Sternberg Flashcards
Describe the clinical presentation of C1q nephropathy.
A rare disease of the young with poor outlook and unknown etiology. Presents with severe proteinemia.
Describe the LM, IF, and EM findings in C1q nephropathy.
LM: Normal. Maybe some MH.
IF: Predominant mesangial C1q (in the absence of full-house SLE staining)
EM: Mesangial deposits
Describe the clinical presentation of Collapsing Glomerulopathy.
Rapidly progressive nephrotic syndrome with poor outcome affecting mostly African Americans. HIV & Pamidronate associated.
Describe the LM findings of Collapsing Glomerulopathy.
Prominent swollen podocytes with large protein droplets. Tubulointerstitial edema & fibrosis with scalloping of microcysts.
Describe the IF and EM findings in Collapsing Glomerulopathy.
IF: Nonspecific.
EM: Endothelial tubuloreticular inclusions (only in HIV-associated form)
Describe the clinical features of acute pyelonephritis.
Arises from ascending infection or hematogenous (“diffuse suppurative”) spread.
Presents with fever, pyuria, and CVA tenderness in usually women (worse with pregnancy & DM). E. Coli #1
Describe the gross findings in acute pyelonephritis.
If ascending: Yellow medullary striping with abscess formation.
If hematogenous: Scattered, glomerulocentric cortical abscesses.
Describe the LM findings in acute pyelonephritis.
Neutrophils in the interstitium with tubular destruction. Follows a medullary/cortical distribution depending on etiology (ascending/hematogenous).
What proportion of TB cases manifest with renal disease? How does it present?
5%
Sterile pyuria
What is the cause of Chinese Herb and Balkan Endemic nephropathies?
Aristolochic acid
What are the most common causes of end-stage kidney?
What role does determining the etiology play?
DM > HTN > GN > Chronic nephritis & ADPKD.
It is difficult/impossible but can be useful in determining utility of transplant.
Describe the gross appearance of the end-stage kidney.
Shrunken & atrophic cortex, granular surface and adherent capsule.
Describe the tubular patterns of atrophy in the end-stage kidney.
Classic: Atrophic tubules with wrinkled basement membranes and simplified epithelium
Endocrine type: Narrow lumina, pale cytoplasm (like adrenal cortex)
Thyroid type
Hypertrophic (compensatory)
Describe the vascular & glomerular LM findings in the end-stage kidney.
Arterial intimal obliteration, without lamellation. Worse with dialysis.
Can have capsular & JGA hyperplasia.
What are the clinical features of acquired renal cystic disease?
Usually appears after several years on dialysis (pathogenesis unknown). Rarely can hemorrhage, increased RCC risk.
