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Undeleted > Exam 1 Path/Clinical > Flashcards

Exam 1 Path/Clinical Flashcards

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1
Q

Azotemia

A

increased serum BUN/creatinine

decreased GFR

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2
Q

Cause of prerenal azotemia

A

kidney hyoperfusion

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3
Q

Nephritic sx

A 
<3.5 protein loss per day
azotemia
HTN
hematuria
inflammatory process
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4
Q

Nephrotic sx

A

> 3.5 protein loss per day
hypoalbuminemia
hyperlipidemia

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5
Q

Cause of hyalinosis

A

accumulation of eosinophilic material

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6
Q

Acute proliferative GN characteristics

A

post-strep GN, 1-4wks after
6-10y/o
immune complex deposition
glomerular proliferation

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7
Q

Acute proliferative GN histo

A

hypercellularity
red cell casts
mesangial/GBM deposition of IgG/IgM/C3

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8
Q

Sx of acute proliferative GN

A

young child post sore throat
red cell casts in urine
periorbital edema
decreased serum C3

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9
Q

Rapidly progressive GN characteristics

A

crescentic GN
loss of renal fxn
epithelial proliferation
oliguria/nephritic syndrome

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10
Q

Types of rapidly progressive GN

A

Anti-GBM (Goodpastures)
immune complex deposition (HSP)
Pauci-immune (c-ANCA)

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11
Q

Fluorescence of RPGN types

A

anti-GBM- linear
immune complex- granular
pauci-immune- no deposition

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12
Q

Clinical sx of rapidly progressive GN

A

hematuria
HTN/edema
anti-GBM/ANA/ANCA abs depending on type

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13
Q

Membranous nephropathy characteristics

A

irregular immune complex deposition
granular on IF
nephrotic syndrome in adult whites
assc with SLE/tumors/infections

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14
Q

Clinical sx of membranous nephropathy

A

nephrotic syndrome
hematuria
mild HTN
sclerosis of glomeruli

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15
Q

Minimal change disease characteristics

A

ages 2-6
follow infection or vaccine
nephrotic syndrome in children
response to corticosteriods

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16
Q

Minimal change disease sx

A

massive proteinuria
good renal fxn
assc with Hodgkin lymphoma in adults

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17
Q

Focal segmental glomerulosclerosis characteristics

A

nephrotic syndrome

ass with Sickle Cell/HIV/heroin use/blacks

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18
Q

Focal segmental glomerulosclerosis histo

A 
lipid droplets/foam cells
hyalinosis of afferent arterioles
retraction/collapse of glomeruli
effacement of foot processes (flattening)
IgM/C3 in mesangium
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19
Q

Membranoproliferative GN characteristics

A

nephrotic/nephritic combo
hypercellular glomeruli
crescents
tram track appearance with silver stain

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20
Q

Type 1 MPGN

A

subendothelial deposits

granular C3 deposition, some IgG

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21
Q

Type II MPGN

A

ribbon like, irregular GBM
granular or linear
C3 in mesangium in circular ring
no IgG/Cl4/C4

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22
Q

IgA nephropathy characteristics

A

Berger disease
IgA deposition in mesangium
hematuria
nephritic/sometimes nephrotic

