Renal Pathology 2 Flashcards
What is the Gross appearance of the kidneys in Chronic Renal Failure?
Kidneys small
Cortex Thinned
Increased pelvic Fat
What is the Micro appearance of the kidneys in Chronic Renal Failure?
Glomerular Sclerosis
Interstitial Fibrosis
Tubular atrophy
What are the causes of nephrOTIC Syndrome?
Primary: Minimal Change disease
Focal Segmental Glomerulosclerosis
Membranous Nephropathy
Secondary: Diabetic Nephropathy
What are the charicteristics of Minimal Change disease? AKA Lipoid Nephrosis
DIFFUSE EPITHELIAL FOOT PROCESS EFFACEMENT
Normal glomeruli on light microscopy an IMF microsc
Lipid in tubular cells
Responds to steroids
What are the traits of Focal Segmental Glomerulosclerosis?
Proteinuria
PROGRESSIVE GLOMERULAR SCARRING
Starts focal and segmental becomes more global
What are the causes of FSGS?
1^ idiopathic 2^ Virus associated: HIV Drug induced: HEROIN Familial Adaptive: Systemic HTN
What is the Clinical presentation of FSGS?
NephrOTIC Synd Hypertension Common in African Americans Var degree of Dec Renal funct Micro Hematuria
What is seen Microscopically in FSGS?
LM- Segmental sclerosis
IF- Mild IgM and C3 or neg
EM- Diffuse epithelial cell injury
What is the Clinical course of FSGS?
Sometimes responds to steroids
What is seen on micro imaging of Membranous Glomerulopathy?
LM: Thickened Capillary walls SPIKES on siver stain
IF: GRANULAR IgG and C3 along GBM
EM: subEPITHELIAL deposits
What is charicteristic of Membrano-prolif Glomerulonephritis?
Slowly Progressive course
Steroids and Immsuppressive NOT EFFECTIVE
50% Chronic Renal failure
What are the causes of Membrano-prolif Glomerulonephritis?
Idiopathic or 2^ to Chronic Immune disease
What is seen microscopically in Membrano-prolif Glomerulonephritis?
Mesangial Hypercellularity Capillary Wall remodeling SUBENDOTHELIAL dep T1 INTRAMEMBRANOUS depT2 Predominant MESANGIAL inv
What is seen on micro in MPGN Type 1?
LM: TRAM TRACK
IF: Granular C3 + some IgG
EM: Subendothelial and mesangial deposits
What is seen on micro in MPGN Type 2?
Low Serum C3 LM: TRAM track on silver stain IF: C3 only Intramembrane deposit Lamina Densa- Electron dense material
What are the features of NephrITIC syndrome?
Dark colored urine
Erythrocytes in urine
Renal Failure: ACUTE nephritic synd
What are infections that can cause GlomerulonephrITIS?
Staph, Pneumococcus, meningiococcus, viruses and parasites
What is seen on micro in Post Strep GN?
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
What is Crescentic GM?
Crescents cause SEVERE glomerular injury
Renal failure and death if untreated
What makes up the crescants in GN?
Anti-GBM Ab
ICs
Anti-PMN Ab
What are the 3 types of Crescentic GN?
T1: Goodpasture disease: LINEAR (cigarette smoke)
T2: SLE: Lumpy-Bumpy GRANULAR
What is Rapidly Progressive GlomeruloNephritis? RPGN
Associated with Crescentic GN
