renal pathology Flashcards
renal hypoplasia is more common ___lateral, and agenesis is more common____lateral
unilateral; bilateral
kidneys just above the pelvic brim with kinking or toruosity of ureters
ectopic kidney
renal cystic disease more often seen in adults
autosomal dominant polycystic kidney disease
simple cysts smaller than____are fine
5 cm
mutation of PKD1 or PKD2
autosomal dominant polycystic kidney disease
in ppl dx’w with ADPKD, when do they develop renal failure
in their 50’s
what is the 4th leading cause of end stage renal disase?
ADPKD
berry aneurysms occurs in 10% of patients, hepatic cysts
ADPKD
when ___of the kidney is affected by ADPKD, dysfxn begins
2/3
mutation of PKHD1, childhood presentation
autosomal recessive polycystic kidney disease
huge, white smooth surfaced kidneys at birth
ARPKD
which PKD is associated with congenital hepatic fibrosis
ARPKD
retention cysts are AKA?
simple cysts
diffuse disease concerns____
glomeruli; at least 51%
when less than 50% of glomerulus are affected, it is called?
focal
renal biopsy is routinely stained for which Ig?
IG G,A,M
syndrome assc’d with hematuria
nephritic
syndrome assc’d with severe proteinuria
nephrotic syndrome
what is due to breaks in the glomerular capillary loops
nephritic syndrome
what is due to glomerular capillary filtration defects?
nephrotic syndrome
tubular injury that presents with oliguria + rapid rise in serum creatinine
acute renal failure
HTN, hematuria, RBC casts
nephritic syndrome
proteinuria>___, edema, hypoalbuminemia, fatty casts
> 3.5g/24 hr; nephrotic syndrome
micro changes seen in chronic renal failure (3)
- glomerular sclerosis
- interstitial fibrosis
- tubular atrophy
most common cause of nephrotic syndome in children 2-6 yo
minimal change glomerulopathy
another name for minimal change glomerulopathy
lipoid nephrosis
diffuse epithelial foot process effacement
minimal change glomerulopathy
can be caused by HIV or heroin use
focal segmental glomerulosclerosis
Af Am, HIV+, pitting edema, c/o HA
FSGS
segmental sclerosis on LM, diffuse epithelial cell foot process effacement
FSGS
spikes on LM, granular IgG & C3 on IF; subepithelial deposits on EM
membranous glomerulopathy
___% of those with membranoproliferative glomerulonephritis will progress to ____within 10 yrs
50%; chronic renal failure
subendothelial deposits characterizes type ____MPGN; intramembranous deposits characterize type ____MPGN
type 1; type 2
thickening of GBM + proliferative mesangial cells
membranoproliferative glomerulonephritis
tram tracks on LM silver stain
MPGN type 1
which type of MPGN has C3 nephritic factor
MPGN type 2
acute nephritic syndrome caused by what 2 conditions
- diffuse prolfierative glomerulonephritis
2. crescenteric glomerulonephritis
acute glomerulonephritis is most commonly associated with____
strep
hematuria, azotemia, oliguria, in kids after latent period of 1-3 weeks post strep infxn
acute glomerulonephritis
acute glomerulonephritis is assc’d with ____complement levels
low
subepithelial humps; scattered granular IgG, IGM & C3 along GBM & mesangium
post-strep GM
anti-GBM, IC, anti-PMN
crescent glomerulonephritis
linear cigarette smoke IF
goodpasture disease
granular, lumpy bumpy IF
SLE
Ab against collagen IV, results in vasculitis, esp in lung & kidney
goodpastures disease
what are the ANCA-associated GN?
pauci-immune crescentic GN
most common type of primary glomerulonephritis worldwide?
IgA nephropathy
immune complex deposition in mesangium, present with mild hematuria, proteinuria
IgA nephropathy
mesangial proliferation is considered >____cells per mesangium
3
defect in the basement membrane due to mutation in alpha-5 chain of collagen IV
alport syndrome
male boy with sensorineural deafness with microscopic hematuria, x linked dominance
alport syndrome
splitting and lamination, basket-weave pattern (key lesions)
alport syndrome
normal LM, negative IF, thin GBM on EM
thin GBM disease
granular immune complex deposition of IgG, IgA, IgM, C3, C4
lupus nephritis
big pale waxy kidney with leaky glomerular basement membrane
amyloidosis
50% of acute renal failure is due to
acute tubular necrosis
acute interstitial nephritis can be due to what drugs (4)
- PCN
- rifampin
- ibuprofen
- thiazide diuretics
most common cause of pyelonephritis
E coli
presentation with pain in costo-vertebral angle, WBC casts in urine, neutrophilic infiltrates
acute pyelonephritis
pitting geographic scars
chronic pyelonephritis
thyroidization
chronic pyelonephritis
which tumor is always in the cortex, and smaller than 0.5 cm, with pale yellow well-circumscribed nodules
papillary adenoma
which tumor is associated with tuberous sclerosis
angiomyolipoma
main risk factors to know for renal cell carcinoma (3)
- tobacco
- chronic renal failure
- acquired cystic renal disease
presentation with hematuria, abdominal mass, invades the renal vein early
renal cell carcinoma
loss of VHL histotype of RCC
clear cell RCC
activation of pro-oncogene MET histotype of RCC
papillary renal cell carcinoma
loss of multiple chrom–>hypodiploidy (histotype of RCC)
chromophobe RCC
which RCC histotype has the best prognosis?
chromophobe RCC
solitary unilateral lesion, yellow-orange with sharply defined margins, abundant capillaries
clear cell RCC
thick capsule with hemorrhage, foamy macrophages, abundant eosinophilic cytoplasm, sparse capillaries
chromophil (papillary) RCC
inactivation of VHL with cavernous hemangiomas in cerebellum and incr incidence of RCC
von hippel lindau syndrome
nephroblastoma is AKA
wilms tumor
most common renal malignancy of early childhood
wilms tumor
wilms tumor results from mutation in?
WT1 or WT2
wilms tumor components on histology (4)?
- blastema
- abortive glomeruli
- spindle cell stroma
- abortive tubules
