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Renal > SM 208 Nephrosis > Flashcards

SM 208 Nephrosis Flashcards

1
Q

What is urinalysis?

A

A basic tool for evaluation of renal function

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2
Q

What does urinalysis evaluate for?

A

Protein, cells, electrolytes

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3
Q

What characterizes a nephritic syndrome?

A

RBC’s in the urine

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4
Q

Is blood in the urine during a nephritic syndrome macroscopic or microscopic?

A

Both!

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5
Q

What does fluorescent microscopy identify?

A

IgG, IgM, IgA and Complement components that deposit on the Glomerulus

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6
Q

What supports a capillary loop?

A

Mesangial cells

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7
Q

What does electron microscopy identify?

A

Exact location of deposition of various inciting agents and other subtle alterations of other components

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8
Q

Is kidney disease diagnosed with clinical pictures or biopsy evaluation?

A

Both; combine imaging with clinical picture

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9
Q

What is the difference between focal and diffuse?

A

Focal involves some glomeruli, while diffuse involves all glomeruli

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10
Q

What is the difference between segmental and global?

A

Segmental involves part of the glomeruli while global involves the entire glomeruli

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11
Q

How can PCT and DCT cells be differentiated on slides?

A

PCT cells form larger tubules and had thick cells due to lots of mitochondria to power active transport DCT cells are thinner and form smaller tubules

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12
Q

What causes a “crescent” on slides?

A

“Crescent” forms due to parietal epithelial cells abnormally proliferate

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13
Q

How does a “crescent” effect the Glomeruli?

A

“Crescent” compresses the Glomeruli and causes a loss of function

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14
Q

What is this?

A

A crescent compressing a glomeruli

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15
Q

What is this?

A

“Hyaline” glomeruli, since it’s so thick and pink

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16
Q

What is this?

A

Tram-Track staining where the Base Membrane has thickened and appears as two layers

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17
Q

What is this?

A

Wire-loop staining because of even thickening of all basement membrane around the capillary loops

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18
Q

What 5 things can cause glomerular disease?

A

Circulating IC’s
IC deposition in-situ
Cell-mediated and Complement mediated
Epithelial injury
Renal Ablation

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19
Q

What do anti-GBM antibodies target?

A

Anti-GBM antibodies target Type IV Collagen

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20
Q

What can cause Immune Complex deposition other than anti-GBM antibodies?

A

Planted Haptens which induce an immunogenic response against the Glomerulus

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21
Q

Why is Renal Ablation a death spiral?

A

Renal Ablation refers to the loss of one glomerulus causing another one to hypertrophy and compensate
However, the pressure and volume in the surviving nephron increases while the wall remains thin, leading to failure
This causes other nephrons to try and copmensate

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22
Q

What does Minimal Change Disease cause?

A

Nephrotic syndrome in young children after an URI, causing edema and effacement of podocyte foot processes

Treat with corticosteroids

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23
Q

A young child presents with an URI and swollen limbs, as well as heavy proteinuria. What disease does he have?

A

Minimal Change Disease

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24
Q

What causes nephrotic syndrome after an URI?

A

Minimal Change Disease

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25
Q

How is Minimal Change Disease treated?

A

Corticosteroids

26
Q

Is FSGS a disease?

A

No, it’s a pattern of injury

27
Q

How does FSGS present on slides?

A

Partial scarring of only some glomeruli

28
Q

Is FSGS primary or acquired?

A

May be primary or drug-induced, especially after HIV + Heroin

29
Q

HIV + Heroin predisposes which disease?

A

FSGS

30
Q

What is FSGS?

A

A pattern of injury that causes partial scarring of some glomeruli that tends to follow HIV + Heroin use

31
Q

How does FSGS appear on light microscopy?

A

Sclerosis affect some parts of some glomeruli

32
Q

Is FSGS specific or non-specific on fluorsecent microscopy?

A

FM is non-specific and depends on the underlying diagnosis

33
Q

How does FSGS appear on electron microscopy?

A

Loss of foot processes and podocyte detachment

34
Q

Compare and contrast FSGS and Minimal Change Disease?

A

FSGS and MCD both present with the loss of foot processes, but MCD is mostly in kids and steroid responsive while FSGS is mostly in adults and non-responsive

35
Q

Mostly effects kids and steroid responsive: FSGS or MCD?

A

Minimal Change Disease

36
Q

Mostly effects adults, steroid non-responsive?

A

FSGS

37
Q

What disease is this?

A

FSGS, since only some glomeruli and only parts of glomeruli are effected

38
Q

How do you distinguish MCD and FSGS on electron microscopy?

A

You can’t; need to know the clinical picture with respect to age (kids = MCD, adults = FSGS) and steroid responsiveness (MCD = steroid responsive, FSGS = steroid unresponsive)

39
Q

What is Membranous Nephropathy?

A

A disease in adults with slowly progressive renal failure due to circulating immunocomplexes and in-situ immune complex formation

Primary or drug induced

40
Q

Is Membranous Nephropathy a primary or acquired disease?

A

Both; tends to follow Lupus

41
Q

What causes wire-loop appearance in the glomerular capillaries?

A

Membranous Nephropathy

42
Q

What causes a spike-and-dome pattern on electron microscopy?

A

Membranous Nephropathy

43
Q

What is MPGN?

A

A histomorphologic designation dependent on light microscopy with 2 subtypes

44
Q

What is Type I Membranoproliferative Glomerulonephritis?

A

A form of MPGN that occurs due to circulating immune complexes

Visualized on fluorescent microscopy as C3 + IgG

Prognosis depends on underlying disease

45
Q

Which type of MPGN complicates chronic infections?

A

Type I MPGN

46
Q

What is Type II Membranoproliferative Glomerulonephritis?

A

A form of MPGN that occurs due to C3 abnormality

Shows only C3 on Fluorescent Microscopy

Poor prognosis

47
Q

How are Type I and Type II MPGN differentiated on fluorescent microscopy?

A

Type I = C3 + IgG
Type II = C3 only

48
Q

Which type of MPGN involves dysregulation of the complement pathway?

A

Type II MPGN

49
Q

Which disease causes a tram-track pattern on silver stain?

A

MPGN

50
Q

What proliferates in MPGN?

A

The GBM proliferates

51
Q

What are Kimmelstiel Wilson nodules pathopneumonic for?

A

Diabetic Nephropathy

52
Q

What is the end stage of many kidney diseases?

A

Chronic Glomerulonephritis

53
Q

How does Chronic Glomerulonephritis present on light microscopy?

A

Since Chronic Glomerulonephritis is the end-stage of kidney diseases, it presents with diffuse sclerosis of most glomeruli

54
Q

What is this?

A

Chronic Glomerulonephritis; due to the completely destroyed Glomeruli

55
Q

Is Tubulointerstitail Nephritis infectious or non-infectious?

A

Both

56
Q

What causes infectious tublulointerstitial nephritis?

A

Pyelonephritis

57
Q

What are non-infectious causes of tubulointerstitlal nephritis?

A

Drugs, ischemia

58
Q

What drugs can cause tubulointerstitial nephritis?

A

AACC
Acetaminophen
Aspirin (NSAIDS)
Caffeine
Codeine

Long-term large doses

59
Q

How does Acetaminophen cause tubulointerstital nephritis?

A

Oxidative damage to the tubules

60
Q

How does aspirin cause tubulointerstitial nephritis?

A

Asprin inhibits Prostaglandin synthesis causing vasoconstriction and ischemia

Renal (19 decks)

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