7. Nephrotic Syndrome Flashcards
A 27 year old male presents to the clinic with left side flank pain. Urinalysis shows fatty casts in urine with high protein and cholesterol content. The patient states that they are HIV positive, and you diagnose them with a nephrotic syndrome. Which nephrotic syndrome BEST fits this description? (MG)
A. Minimal Change Disease B. FSGS C. Membranous Nephropathy D. MPGN E. Diabetes Mellitus F. Systemic Amyloidosis
B. FSGS
Focal segmental glomerulosclerosis: very common with HIV pos people and heroin users.
A 64 year old female presents to the clinic with left side flank pain. Urinalysis shows fatty casts in urine with high protein and cholesterol content. You perform a renal biopsy and view the sample with H&E stain under light microscopy. The glomeruli appear normal, but the paitent has a nephrotic syndrome. What causes the effacement of foot processes seen under EM in Minimal Change Disease? (MG)
A. Complement deposits
B. Mesangial proliferation
C. Cytokines
D. Kimmelstiel-Wilson bodies
C. Cytokines
A 27 year old morbidly obese man male presents to the clinic with left side flank pain. Urinalysis shows fatty casts in urine with high protein and cholesterol content. You diagnose them with a nephrotic syndrome. Which nephrotic syndrome BEST fits this description?
A. Minimal Change Disease B. FSGS C. Membranous Nephropathy D. MPGN E. Diabetes Mellitus F. Systemic Amyloidosis
RFA
Ans. FSGS- FSGS is also secondary to Morbid obesity
A 27 year old morbidly obese man male presents to the clinic with left side flank pain. Urinalysis shows fatty casts in urine with high protein and cholesterol content. IF finds a membrane with fine granular deposits of IgG and C3. You diagnose him with a nephrotic syndrome. What would you expect to find under EM examination ?
A. Foot processes & effacement B GMB spike formation C. Subepithelial humps D.Subendothelial fibrils E. Mesangial and Subendothelial deposits
RFA
Ans. B From the patients history name the IF with IgG and C3 in the membrane it can be concluded that the patient has Membranous Nephropathy. And how the EM would present.
A. Foot processes & effacement- is a presentation of MCD or FSGS
C. Subepithelial humps- is a presentation of post Strep GN
D. Subendothelial fibril- This is the EM presentation of Amyloidosis
E. Mesangial and subendothelial deposits- is an EM presentation of IgA nephropathy a Nephritic syndrome
A 45 y/o male is diagnosed with an idiopathic nephrotic syndrome. Silver stain shows spikes and domes. IF shows IgG and C3. Which of the following would also be present?
A. Kimmelsteil-wilson nodules B. AA Amyloids C. AL Amyloids D. PLA 2R antibodies E. Subendothelial Humps
SZ
Ans D. PLA 2R antibodies
A 65 y/o diabetic man is diagnosed with diabetic nephropathy. Kimmelsteil Nodules are found on H&E. What are these nodules composed of?
A. Fibrin and macrophages B. Fibrin and Lipids C. Fibrin and neutrophils D. Lipids and Plasma Cells E. Macrophages and Plasma cells
SZ
Ans B. Fibrin and Lipids
