25.6.2013(pathology) 48 Flashcards
(155 cards)
0
Q
Extra renal manifestations of ADPKD
A
Berry aneurysm Cysts in other organs Liver(most common) Pancreas Spleen Ovary Colonic diverticula MVP and AR
1
Q
Mutation in ARPKD
A
PKHD 1 which codes for fibrocystin
2
Q
Chr of ADPKD
A
Chr 16
3
Q
Heyman antigen
A
Megalin
4
Q
Site of deposition based on charge of molecules
A
Mesangium (Neutral)
Subepithelial(cation)
Subendothelial(anion)
5
Q
Antigens responsible for PSGN
A
Endostreptosin
Nephritis strain associated protein(NSAP)
6
Q
Starry sky appearance of BM and mesangium is seen in
A
PSGN
7
Q
Level of complement proteins in PSGN
A
Transient reduction for 6-8wks
8
Q
Type II RPGN
A
HSP
SLE
post infectious
9
Q
Deposits in MPGN
A
Subendothelial deposits of IgG,C1q,C4(Type 1)
Intramembranous deposits of C3 alone(Type 2)
10
Q
Complement activation in MPGN
A
Both classical and alternative pathways are activated in MPGN1
Only alternative pathway activated in MPGN2
11
Q
EM appearance of MPGN
A
Tram track or double contour appearance(MPGN1)
Dense deposit disease(MPGN2)
12
Q
NPHS1
A
Nephrin
Hereditary form of congenital nephrotic syndrome
Finnish type
13
Q
NPHS2
A
Podocin
Steroid resistant nephrotic syndrome
autosomal recessive FSGS
14
Q
Autosomal dominant FSGS
A
A actinin-4
15
Q
Mutation causing adult onset FSGS
A
TRPC6
16
Q
Deposits in membranous glomerulopathy
A
Subepithelial
17
Q
HPE of collapsing glomerulopathy
A
Collapse and sclerosis of entire glomerular tufts
Microcysts in tubules
18
Q
Cause of collapsing glomerulopathy
A
Podocin expression of vpr and nef
19
Q
Most common cause of collapsing glomerulopathy in children
A
Cystinosis
20
Q
EM appearance of collapsing glomerulopathy
A
Tubuloreticular inclusions induced by interferon alpha
21
Q
Secondary causes of Berger disease
A
Liver failure
Intestinal disease
22
Q
Alternative complement pathway alone is activated in
A
MPGN2
Berger disease
23
Q
Deposits in FSGS
A
C3
IgM
24
Deposits in PSGN
IgG,IgM
| C3
25
Deposits in MPGN1
IgG
C1q
C4
C3
26
Deposits in MPGN2
C3
| No IgG
27
Deposits in membranous nephropathy
C3
| IgG
28
Deposits in FSGS
C3
| IgM
29
Deposits in Berger
IgA
Properdin
C3
30
Light microscopy in alport
Foam cells in interstitium
31
EM appearance of alport
Basket weave appearance
32
Normal GBM thickness
300-400nm
33
GBM thickness in thin basement membrane disease
150-250nm
34
Defect in benign familial hematuria
A3 and A4 chains of type 4 collagen
35
Good pasture disease
Affects elderly females
Lungs not affected
Good prognosis
36
Subendothelial deposits
MPGN1
SLE
acute GN
37
Sub epithelial deposits
```
PSGN
membranous
Heyman nephritis
RPGN(some cases)
MPGN1(rarely)
```
38
Basement membrane deposits
Membranous
| MPGN2
39
Mesangial deposits
IgA nephropathy
HSP
anti GBM diseases like good pasture and RPGN
40
Proliferative glomerulonephritis
```
MPGN
SLE
PSGN
neoplasia(CLL,MALT)
HIV
```
41
Urinalysis in chronic glomerulonephritis
Broad waxy casts
42
Earliest morphological abnormality in diabetic nephropathy
GBM thickening
43
Morphological changes in diabetic nephropathy
```
GBM thickening
Diffuse mesangial thickening
KW disease
Hyalinising arteriolar sclerosis affecting both afferent and efferent arteries
Fibrin caps
Capsular drops
Armani ebstein cells
Papillary necrosis
```
44
Level of Fibronectin in Fibronectin nephropathy
Normal
45
HPE in Fibronectin nephropathy
PAS and Trichrome positive
46
Gross appearance of benign nephrosclerosis
Leather grain appearance
47
Most common cause of ARF
ATN
most common cause of ATN is ischemia
48
Ischemic ATN affects
Focally
Proximal straight tubule
Ascending loop of henle
49
Nephrotoxic ATN affects
PCT
| ascending henle loop
50
Tubular finding in mercuric chloride poisoning
Large Acidophilic inclusions
51
Tubular finding in CCl4 poisoning
Accumulation of neutral lipids
52
Tubular finding in ethylene glycol poisoning
Ballooning and vacuolar degeneration of PCT
| Calcium oxalate tubules in tubular lumen
53
Tubulorrhexis
Rupture of tubular basement membrane
| Seen in ATN
54
Phases of ATN
Initiation
Maintanence
Recovery
55
Phase of ATN susceptible to infection
Recovery
Also associated with polyuria
56
Causes of pyelonephritis
1.E.coli
