B5.039 - Prework 2 Patterns of Glomerular Injury

Question 1

how do you describe all glomeruli

Answer 1

focal or diffuse

Question 2

what do focal and diffuse mean

Answer 2

focal - less that half

diffuse - half or more

Question 3

how do you describe a single glomerulus

Answer 3

segmental or global

Question 4

what do segmental or global mean

Answer 4

segmental - portions of glomerulus affected

global - entire glomerulus affected

Question 5

segmental or global

Answer 5

segmental

Question 6

segmental or global

Answer 6

global

Question 7

subtypes of hypercellularity

Answer 7

intrinsic - within glomerular tuft

extrinsic - in glomerulus but outside glomerular tuft

Question 8

types of intrinsic hypercellularity

Answer 8

mesangial, endocapillary, lobular

Question 9

types of extrisic hypercellularity

Answer 9

extracapillary, crescents

Question 10

Answer 10

normal glomerulus

Question 11

describe a normal capillary in the glomerulus

Answer 11

patent lumina, smooth GBM contours, small endothelial cells, inconspicuous podocytes

Question 12

describe a normal mesangium

Answer 12

1-3 cells per contiguous area; small amount of matrix

Question 13

Answer 13

endocapillary intrinsic hypercellularity

the cells are encroaching upon capillary lumina

hard to find open capillary lumina

Question 14

Answer 14

mesangial intrinsic hypercellularity

patent capillary lumina but misangeal matrix abnormal

Question 15

Answer 15

crescent extrinsic hypercellularity

Question 16

Answer 16

crescent extrinsic hypercellularity

silver stain highlights BM

Question 17

intrinsic HC often associated with what

Answer 17

immune complex deposition

Question 18

extrinsic HC often associated with what

Answer 18

GBM break/rupture

goodpasture, ANCA vasculitis…

Question 19

Answer 19

double contour BM

“tram tracking” extra BM laid down due to injury

Question 20

double contours typically due to what

Answer 20

endothelial/subendothelial injury

endothelial cells make new BM, so do podocytes if they need to

can be accompanied by mesangial cell migration (interpositioning) or immune cell infiltration

Question 21

Answer 21

mesangial matrix expansion

glue that holds everything together shows tons of matrix

Question 22

Answer 22

nodular mesangial expansion

seen in DM

Question 23

causes of MME

Answer 23

DM, HTN

immunoglobulin or immune complex deposition

Question 24

Answer 24

capillary pattern (granular) glomerular injury

Question 25

Answer 25

mesangial pattern glomerular injury

Question 26

Answer 26

GBM linear pattern think goodpastures diffuse

Question 27

what are arrows pointing to

Answer 27

granular deposits

Question 28

Answer 28

fibrillar desposits seen in amyloid

Question 29

Answer 29

tubular pattern thumbprint deposit seen in lupus

Question 30

when do you seen thrombosis in glomeruli

Answer 30

as part of thrombotic microangiopathy also in DIC

Question 31

causes of TMA

Answer 31

SLE, HUS/TTP, PSS, HTN

Question 32

Answer 32

Fibrin thrombus TMA

Question 33

tuft necrosis is associated with what

Answer 33

immune mediated injury

Question 34

Answer 34

tuft necrosis nuclear debris, karyorexis

Question 35

insudate

Answer 35

when fluid passes thru capillary or epithelial cell and causes glassy appearance

Question 36

Answer 36

scar in glomerulus in bowmans space

Question 37

Answer 37

entire glomerulus scarred tf up

Question 38

Answer 38

segmental sclerosis

Question 39

Answer 39

scar with associated insudate (note glassy/hyaline apperance of cells at bottom)