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Renal Pathology Flashcards

1
Q

Hypoplasia with no scarring and a decrease in lobe number indicates?

A

Primary Hypoplasia (not due to any external factors)

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2
Q

ADPCKD chromosomes?

A

polycystin 1 or 2 (1 more common)

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3
Q

Non-kidney anomalies in ADPCKD?

A 
Liver cysts (40%)
Berry Aneurysms (DEATH)
Mitral Valve Prolapse (25%)
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4
Q

Child with progressive polyuria and polydipsia. Pathology shows medullary cysts.

A

Nephronophthisis-Uremic Medullary Cystic Disease Complex

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5
Q

Nephritis Syndrome caused by and characteristics?

A 
Inflammation of glomerulus with 
RBC casts, 
hematuria, 
BUN/Creatinine >15, 
HTN, 
Edema
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6
Q

Child with malaise, mild proteinuria, hematuria with smokey urine, HTN. Pathology shows:
Neutrophil infiltrate in glomerulus
Granular IF pattern
Subepithelial humps on EM

A

Post-Strep GN

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7
Q 
Patient presents with progressive hematuria, edema.
Pathology shows:
Large pale petechial kidneys
Crescent formation in glomerulus
What are three possible causes?
A

Crescent Rapidly Progressing GN

  1. Anti GBM (linear IF)
  2. IC disease - granular IF
  3. P or C ANCA (Vasculitis)
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8
Q

Nephrotic Syndrome?

A 
Cytokine induced podocyte effacement
Massive Proteinuria
Fatty Casts
Edema (decreased albumin)
Susceptibility to infection (Decreased Ig)
Hypercoagulable (Decreased ATIII)
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9
Q 
Patient with chronic proteinuria.  Pathology shows:
Normal cellularity
diffuse thickening of capillaries
Granular IF
Subepithelial spikes on EM
A

Membranous GN

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10
Q

Causes of Membranous GN?

A

85% Idiopathic

  • NSAIDs
  • Malignancy
  • IC
  • DM
  • HBV
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11
Q

Child with massive proteinuria, Normotensive, following URTI. Pathology shows:
Normal looking except Podocyte effacement and lipoid deposits

A

Minimal Change Disease

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12
Q

Cause of Minimal Change disease and treatment?

A

T-Cell mediated loss of GBM charge

TX = Steroids

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13
Q

Cancer associated with Minimal Change Disease?

A

Hodgkin’s Lymphoma

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14
Q

Adult with nephrotic syndrome, HTN. Pathology shows:
Focal changes
Collapsed GBM
Increased mesangial matrix hyalinization

A

Focal Segmental Glomerulosclerosis

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15
Q

Causes of FSGS?

A

HIV
Heroin
Compensatory hypertrophy

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16
Q

Prognosis of FSGS?

A

Bad
RAS can slow progression
50% with have end-stage renal disease in 10 years

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17
Q 
Adult with nephrotic syndrome, HTN.  Pathology shows:
Focal changes
Collapsed GBM
Increased mesangial matrix hyalinization
Cystic dialted tubules
tubuloreticular inclusions

What disease does this person have?

A

HIV nephropathy

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18
Q

Type 1 membranoproliferative disease features?

A

Alternate and Classic SUBENDOTHELIAL complement deposition
Leukocyte infiltration
Very cellular

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19
Q

Type 2 membranoproliferate disease features?

A

Alternate complement deposition in the lamina densa
Leukocyte infiltration
(Dense deposit disease)

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20
Q

Recurrent hematuria
Pathology shows:
Mesangial deposits of IgA

A

Berger’s disease (IgA Nephropathy)

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21
Q

IgA nephropathy associated with which vasculitis?

A

Henoch-Schonlein

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22
Q

Genetic mutation in alpha-5-chain type VI collagen with irregular GBM

A

Alport Syndrome

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23
Q

Inheritance of Alport Syndrome

24
Q

Thin GBM due to genetic deficiency in collaged

A

Thin Membrane Disease

25
What can progress to Chronic GN
``` Rapidly progressing GN Focal Segmental Glomerulosclerosis Membranous GN Membranoproliferate GN Post-Strep IgA nephropathy ```
26
Decreased Urine output, increased BUN, oliguria, hyperkalemia, metabolic acidosis. Urine has hyaline and granular casts.
Acute Tubular Necrosis
27
Causes of ATN?
Ischemia | Toxicity (Aminoglycosides most common)
28
Polyuria, nocturia, and metabolic acidosis with normal looking tubules. PMN and eosinophil infiltrates
Tubulointerstitial Nephritis
29
Acute Drug-induced Interstital nephritis - When? - Pathology? - Causes?
15 days after drugfs Lymphocyte and macrophage granulomas Type 1 and 4 immune response
30
What causes uric acid to precipitate and cause kidney damage?
Chemo or gout cause uric acid crystals to obstruct tubules
31
NSAID nephropathy mechanism of injury?
Inhibition of PGE vasodilation decreased perfusion causing both Interstitial nephritis and glomerulonephritis
32
Multiple Myeloma mechanism of kidney injury?
Ig chains directly toxic to tubules (Bence-Jones proteinuria)
33
Bruit on kidney ascultation?
Renal Artery Stenosis
34
Young black male with HTN, nausea, vomiting, hematuria and proteinurua. Pathology Shows: Petechial kidney Fibrinoid necrosis Onion skinning hyperplastic arteriolitis
Malignant Nephrosclerosis
35
Sudden onset bleeding, oliguria, hematuria, MAHA?
Hemolytic Uremic Syndrome
36
Typical HUS cause?
Verycytotoxin E Coli
37
Atypical HUS cause?
Anti-Phospholipid Pregnancy Cyclosporine Factor H Mutation
38
TTP Pentad?
``` Fever Hematuria Thrombocytopenia MAHA Renal Failure ```
39
TTP Cause?
ADAMTS-13 deficiency
40
Mahogany brown tumor with large eosinophilic cells in the collecting ducts?
Oncocytoma
41
Benign kidney tumors?
Angiomyolipoma | Oncocytoma
42
Most common RCC?
Clear Cell Carcinoma
43
Renal Cysts and hemangioblastomas due to what mutation?
VHL (autosomal dominant) angiogenesis | Von-Hippel-Lindau Syndrome
44
Bright Yellow tumor with solid cystic pattern. Cells have clear cytoplasm
Clear Cell carcinoma
45
Cuboidal cell cancer with papillary growth
Papillary Carcinoma
46
Vegtable-like cells
Chromophobe carcinoma
47
Renal Cell Carcinoma risk factors
Male Elderly Smoking = #1
48
Most common cause for acute kidney failure (disease state with many causes)?
Acute Tubular Necrosis
49
Ischemic vs. Nephrotoxic ATN patterns and causes
Ischemic: Patchy necrosis, due to volume loss, shock Nephrotoxic: Mostly PCT damage due to drugs (aminoglycosides most common)
50
Nerve deafness, eye disorders, and nephritis = what syndrome?
Alport Syndrome
51
``` What nephrotic syndrome is associated with: Chronic IC disease Lipodystrophy Alpha-1-antitrypsin deficiency CLL, lymphomas, melanomas? ```
Membranoproliferative disease
52
RCC, renal cysts, hemangioblastomas of cerebellum and retina?
VHL (AD tumor supressor mutation)
53
Cartilage present in the kidneys indicates?
Cystic Renal Dysplasia
54
Tubulo-interstital nephritis with infiltrates IN the tubles? | Not in the tubules?
``` In = Pyelonephritis Out = Drug induced ```
55
Calyx damage?
NSAID tox or chronic pyelonephritis

Renal (5 decks)

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