

LM: Thickened Capillary walls SPIKES on siver stain
IF: GRANULAR IgG and C3 along GBM
EM: subEPITHELIAL deposits

Question 11

What is charicteristic of Membrano-prolif Glomerulonephritis?

Answer 11

Slowly Progressive course
Steroids and Immsuppressive NOT EFFECTIVE
50% Chronic Renal failure

Question 12

What are the causes of Membrano-prolif Glomerulonephritis?

Answer 12

Idiopathic or 2^ to Chronic Immune disease

Question 13

What is seen microscopically in Membrano-prolif Glomerulonephritis?

Answer 13

Mesangial Hypercellularity
Capillary Wall remodeling 
SUBENDOTHELIAL dep T1
INTRAMEMBRANOUS depT2
Predominant MESANGIAL inv

Question 14

What is seen on micro in MPGN Type 1?

Answer 14

LM: TRAM TRACK
IF: Granular C3 + some IgG
EM: Subendothelial and mesangial deposits

Question 15

What is seen on micro in MPGN Type 2?

Answer 15

Low Serum C3
LM: TRAM track on silver stain
IF: C3 only
Intramembrane deposit
Lamina Densa- Electron dense material

Question 16

What are the features of NephrITIC syndrome?

Answer 16

Dark colored urine
Erythrocytes in urine
Renal Failure: ACUTE nephritic synd

Question 17

What are infections that can cause GlomerulonephrITIS?

Answer 17

Staph, Pneumococcus, meningiococcus, viruses and parasites

Question 18

What is seen on micro in Post Strep GN?

Answer 18

LM: Diffuse Prolif GN with Neutrophils
IF: Scattered Granular (starry sky) IgG, IgM and C3 along GBM AND MESANGIUM
EM: Subepithelial HUMPS Focal immune deposits

Question 19

What is Crescentic GM?

Answer 19

Crescents cause SEVERE glomerular injury

Renal failure and death if untreated

Question 20

What makes up the crescants in GN?

Answer 20

Anti-GBM Ab
ICs
Anti-PMN Ab

Question 21

What are the 3 types of Crescentic GN?

Answer 21

T1: Goodpasture disease: LINEAR (cigarette smoke)
T2: SLE: Lumpy-Bumpy GRANULAR

Question 22

What is Rapidly Progressive GlomeruloNephritis? RPGN

Answer 22

Associated with Crescentic GN