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Renal > Renal pathology > Flashcards

Renal pathology Flashcards

1
Q

What is nephritis?

A

Inflammation of the kidney

Can be infective (pyelonephritis) or non-infective (glomerulonephritis)

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2
Q

What is the pathogenesis of goodpasture’s disease/

A

IgG antibodies against alpha 3 subunit of collagen 4

Present in glomeruli and alveoli

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3
Q

What antibody is present in goodpasture’s disease?

A

Anti-GBM

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4
Q

What vasculitis can cause glomerulonephritis?

A

GPA - cANCA

MPA - pANCA

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5
Q

What is nephritic syndrome?

A

Haematuria, hypertension

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6
Q

What is nephrotic syndrome?

A

Heavy proteinuria
Non-dependent oedema, hyperlipidaemia
Protein loss - antibodies, complement, and proteins in clotting cascade
Can predispose to immunosuppression and renal vein thrombosis

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7
Q

What are crescents associated with?

A

BAD

Rapidly progressive GMN

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8
Q

What conditions can cause granuloma formation in the glomerulus?

A

GPA

Sarcoidosis

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9
Q

What is light microscopy used for?

A

Hypercellularity - inflammatory cells and reactive proliferations
Sclerosis
Crescents
Vasculitis

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10
Q

What condition will show linear IgG on immunofluorescence?

A

Goodpasture’s

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11
Q

Describe minimal change disease?

A

Nephrotic syndrome
Children get it
Resolves with steroids
Can only be diagnosed from EM

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12
Q

What can cause FSGS?

A

Obesity
HIV
Sickle cell
PWID

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13
Q

What syndrome will FSGS cause?

A

Nephrotic syndrome

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14
Q

What can cause membranous glomerulonephritis?

A

Infection - streptococcus
Hepatitis
Malaria
Syphilis
Drugs: penicillamine, NSAIDs, catopril, gold
Malignancy: lung, colon, melanoma
Immunological: SLE, RA, sarcoid, sjogrens

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15
Q

What syndrome will membranous glomerulonephritis cause?

A

Nephrotic

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16
Q

What is the histological appearance of membranous glomerulonephritis?

A

Thick membranes
Sub-epithelial immune deposits
Spikes seen on silver stain

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17
Q

What antibodies will membranous glomerulonephritis show?

A

Anti-phospholipase A2 receptors

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18
Q

Who is likely to get IgA glomerulonephritis?

A

Genetic
Acquired
Coeliac
Post infectious

19
Q

What syndrome will IgA glomerulonephritis cause?

A

Nephritic syndrome - commonly asymptomatic with painless haematuria

20
Q

What will IgA glomerulonephritis show on renal biopsy?

A

IgA deposits in the mesangium

21
Q

What causes membranoproliferative glomerulonephritis?

A

Idiopathic (type 2 - infection, lupus, malignancy)

Commonly hodgkin’s lymphoma

22
Q

What type of syndrome will membranoproliferative glomerulonephritis cause?

A

Either

23
Q

What is the histological appearance of membranoproliferative glomerulonephritis?

A

Big lobulated hypercellular glomeruli with thick membranes

TRAM TRACKS

24
Q

What kidney issues can diabetes cause?

A 
Diffuse and nodular glomerulosclerosis
Kimmel Stiel Wilson Lesions 
Afferent arterial sclerosis 
Pyelonephritis
Papillary necrosis
25
Q

What is the bosniak score?

A

Predicts malignant change in a kidney cyst

26
Q

What is ADPCKD due to?

A

PKD1: chromosome 16
PKD2: chromosome 4

27
Q

What is ARPCKD due to?

A

PKDH1: chromosome 6

28
Q

How will ADPCKD present?

A 
When adult
Lots and lots of cysts
Haemorrhage
Infarction 
Rupture
Pain
Haematuria
Liver cysts
Cerebral aneurysms leading to subarachnoid haemorrhage
29
Q

How will ARPCKD present?

A

In children
Younger the age, the higher the mortality
Kidney of a normal size with dilated collecting ducts

30
Q

What is xanthogranulomatous pyelonephritis?

A

Infection that creates a mass that resembles a malignancy

31
Q

What benign tumour is assoc with the kidneys?

A

Oncocytoma

32
Q

What malignant tumours are assoc with the kidneys?

A

Chromophobe
Clear cell
Papillary
Collecting duct

33
Q

What paediatric tumour is associated with the kidneys?

A

Wilm’s tumour

34
Q

Describe an oncocytoma

A

Small, oval, well circumscribed

Mahogany brown with a central stellate scar

35
Q

What is an oncocyte?

A

A pink cell with a fluffy cytoplasm due to a very high number of mitochondria

36
Q

What is the histological appearance of a chromophobe?

A

Oncocytic but with raisinoid nuclei and perinuclear halos

37
Q

What is the histological appearance of a papillary tumour?

A

Low grade

Papillary projections

38
Q

What is the histological appearance of a collecting duct carcinoma?

A

High grade appearance with a very desmoplastic stroma

Poor survival - mean around 4 month

39
Q

What are risk factors for developing clear cell carcinoma?

A

Obesity

Genetic influecnen

40
Q

What is the common presentation of clear cell carcinoma?

A

Haematuria
Mass
Hypertension - rare
NEPHRITIC SYNDROME

41
Q

What colour is a clear cell carcinoma?

A

Yellow

42
Q

Where will clear cell carcinoma of the kidney spread?

A

Propensity to spread up the renal vein, into the IVE and into the heart
Doesn’t grow on the vessel walls, grows like a finger projection

43
Q

What genetic condition predisposes to renal carcinoma?

A

VHL

Codes for hypoxia inducible factor which acts as a transcription factor for VEGF, PDGFRB and EPO

Renal (22 decks)

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