Renal- Pathoma

Question 1

Dysplastic kidney?

• What is it?
• Inheritance pattern?
• unilateral or bilateral?
• What disease should I NOT be confused with?

Answer 1

• dysplastic kidney containing CYST and other types of tissue (collagen is commonly involved)
• NOT INHERITED
• mostly unilateral
• ADPKD. because dysplastic kidney also has cysts
  ADPKD is bilateral!!

Question 2

What condition is associated with ARPKD? vs. ADPKD?

Answer 2

ARKPD: cysts in kidney, liver (liver cirrhosis)

ADPKD: cysts in kidney, liver, AND BRAIN (berry aneurysm), HEART (MVP)

Question 3

Medullary cystic kidney

• inheritance pattern?
• gross appearance (2)

Answer 3

• autosomal dominant

- shrunken kidney and parenchymal fibrosis

Question 4

What does penicillin do on kidney?

Answer 4

interstitial nephritis

• remember sketchy?

Question 5

What kind of dyslipidemia is seen in nephrotic syndrome

Answer 5

hypercholesterolemia and hyperlipidemia

• way to remember this: Because protein is getting lost in nephrotic syndrome, liver reacts to make more of cholesterol to replace it. This is not exact mechanism, but easy way to rembmer
• This may also explain why fatty cast is seen in nephrotic syndrome

Question 6

What malignancy is associated with minimal change nephropathy?

Answer 6

Hodgkin lymphoma

Question 7

What is the only nephrotic syndrome that responds well to glucorcorticoid?

Answer 7

minimal change

Question 8

What population has increased risk for developing membranous nephropathy?

Answer 8

caucasian adults

Question 9

How does C3 level affected in type 2 membranoproliferative glomerulonephritis? explain why

Answer 9

C3 level is decreased

C3 nephritic factor is associated with MPGN. C3 nephritic factor stabilizes C3 convertase, leading to excess production of C3a, C3b and decrease in C3

Question 10

EM finding in PSGN?

Answer 10

subepithelial deposits, hump

• check image pathoma p.130

Question 11

focal segmental vs. rapidly progressive: what consists the legion in microscope? (3 answers for rapidly progressive)

Answer 11

• focal segmental: hyaline

- rapidly progressive: C3, fibrin, macrophage ( all are inflammatory mediators)

Question 12

Calcium kidney stone: what is level of

• serum calcium
• urine calcium

Answer 12

• serum calcium: normal

- urine calcium: idiopathic hypercalciuria

Question 13

What kidney stone(1 or 2?) form staghorn calculi?

Answer 13

TWO

• struvite
• ALSO cystine

Question 14

Renal angiomylolipoma: what neuro condition?

Answer 14

tuberous sclerosis

mass in kidney with blood vessels, fat, muscle tissues

Question 15

Which 4 neoplastic syndromes can renal cell carcinoma cause?

Answer 15

• ACTH
• EPO
• renin
• PTHrP

Question 16

Wilms tumor is comprised of what embryological origin?

Answer 16

metanephric blastema (which gives rise to metanephric mesenchyme)

Question 17

Compare progression of two types of transitional cell carcinoma

• papillary
• flat

Answer 17

• papillary: low grade -> high grade -> invasion

- flat: high grade -> invasion, associated with early loss of p53

Question 18

adenocarcinoma of bladder is derived from what embryological structure? How does this explain the location of adenocarcinoma?

Answer 18

• urachal remnant

- dome of bladder (upper part); site where urachus and bladder are originally joined during embryologic development