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Renal II path > The Kidney > Flashcards

The Kidney Flashcards

1
Q

Primary Glomerulopathies 20.1

A

Acute proliferative GN, postinfectious, other, rapidly progressive (crescentic) GN, MGN, MCD, FSGS, MPGN, dense deposit disease, IgA nephropathy, Chronic GN

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2
Q

Systemic Diseases with Glomerular Involvement 20.1

A

SLE, DM, Amyloidosis, goodpasture syndrome, microscopic polyarteritis/polyangitis, wegener granulomatosis, henoch-schonlein purpura, bacterial endocarditis

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3
Q

Hereditary Disorders 20.1

A

Alport Syndrome, thin basement membrane disease fabry disease

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4
Q

Glomerular syndromes 20.2

Nephrotic Syndrome

A

Hematuria, azotemia, variable proteinuria, oliguria, edema, HTN

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5
Q

Glomerular Syndromes 20.2

RPGN

A

Acute nephritis, proteinuria, acute renal failure

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6
Q

Glomerular Syndromes 20.2

Nephrotic Syndromes

A

> 3.5 g/day proteinuria, hypoalbuminemia, hyperlipidemia, lipiduria

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7
Q

Glomerular Syndromes 20.2

Chronic Renal Failure

A

Azotemia-> uremia progressing for months to years

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8
Q

Glomerular Syndromes 20.2

Isolated urinary abnormalities

A

Glomeruluar hematuria, and/or sunephrotic proteinuria

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9
Q

Ab-mediated injury, In Situ immune complex deposition 20.3

A

Fixed intrinsic tissue antigens
NC1 domain of Type IV collagen antigen (anti-GBM nephritis)
PLA2R antigen (membranous glomerulopathy)
Mesangial antigens
Others
Planted antigens
Exogenous (infectious agents, drugs)
Endoegenous (DNA, nuclear proteins, Igs, immune complexes, IgA)

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10
Q

Circulating Immune Complex Depoosition

A 
Endogenous antigens (DNA, tumor antigens)
Exogenous antigens (e.g. infectious products)
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11
Q

Summary of Major Primary Glomerulonephritides 20.4

Postinfectious GN

A

Pres: Nephritic Syndrome
Patho: Immune complex mediated; circulating or planted antigen
Light Micro: Diffuse endocapillary proliferation; leukocytic infiltration
Fluorescence Microscopy: Granular IgG and C3 in GBM and mesangium; granular IgA in some cases
EM Primary subepithelial humps; subendothelial deposits in early disease stages

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12
Q

Summary of Major Primary Glomerulonephritides 20.4

Goodpasture Syndrome

A

Pres: RPGN
Path: Anti-GBM COL 4-A3 antigen
Light Micro: Extracapillary proliferation with crescents; necrosis
Flurescence Micro: Linear IgG and C3; fibrin in crescents
EM: No deposits; GBM disruptions; fibrin

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13
Q

Summary of Major Primary Glomerulonephritides 20.4

Chronic GN

A

Pres: Chronic renal failure
Path: Variable
Light Micro: Hyalinized glomeruli
Fluorescence: Granular or negative

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14
Q

Summary of Major Primary Glomerulonephritides 20.4

MGN

A

Pres: Nephrotic Syndrome
Path: In situ immune complex formation: PLA2R antigen in most cases of primary disease mostly unknown
Light Micro: Diffuse capillary wall thickening
Fluorescence: Granular IgG and C3; diffuse
EM: Subepithelial deposits

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15
Q

Summary of Major Primary Glomerulonephritides 20.4

MCD

A 
Pres Nephrotic Syndrome
Path: Unknown; loss of glomerular polyanion; podocyte injury
Light: Normal; lipid in tubules
Flurosence: Negative
EM: Loss of foot processes; no deposits
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16
Q

Summary of Major Primary Glomerulonephritides 20.4

FSGS

A

Pres: Nephrotic Syndrome; non-nephrotic proteinuria
Path: Unknown, ablation nephropathy plasma factor (?); podocyte injury
Light Micro: Focal and segmental sclerosis and hyalinosis
Fluorescence: Focal; IgM + C3 in many cases
EM: Loss of foot processes; epithelial denudation

17
Q

Summary of Major Primary Glomerulonephritides 20.4

MPGN Type 1

A 
Pres Nephrotic Syndrome
Path Immune Complex
Light Micro: Mesangial Proliferative or membranoproliferative patterns of proliferation; GBM thickening; splitting
Fluorescence: IgG + C3; C1q + C4 
EM: Subendothelial deposits
18
Q

Summary of Major Primary Glomerulonephritides 20.4

Dense Deposit disease (MPGN Type II)

A

Pres Hematuria, Chronic renal failure
Path Autoantibody; alternative complement pathway
Light Micro: Mesangial proliferative or membranoproliferative patterns of proliferation; GBM thickening; splitting
Fluorescence: C3; No C1q or C4

19
Q

Summary of Major Primary Glomerulonephritides 20.4

IgA

A

Pres Recurrent hematuria or proteinuria
Path unknown
Light Microscopy: Focal Mesangial proliferative GN; mesangial widening
Fluorescence Micro IgA + IgG, IgM, and C3 in mesangium
EM Mesangial and paramesangial dense desposits

20
Q

Rapidly Progressive Glomerulonephritis 20.5

Type 1 RPGN (Anti-GBM Ab)

A

Renal Limited, Goodpasture syndrome

21
Q

Rapidly Progressive Glomerulonephritis 20.5

Type II RPGN (Anti-GBM Ab)

A

Idiopathic, postinfectious, SLE, Henoch-Schlonlein purpura (IgA), Others

22
Q

Rapidly Progressive Glomerulonephritis 20.5

Type III RPGN (Anti-GBM Ab)

A

ANCA-associated, idiopathic, Wegner Granulomatosis, microscopic polyarteritis nodosa/microscpic polyangitis

Renal II path (1 decks)

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