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Renal disease > Renal Pathology > Flashcards

Renal Pathology Flashcards

1
Q

Postinfectious Glomerulonephritis/ Acute proliferative glomerulonephritis

Nephrotic of nephritic

A

Nephritic

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2
Q

Focal Segmental Glomerulosclerosis

Nephritic or Nephrotic

A

Nephrotic

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3
Q

Postinfectious Glomerulonephritis/ Acute proliferative glomerulonephritis

Presentation

A

1-4 weeks post strep skin or pharynx infxn. Usually kids

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4
Q

Postinfectious Glomerulonephritis/ Acute proliferative glomerulonephritis

EM

A

HUMPS

Epithelial side of basement membrane (subepithelial)

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5
Q

Focal Segmental Glomerulosclerosis

Pathogenesis

A

Visceral epithelial damage

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6
Q

Membranous Glomerulonephropathy

Immunofluorescence

A

Granular IgG and C3

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7
Q

RPGN Type I
Goodpasture Syndrome

Pathogenesis

A

Ruptures in GBM

Immunologically mediated

Anti-GBM Abs

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8
Q

Henoch-Schoenlein Purpura

Symptoms (not skin and gi)

A

Non migratory arthralgia, hematuria, nephritic or nephrotic syndrome

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9
Q

Dense-deposit disease (MPGN) Type II

1st or 2nd degree?

A

1st degree only

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10
Q

Diabetic Nephropathy

Clinical presentation (most common syndromes)

A

Non-Nephrotic proteinuria

Nephrotic syndrome

Chronic renal failure

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11
Q

Membranoproliferative Glomerulonephritis (MPGN) Type I

LM

A

Proliferation of mesangial cells and capillary endothelium

Glomerular capillary wall has a TRAM-TRACK appearance

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12
Q

RPGN Type II

Pathogenesis

A

Ruptures in GBM

Immunologically mediated

Immune Complex deposition

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13
Q

Dense-deposit disease (MPGN) Type II

Nephritic or Nephrotic

A

Nephrotic

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14
Q

IgA Nephropathy

Pathogenesis

A

Genetic or acquired abnormality of immune regulation

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15
Q

IgA Nephropathy

EM

A

Dense deposits in mesangium

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16
Q

Diabetic Nephropathy

Hemodynamic changes associated with:

A

Glomerular hypertrophy

Inc glomerular filtration area

Inc GFR

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17
Q

Diabetic Nephropathy

Morphology

A

Capillary basement membrane thickening

Diffuse mesangial sclerosis

Diffuse glomerulosclerosis

Nodular glomerulosclerosis

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18
Q

Henoch-Schoenlein Purpura

Skin presentation

A

Purpuric lesions on extensor surfaces of arms and lugs, buttocks

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19
Q

Membranous Glomerulonephropathy

Presentation

A

Adults, idiopathic

May appear nephritic

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20
Q

RPGN Type I
Goodpasture Syndrome

Immunofluoresent

A

Linear GBM

Ig and complement

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21
Q

Henoch-Schoenlein Purpura

Disease course

A

Hematuria may recur for years

Excellent prognosis in children

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22
Q

Membranoproliferative Glomerulonephritis (MPGN) Type I

Nephritic or Nephrotic

A

Nephrotic

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23
Q

Dense-deposit disease (MPGN) Type II

LM

A

Proliferation of mesangial cells and capillary endothelium

Glomerular capillary wall has a TRAM-TRACK appearance

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24
Q

Henoch-Schoenlein Purpura

Vasculitis occurs in what organs?

A

GI tract etc. but NOT kidney

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25
Q

Dense-deposit disease (MPGN) Type II

Immunofluorescence

A

C3

NO IgG or C1q or C4

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26
Q

Henoch-Schoenlein Purpura

Pathogenesis

A

IgA deposited in glomerular mesangium (IgA nephropathy in younger kids)

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27
Q

RPGN Type I
Goodpasture Syndrome

EM

A

Ruptures in GBM

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28
Q

Postinfectious Glomerulonephritis/ Acute proliferative glomerulonephritis

Immunofluorescent microscopy

A

Granular deposits of IgG, IgM, C3 in mesangium and along GBM

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29
Q

RPGN Type III
Pauci-immune

Presentation

A

Hematuria, casts, htn, edema, proteinuria

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30
Q

RPGN Type III
Pauci-immune

EM

A

Ruptures in GBM

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31
Q

Diabetic Nephropathy

Pathogenesis

A

Hyperglycemia resulting from insulin deficiency and/or glucose intolerance cause alterations in GBM

VASCULATURE IS PROBLEM

Nonenzymatic glycosylation of proteins=hyperglycemia

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32
Q

Minimal-change disease

Immunofluorescence

A

NO Ig or complement deposits

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33
Q

Alport Syndrome

Presentation

A

Hematuria with progression to chronic renal failure

Nerve deafness

Eye disorders

Red cell casts

34
Q

Membranous Glomerulonephropathy

Pathogenesis

A

Immune-complex mediated

35
Q

Membranous Glomerulonephropathy

EM

A

Deposits between GBM and epithelial cells

SPIKES AND DOMES

36
Q

IgA Nephropathy

Presentation

A

Hematuria

37
Q

Focal Segmental Glomerulosclerosis

EM

A

Effacement of foot processes

Detachment of epithelial cells and denudation of GBM

38
Q

Minimal-change disease

Nephritic or Nephrotic

A

Nephrotic

39
Q

Postinfectious Glomerulonephritis/ Acute proliferative glomerulonephritis

Light microscopy

A

Proliferation, neutrophil and monocytes infiltration, endothelial and masangial cells

40
Q

Membranoproliferative Glomerulonephritis (MPGN) Type I

1st or 2nd degree?