2.proteus
3.klebsiella
Enterobacter
Strep.fecalis
57
Xanthogranulomatous pyelonephritis
Repeated pyelonephritis due to stone obstruction
58
Hexagon shaped crystal
Cysteine
59
Diamond shaped crystal
Uric acid
60
Coffin lid shaped crystal
Struvite
61
Envelope shaped crystal
Calcium oxalate dihydrate
Monohydrate is rod/dumbbell shaped
62
Stones are common in
Males
63
Common type of stone in males
Calcium oxalate
64
Common type of stone in females
Struvite
65
Stones common in both males and females
Cysteine
| Urate
66
Monohydrate oxalate crystals are the predominant form in
Ethylene glycol poisoning
67
Inhibitors of crystal formation
```
Citrate
Pyrophosphate
Diphosphate
Osteopontin
Nephrocalcin
```
68
Radiolucent kidney stones
Xanthine
Indinavir
Triamterine
69
Stone which changes color from yellow to green on air exposure
Cystine
70
Hyaline cast
Normal constituent
| Tamm horsfall protein
71
Casts in ATN
Pigmented muddy brown granular casts
72
Lipid casts are seen in
Nephrotic syndrome
SLE
toxic renal poisoning
73
Markers of oncocytoma
Carbonic anhydrase C
| Band 3
74
Benign tumor arising from intercalated cells
Oncocytoma
75
Tumors in Beckwidth wideman
Hepatoblastoma
Adrenocortical tumors
Pancreatic tumors
Rhabdomyosarcoma
76
Other name for RCC
Hypernephroma
| Grawitz tumor
77
Genetic factors in papillary RCC
Trisomy 7,16,17
t(x;1)
Loss of y in males
78
Risk factors for Grawitz tumor
```
Smoking(most important)
Hypertension
Obesity
Tuberous sclerosis
CRF
acquired cystic disease
Estrogen therapy
Asbestos exposure
```
79
Other name for papillary cancer of kidney
Chromophilic
80
Most common site of RCC
Upper pole
81
Staining of Chromopheobe cancer
Hale acid iron stain
| Colloid stain
82
Marker for chromophobe renal carcinoma
Carbonic anhydrase C
But band 3 is absent
83
Genetic alteration in Chromopheobe renal carcinoma
Extreme hypodiploidy
84
Renal Cancer with predilection for vein invasion
Papillary cancer
85
Triad of RCC
Hematuria(earliest and most common symptom)
Flank pain
Palpable mass
86
Paraneoplastic syndromes associated with RCC
```
Polycythemia/Anemia
Hypercalcemia
Hypertension
cushing
Fever
Elevated ESR
Stauffer syndrome
Feminization/masculinisation
Eosinophilia
Amyloidosis
Leukomoid reaction
```
87
Most common site of metastasis of RCC
Lung
88
Causes of hemorrhagic cystitis
ADENO virus
| Cyclophosphamide
89
Characteristic cells in hunner ulcer
Mast cells
90
Hunner ulcer is common in
Women
91
Cause of hunner ulcer
Idiopathic
| SLE
92
Hunner ulcer
Painful chronic cystitis
| Hemorrhage and fibrosis of bladder wall
93
HPE in malacoplakia
Von hansemann histiocytosis
| Michalis guttman bodies
94
Michalis guttman bodies contain
Iron
| Calcium
95
Cause of malacoplakia
Infection with e.coli,proteus
96
Sites of malacoplakia
```
Bladder
Lungs
Colon
Bones
Kidneys
Prostate
```
97
Risk factors for transitional cell cancer
```
Smoking
B naphthyl amine
Aniline
Benzidine
Pelvic irradiation
Analgesic abuse
Cyclophosphamide
```
98
Risk factors for SCC of bladder
Bladder diverticula
Schistosoma hematobium
Chronic bladder infection and irritation
99
Risk factor for adenocarcinoma of bladder
Arises from urachal remnants
| Intestinal metaplasia
100
Genetic factors in bladder cancer
9p deletion superficial papillary cancer
| 17p deletion invasive urothelial cancer
101
Most common symptom of bladder cancer
Painless hematuria
102
Worst prognosis in bladder cancer
Tumor invading muscularis mucosa(detrusor muscle)
103
Urine cytological markers of bladder cancer
```
Telomerase
DNA content
Nuclear matrix proteins
Hyaluronic acid
Hyaluronidase
Fibrin-fibrinogen degradation products
Mucins
CEA
human complement factor H
```
104
Most common benign tumor of bladder
Leiomyoma
Malignant tumor is leomyosarcoma
105
Indication for intra vesical BCG
Carcinoma in situ
| Lamina propria invasion
106
Indications for radical cystectomy
Resistant to intra vesical BCG
Muscularis invasion
CIS extending into prostatic urethra
107
Chemotherapy in bladder cancer
Thiotepa
| Mitomycin
108
Polycystin1 is localised to
Distal nephron
| Involved in cell-cell and cell-matrix interaction
109
Polycystin 2
Calcium channel
| Localised to all segments of nephron
