Renal Pathology Flashcards
What is H&E staining used for
To look at histological structure e.g. thickening of a membrane
What is periodic Acid-Schiff (PAS) used for
To stain carbohydrates and proteins
What is Masons trichrome used for
To stain collagen (blue) and look for connective tissues
What is Jones silver stain used for
Look for lacy membranes in conjunction with PAS or H&E
How is a Glomerular disease classified
By histological changes e.g. ADPGN
What are the characteristics of Crescentic Glomerulonephritis
Proliferation of epithelial cells
Enlargement and compression of glomerular rift causing it to shrivel and lose func.
Hard to treat
What could be a cause of crescentic glomerulonephritis
Diffuse GN
ADPGN
MPGN
Focal Segmented GN
Describe some clinical features and histological findings of renal disease
Increased proliferation of endo/epi/mesangial cells —> haematuria/nephritic
Changes to BM sensitivity —> proteinuria
Possible —> ARF
Name 4 methods of diagnosis for renal pathologies
- Renal biopsy
- Light microscopy (H&E, PAS, Jones & Trichrome)
- immunofluorescence microscopy If electron microscopy
Characteristics of Focal Segmented GN
Cellular proliferation affecting one segment of glomerular tuft
Only affects portion of glomeruli (focal)
Difference between primary and secondary
Primary - caused by disease Incl. IgA mesangial disease and good pastures syndrome
Secondary - associated with systematic diseases
What can Minimal Change Disease cause
Most common nephrotic disease in children, proteinuria, fusion of podocyte feet altering specificity
What are the characteristics of Minimal change disease
Most common nephrotic disease in children, proteinuria, fusion of podocyte feet altering specificity
How can minimal change disease be treated
Typically with steroids to bring about remission
Characteristics of Membranous Nepropathy
Immune complex deposition in BM if all segments of Glom (Global)
No inflammation of epi/endothelial cells or proliferation
Origin of complexes unknown
Describe the process of the affect of Membranous Nepropathy
Immune complexes in Basal Membrane epithelial side —> new basal membrane forms around it —> complexes disappear leaving holes behind —> lacy BM affects specificity —> proteinuria —> nephrotic syndrome
Describe the difference between Type 1 and Type 2 MPGN
Type 1 (90%) lobularity by proliferation of mesangial cells, capillaries thicken due to immune complexes Type 2 (10%) less prominent proliferation, thickening of GNM, dense deposits of C3 in BM (no immune complexes, just compliment)
What can Membranous Proliferative GN cause
Haematuria, nephrotic syndrome or mixed nephrotic nephritic syndrome
What is nephrotic syndrome
Disturbance in glomerular structure.
- reduces blood flow through glom —> leakage of RBCs to urine, haematuria
- retention of waste products (uraemia, particularly nitrogenous waste)
- activation of RAA system for fluid retention and mild hypertension
What is nephritic syndrom
Glom loses ability to retain protein (proteinuria).
- conseq. Albumin decrease —> hypoalbuminaemia
- oedema, result of abnormality in glomerular BM
What are the 4 patterns in glomerular disease
Deposition of immune complex
Proliferation of endothelial cells
Neutrophil polymorphism
Mildd mesangial cell Proliferative
Characteristics of Global, Segmental, Diffuse & Focal
Global - Whole glom and glom capillaries affected
Segmental - only part of glomeruli affected
Focal - some glomeruli affected
Diffuse - All glomeruli affected
How does ADPGN affect you
- Blockage of capillaries —> less blood flow —> less filtration —> oliguria —> haematuria
- Low BP —> hypertension —> (RA system) —> increase in BP
Describe glomerulus function
Specialised capillary system, highly selective filtration barrier responsible for urine filtration
- ultrafiltration gets collected in B capsule —> drains into tubules