A

Both

41
Q

Henoch-Schoenlein Purpura

IF

A

Deposition of IgA (maybe IgG and C3 as well) in mesangial region

42
Q

Minimal-change disease

EM

A

Effacement of foot processes

43
Q

RPGN Type II

Immunofluorescent

A

Granular immune deposits

44
Q

Focal Segmental Glomerulosclerosis

Presentation

A

Poor response to corticosteroid tx

45
Q

Henoch-Schoenlein Purpura

Tx

A

Monitor, supportive

46
Q

Membranoproliferative Glomerulonephritis (MPGN) Type I

Immunofluorescence

A

C3 deposited in granular pattern

IgG, C1q, and C4

47
Q

Alport Syndrome

Pathogenesis

A

Abnormal a3,a4, or a5 chains of collagen IV

Defective assembly of collagen IV

48
Q

Focal Segmental Glomerulosclerosis

Immunofluorescence

A

IgM and C3 in sclerotic areas

49
Q

Minimal-change disease

MC…

A

Cause of nephrotic syndrome in children

50
Q

Focal Segmental Glomerulosclerosis

LM

A

Sclerosing (focal)

Affected glomerulus (segmental)

Affected capillary loops collapse

Hyalinosis

51
Q

Membranous Glomerulonephropathy

LM

A

Diffuse thickening of glomerular capillary wall

52
Q

RPGN Type I
Goodpasture Syndrome

Nephritic or Nephrotic

A

Nephritic

53
Q

Dense-deposit disease (MPGN) Type II

Pathogenesis

A

Activation of alternative complement pathway

54
Q

Minimal-change disease

Presentation

A

Respond rapidly to corticosteroid tx

Selective proteinuria

55
Q

Postinfectious Glomerulonephritis/ Acute proliferative glomerulonephritis

Pathogenesis

A

Immune-complex mediated

56
Q

Membranoproliferative Glomerulonephritis (MPGN) Type I

Presentation

A

Children and young adults

57
Q

RPGN Type I
Goodpasture Syndrome

Light Microscopy

A

CRESCENTS

58
Q

Alport Syndrome

EM

A

Early lesion: GBM thinning

Fully developed disease: GBM alternating thick and thin

Splitting and layering of lamina densa

59
Q

Minimal-change disease

Pathogenesis

A

Thought to be immunologically mediated, but no proof

60
Q

Membranoproliferative Glomerulonephritis (MPGN) Type I

EM

A

Subendothelial electron-dense deposits

61
Q

Minimal-change disease

LM

A

NO CHANGE

62
Q

RPGN Type III
Pauci-immune

Immunofluorescence

A

Little or no deposition

63
Q

Henoch-Schoenlein Purpura

Skin lesion morphology

A

Subepidermal hemorrhages

Necrotizing vasculitis of dermis small vessels

IgA deposits in walls of small vessels

64
Q

IgA Nephropathy

LM

A

Mesangial deposition of IgA

C3, IgG, IgM often

65
Q

Henoch-Schoenlein Purpura

Commonly seen after?

A

Upper respiratory infxn

66
Q

RPGN Type II

LM

A

CRESCENTS

67
Q

Diabetic Nephropathy

Slowed by

A

Diabetic control and angiotensin inhibition

68
Q

IgA Nephropathy

Disease Association

A

Berger disease

69
Q

Henoch-Schoenlein Purpura

LM

A

Mesangial proliferation, focal or diffuse

Endocapillary to Cresectic glomerulonephritis

70
Q

Dense-deposit disease (MPGN) Type II

Presentation

A

Children and young adults

71
Q

Membranoproliferative Glomerulonephritis (MPGN) Type I

Pathogenesis

A

Immune complexes

Activation of classical and alternative complement pathways

72
Q

Henoch-Schoenlein Purpura

GI presentation

A

Abdominal pain, vomiting, intestinal bleeding

73
Q

RPGN Type III
Pauci-immune

Nephritic or Nephrotic

A

Nephritic

74
Q

RPGN Type II

EM

A

Ruptures in GBM

75
Q

RPGN Type III
Pauci-immune

LM

A

CRESCENTS

76
Q

RPGN Type III
Pauci-immune

Pathogenesis

A

Ruptures in GBM

Immunologically mediated

NO anti-GBM or immune complexes

77
Q

Dense-deposit disease (MPGN) Type II

EM

A

Dense material into GBM

“Ribbon-like”

78
Q

Membranous Glomerulonephropathy

Nephritic or Nephrotic

A

Nephrotic

79
Q

RPGN Type II

Presentation

A

Hematuria, casts, htn, edema, proteinuria

80
Q

RPGN Type I
Goodpasture Syndrome

Presentation

A

Hemoptysis=Goodpastures

Hematuria, casts, hypertension, edema, proteinuria

81
Q

RPGN Type II

Nephritic or Nephrotic

A

Nephritic

82
Q

Henoch-Schoenlein Purpura

Epidemiology

A

Children 3-8

Renal disease (6 decks)

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