110
Chr of NPHS
NPHS1 chr19
| NPHS2 chr1
111
Chromosomes in PCKD
Polycystin 1 chr16
| Polycystin 2 chr 4
112
Contracted kidney
Less than 8cm in length
113
Normal size of kidney
3 times length of L1 vertebra
| 2/3rd of additive length of T11,T12,L1
114
Causes of enlarged kidney
```
Diabetes
Amyloidosis
Myeloma kidney
RPGN
PCKD
b/l obstruction
```
115
Nephritic syndrome with low c3
```
PSGN
shunt nephritis
Bacterial endocarditis
Sepsis
Lupus nephritis
Cryoglobulinemia
MPGN
Crescentric glomerulonephritis
Idiopathic proliferative glomerulonephritis
Atheroembolic renal disease
Acute pancreatitis/advanced liver disease
```
116
Subtypes of FSGS
```
Collapsing
Perihilar
Cellular
Glomerular tip lesion
Not otherwise specified(NOS)
```
117
Most common type of FSGS
NOS
118
HPE feature of collapsing nephropathy
Hypertrophy and necrosis of visceral epithelium
119
Most common cause of death due to amyloidosis
Renal
120
$ Albumin is the first to appear in urine because
Has molecular weight slightly greater than the molecules normally getting filtered
121
Good prognostic factors in RPGN
Pauci immune
Non circumferential
Endocapillary proliferation
Bad prognosis
Oliguria and Azotemia at presentation
Glomerular tuft necrosis,global glomerular sclerosis
Gaps in bowman membrane,interstitial fibrosis
122
Pulmonary renal syndrome
```
Wegener
Good pasture
Leptospirosis
Hantavirus
HSP
churgstrauss
Cryoglobulinemia
Microscopic polyangitis
```
123
Papillary necrosis associated with calcification is seen in
Analgesic nephropathy
| Obstruction
124
Papillary necrosis,number of papillae affected in different diseases
Several,all of same stage(DM)
Almost all,but in different stages of necrosis(analgesic)
Few(sickle cell)
125
Balkan nephropathy
Degenerative interstitial nephropathy
126
Tumor associated with Balkan nephropathy
Transitional cell carcinoma of renal pelvis and upper ureter
127
Cause of Balkan nephropathy
Aristolochic acid
128
Megalin has homology to
LDL receptor
129
Type of glomerulonephritis in leishmaniasis
Mesangioproliferative glomerulonephritis
130
$ Peri glomerular fibrosis is typical of
Chronic pyelonephritis
131
Salt losing nephritis
Interstitial nephritis
132
Visceral leishmaniasis is caused by
L.donovani
133
Mucocutaneous leishmaniasis
L.Brasiliensis
134
Clinical features of kala azar
```
Hepatosplenomegaly
Hyperpigmentation
Lymphadenopathy
Pancytopenia
Fever
Weight loss
```
Renal amyloidosis may occur at late stage
135
Electron dense deposits in the region of hyalinosis and sclerosis with diffuse loss of foot process
FSGS
136
Diet advised in nephrolithiasis patient
Low sodium
Low protein
Normal calcium
137
Sterile pyuria
```
Acute/chronic interstitial nephritis
TB,fungal infection
Chronic pyelonephritis
Recently treated UTI
Perinephric abscess
Chronic prostatitis
```
138
Kidney finding in shock
Diffuse cortical necrosis
139
Mutation in nephronophthisis 2
Inversin
140
Mutations in nephronophthisis
Nephrocystin
141
Nephronophthisis associated with situs inversus
Type 2
142
Mode of inheritance of nephronophthisis
AR
143
Chr location of fibrocystin
6p
144
Nephronophthisis associated with retinitis pigmentosa
1,3,4
145
Infantile form of nephronophthisis
2
146
Extra-renal finding in type5 nephronophthisis
Amaurosis
147
Renal abnormalities in nephronophthisis
Medullary cysts
| Small fibrotic kidneys
148
Renal finding in type 2 nephronophthisis
Large kidneys
| Widespread cysts
149
Indications of steroid in HSP
Abdominal pain
| CNS involvement
150
Nephritigenic streptococcal strains
4,12 causing pharyngitis
| 49 causing pyoderma
151
Role of prevention of PSGN by early antibiotic treatment of strep pharyngitis or skin infection
No role
152
Indications of renal biopsy in AGN
```
Normal complement levels
No evidence of streptococcal infection
Presence of acute renal failure
Presence of nephrotic syndrome
Systemic complaints like malar rash
Persistent hematuria or proteinuria,diminished renal function and low C3 for more than 2 months
```
153
Nephronophthisis associated with hepatic fibrosis
Type3
154
_________ and ___________ may persist for several months in PSGN without any significance
Microscopic hematuria
| Mild proteinuria
