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Flashcards in Glomerulonephropathies Deck (28)
1

5 characteristics of nephrotic syndrome

1. proteinuria > 3.5 g/day
2. hypoalbuminemia
3. hypogammaglobulinemia
4. hypercoagulable state
5. hyperlipidemia and hypercholesterolemia

2

Most common cause of nephrotic syndrome in children

Minimal change disease

3

Cancer associated with minimal change

Hodgkin lymphoma

4

Minimal change findings on H&E stain, EM, and IF

H&E: normal glomeruli

EM: effacement of foot processes due to production of cytokines

IF: negative

5

Symptoms of minimal change disease

Selective loss of albumin, periorbital edema following an upper respiratory tract infection or vaccination

Has an excellent response to steroids

6

Populations most likely to have focal segmental glomerulosclerosis

Hispanics and African Americans, also associated with HIV, heroin use and sickle cell disease

7

Focal segmental findings on H&E stain, EM, and IF

H&E: focal (some glomeruli) and segmental (involving only part of the glomerulus) sclerosis

EM: effacement of foot processes

IF: negative

8

Populations most likely to have membranous nephropathy

Caucasian adults, also associated with HBV and HCV, solid tumors (lung, breast, colon), SLE or drugs (NSAIDS and pencillamine, gold)

9

Membranous nephropathy findings on H&E stain, EM, and IF

H&E: thick glomerular basement membrane

EM: subepithelial deposits with spike and dome appearance

IF: immune complex deposition giving a granular appearance

10

Membranoproliferative, type I findings on H&E stain and IF

H&E: thick glomerular basement membrane often with tram track appearance due to basement membrane splitting by mesangial ingrowth

IF: immune complex deposition giving a granular appearance

11

Diseases associated with membranoproliferative, type I

HBV and HCV

12

Membranoproliferative, type II findings on IF

IF: intramembranous dense deposits

13

Association with membranoproliferative, type II

C3 nephritic factor: autoantibody that stabilizes C3 convertase, leading to over activation of complement, inflammation and low levels of circulation C3

14

Microscopic findings in diabetic glomerulonephropathy

Sclerosis of the mesangium with formation of Kimmelstiel-Wilson nodules

15

Microscopic findings in systemic amyloidosis affecting the kidney

Amyloid deposits in the mesangium, characterized by apple-green birefringence under polarized light after staining with Congo Red

16

4 characteristics of nephritic syndrome

1. limited proteinuria < 3.5 g/day
2. oliguria and azotemia
3. periorbital edema and hypertension
4. RBC casts and dysmorphic RBCs in urine

17

Acute poststreptococcal glomerulonephritis findings on H&E stain, EM, and IF

H&E: glomeruli enlarged and hypercellular

EM: subepithelial immune complex humps

IF: granular appearance due to IgG, IgM, and C3 deposition along GBM and mesangium

18

Symptoms of PSGN

Peripheral and periorbital edema, dark urine, and hypertension usually 2-3 weeks following infection

19

RPGN findings on EM, and IF

EM: crescents in Bowman's space composed of fibrin and macrophages

IF: varies on disease

20

RPGN condition with linear IF pattern

Goodpasture syndrome: antibody against collagen in glomerular and alveolar basement membranes

21

RPGN conditions with granular IF pattern

PSGN or diffuse proliferative glomerulonephritis

22

RPGN conditions with negative IF pattern (pauci immune)

Wegener's, microscopic polyangiitis, and Churg-Strauss

23

Differentiate between microscopic polyangiits and Churg-Strauss

Both are p-ANCA+

Granulomatous inflammation, eosinophilia, and asthma are only associated with Churg-Strauss

24

Berger's disease findings on H&E stain, EM, and IF

H&E: mesangial proliferation

EM: mesangial IC deposits

IF: IgA-based IC deposits in mesangium

25

Symptoms of Berger's disease

Usually presents in childhood with episodic gross or microscopic hematuria with RBC casts usually following mucosal infections

26

Mutation found in Alport syndrome and inheritance pattern

Inherited defect in type IV collagen, most commonly X-linked

27

Symptoms of Alport syndrome

Isolated hematuria, sensory hearing loss, and ocular disturbances

28

Diffuse proliferative glomerulonephritis findings on H&E stain, EM, and IF

H&E: "wire looping" of capillaries

EM: subendothelial and sometimes intramembranous IgG-based ICs often with C3 deposition

IF: granular appearance