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23
Q

Microscopy of IgA nephropathy

A

mesnagial IgA deposition

C3/properdin

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24
Q

Henoch-Schonlein purpura characteristics

A 
purpuric skin lesions on arm/legs
nonmigratory arthralgias
hematuria
nephritic/nephrotic syndromes
3-8y/o
follows URT infection
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25
Morphology of HSP
crescentic glomerulonehpritis mesangial proliferation deposition of IgA in mesangial regions
26
Alport syndrome characteristics
``` hematuria/red cell casts nerve deafness eye disorders X-linked 5-20y/o ```
27
Alport syndrome morphology
GBM thinning splitting of lamina dense (basket weave appearance) glomerulosclerosis
28
Chronic glomerulonephritis characteristics
crescentic glomerulonephritis contraction of kidneys thin cortex atrophy of tubules
29
Micro and macroabluminuria levels
micro: 30-300mg/day macro: >300mg/day
30
Urinalysis measurement
only albumin
31
Nephrotic syndrome in children
minimal change disease
32
Nephrotic syndrome with adults
membranous and focal sclerosis
33
Complications of nephrotic syndrome
hyperlipidemia | hypercoagulability
34
Tubular proteinuria protein loss
no albumin loss | 500-2000mg/day
35
Orthostatic proteinuria protein loss
daytime urine has higher proteinuria
36
Overflow proteinuria protein loss
light chains/small MW proteins lost | multiple myeloma assc
37
False (+) for hematuria
foods/drugs | myoglobing-rhabdomyolysis (no RBC's)
38
What are red blood cell casts?
Tamm Horsfall protein + RBC's in tubules
39
Demographic for minimal change disease
children
40
Demographic for focal segmental GN
black HIV heroin users
41
Demographic for membranous nephropathy
caucasian adults
42
Demographic for IgA nephropathy
Asian Hispanics American Indian
43
Microscopy of minimal change disease
fusion of foot processes
44
Microscopy of focal segmental GN
focal/segmental damage
45
Microscopy of membranous nephropathy
subepithelial immune deposits (PLA2R) | thick basement membrane
46
Microscopy of IgA nephropathy
mesangial IgA deposition
47
Nephrotic syndromes
minimal change disease focal segmental GN membranous nephropathy
48
Postinfection GN characteristics
2-3wks post infection nephritic low complement subepithelial humps
49
Membranoproliferative GN
assc with Hep C cryoglobulinemia nephritic syndrome/sometimes nephrotic
50
Types of cryoglobulinemia
I-monoclonal IgM, multiple myeloma/Waldenstrom assc II-monoclonal IgM against IgG III-polyclonal IgM against IgG, Hep C/rheumatoid factor assc
51
Glomerulonephritis diseases with low serum complement
post infection membranoproliferative cryoglobulinemia lupus nephritis
52
Membranoproliferative GN microscopy
splitting of thick membranes tram tracking cryoglobulin precipitates in capillaries subendothelial immune complex deposition
53
Hyperacute transplant rejection cause
preformed Abs react with allo-Ags | thrombosis/necrosis results
54
Membranoproliferative GN type 1
C3 and IgG/IgM classic C pathway rail track appearance
55
Membranoproliferative GN type 2
C3 nephritic factor, C3 convertase stabilized alternative C pathway ribbon appearance
56
Focal segmental GN asscs
HIV heroin use Sickle cell disease Hispanics/blacks
57
Membranous nephropathy assc
``` white adult male Hep B/C tumors SLE drugs (NSAIDS/penicillamine) ```
58
Diabetes mellitus characteristics on kidneys
nonenzymatic glycosylation results in hyaline arteriolosclerosis Kimmelstiel-Wilson nodules
59
Systemic amyloidosis characteristics on kidneys
amyloid deposits in mesangium nephrotic syndrome Congo red/apple green birefringence
60
Nephrotic syndrome groupings
FSGS/MCD- foot process effacement MN/MPGN-deposits of immune complexes DM/amyloidosis-nodular glomerulosclerosis
61
Ischemic acute kidney injury sign
hyaline/granular casts | from Tamm Horsfall protein
62
Toxic acute kidney injury causes
HgCl-acidophilic inclusions CCl4-neutral lipids in cells Ethylene glycol-vacuolar degeneration/calcium oxalate crystals
63
Acute pyelonephritis immune cells present
neutrophils
64
Chronic pyelonephritis morphology
thyroidization-flat epithelium/dilated tubules | fibrosis
65
Analgesic nephropathy clinical picture
women with muscle pain | hypochondriac
66
Urate nephropathy types
uric acid crystals/lymphoma monosodium urate crystals/Tophus uric acid stones/gout
67
Types of urolithiasis
calcium oxalate/phosphate, most common Mg/ammonium/phosphate, bacterial/staghorn stone uric acid, radiolucent cystine, congenital defect
68
AD polycystic kidney disease
bilateral enlarged kidneys cysts filled with serous/red-brown fluid from tubules
69
AR polycystic kidney disease
``` PKHD1/2 gene mutation childhood onset smooth external surface of kidney spongelike appearance with small cysts portal fibrosis/liver cysts ```
70
Medullary sponge kidney
dilation of medullary collecting ducts assc with Marfans/Carolis/Ehlers-Danlos sponge like appearance of medulla
71
Renal papillary adenoma
branching/papillomatous structure | metastasizes over 3cm
72
Angiomyolipoma
hamartoma assc with tuberous slcerosis spontaneous hemorrhage assc
73
Oncocytoma
tan/mahogany brown color well encapsulated lg eosinophilic cells
74
Renal cell carcinoma
yellow color 60-70's tobacco increases risk from tubular epithelium
75
Clear cell carcinoma
most common renal cell carcinoma orange/yellow color upper pole of kidney chromosome 3p deletion
76
Asscs with clear cell carcinoma
von Hippel-Lindau | tuberous sclerosis
77
Papillary carcinoma
fibrous capsule | foamy macrophages/intracellular hemosiderin
78
Genetics of papillary carcinoma
sporadic: trisomy 7,16.17, loss of Y familial: trisomy 7
79
Chromophobe renal carcinoma
tan brown/well circumscribed compact architecture of nests halo around nuclei (+) Hale's colloidal iron stain
80
Collecting duct carcinoma
Bellini duct carcinoma infiltrative borders hobnail cell lined mucin producing/desmoplastic response
81
Acute transplant rejection
5-7 days after transplant HS type IV immunosuppression helps lymphocytes predominant cell type
82
Benign nehproslcerosis
caused by HTN hyaline arteriosclerosis assc with diabetes and fibromuscular dysplasia
83
Malignant nephrosclerosis
from malignant HTN uremia causes death fibrinoid necrosis/hyperplastic arteriosclerosis angiotensin II released, perpetuates damage
84
Renal artery stenosis
number 1 cause-atheromatous plaque | number 2-FMD, women 20-40y/o
85
Factors with thrombotic microangiopathy
endothelial injury-vasoconstriction | platelet aggregation-von Willebrand factor/ADAMTS-13
86
Childhood hemolytic uremic syndrome
follows EHEC infection shigella like toxin assc with petting zoos/undercooked meats Verocytotoxin causes platelet aggregation
87
Adult (atypical) hemolytic uremic syndrome causes
``` SLE pregnancy malignant HTN immunosuppressants factor H complement defect ```
88
Thrombotic thrombocytopenic purpura
hemolytic anemia purpura neuro sx caused by defect of ADAMTS-13 (thins blood)
89
ANCA (+) disease
Wegener's granulomatosis microscopic polyangitis Churg-Strauss syndrome
90
Wegener's granulomatosis
chronic sinusitis ANCA (+) noncaseating granulomas nephritic syndrome
91
Microscopic polyangitis vs Wegener's granulomatosis
similar to Wegener's but no granulomas
92
Isolated pauci-immune GN vs Wegener's granulomatosis
Wegener's but limited to the kidney (no lung involvement)
93
Churg-Strauss syndrome
``` allergic rhinitis worsening asthma rash with palpable purpura peripheral neuropathy nephritic syndrome ANCA (+) eosinophilia with small vessel vasculitis ```
94
Goodpasture's disease
anti-GBM against lungs and kidneys nephritic syndrome crescentic, necrotizing GN linear deposition of IgG on IF
95
Lupus nephritis
young women with SLE can mimic any glomerular disease "full house" on IF
96
SLE sx
photosensitive rash Raynaud's alopecia anti-dsDNA and ANA (+)
97
Diabetic nephropathy
Kimmelstiel-Wilson nodules | nonenzymatic glycosylation
98
Amyloidosis on kidneys
primary-light chains assc with multiple myeloma secondary-amyloid Congo red/apple green birefringence
99
Sickle cell disease on kidneys
hematuria/proteinuira from sickled cells | decreased renal conc mechanism
100
Diffuse cortical necrosis causes
OB emergency septic shock extensive surgery
101
Henoch-Schonlein purpura
small vessel vasculitis palpable purpura with IgA deposits on bx children/young adults following URT infection
102
HIV assc nephropathy
increased in blacks FSGN collapsing glomeruli
103
Minimal change disease findings
foot process effacement
104
Membranous GN findings
granular IF | subepithelial deposits
105
Focal segmental GN findings
no deposits on EM | segmental GS
106
IgA nephropathy findings
mesangial proliferation | IgA deposits in mesangium
107
Post strep GN/acute proliferative GN findings
garland on IF | subepithelial deposits
108
ANCA diseases findings
crescentic, necrotizing GN | no deposits/IF
109
Goodpasture's findings
crescentic, necrotizing GN linear IF no deposits
110
Membranoproliferative GN findings
granular IF subendothelial/mesangium deposits tram track appearance (membrane splitting)
111
Lupus findings
"full house" on IF | any histo of other diseases
112
Diabetes mellitus findings
nodular GS | thick basement membrane
113
Amyloidosis findings
nodular GS Congo red (+) fibrils
114
HIV assc nephropathy findings
collapsing FSGN | reticular inclusion bodies

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