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Flashcards in Hefs Lectures - Kidney Deck (25)
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1
Q

what do you think if you see a solid tumor/mass in the kidney in someone 60-70 y/o?

A

RCC

-worry about cancer

2
Q

Angiomyolipoma

A
  • high risk in PREGNANCY due to hemorrhage
  • seen in tuberous sclerosis
  • mutations in TSC1/TSC2
  • nucleus FLAT and pushed to SIDE
3
Q

Renal Papillary adenoma

A
  • benign tumor of tubular epithelium

- benign unless >3cm -> malignant

4
Q

oncocytoma

A
  • benign tumor of collecting ducts

- Mahogany- brown color w/ central scars

5
Q

renal cell carcinoma

A
  • adults 60-70 y/o
  • tobacco #1 cause
  • Von-Hippel-Lindau -> loss of VHL
  • Hereditary papillary carcinoma -> MET mutation
  • SOLID mass
  • Paraneoplastic syndrome
  • metastatize to renal vein -> PE
6
Q

clear cell RCC

A
  • most common
  • tumor of PCT
  • vacuole w/ nucleus in CENTER
7
Q

Papillary carcinoma RCC

A
  • tumor of DCT
  • FOAM cells
  • Psammoma bodies
8
Q

Chromophobe type RCC

A
  • pale clear cells

- PERINUCLEAR HALO

9
Q

Urothelial Carcinomas

A
  • malignant tumor of renal pelvis
  • cause -> SMOKING
  • Lynch syndrome and analgesic nephropathy
10
Q

Wilm’s tumor

A
  • blastema (epithelial + mesenchyme)
  • children 1-6 y/o
  • WAGR, Denys-Drash, BWS
  • FISHFLESH-like grey-white to cream yellow
  • myxomatous or cartilage filled
11
Q

pathologic response to glomerular injury - hypercellularity

A

CRESCENT formation -> thick BM reducing filtration

12
Q

pathologic response to glomerular injury - Sclerosis

A

COLLAGEN matrix -> obliterate BV lumen

13
Q

podocyte injury

A
  • PERMANENT damage

- lead to proteinuria

14
Q

Nephritic syndrome

A
  • BLOOD in urine (hematuria)

- proteinuria (<3g/day)

15
Q

Nephrotic syndrome

A
  • PROTEIN in urine (proteinuria) - >3g/day

- see hyperlipidemia & lipids in urine

16
Q

what do immune complexes look like on IF?

A

-PATCHY, GRANULAR deposition -> “starry sky”

  • can be circulating or local deposits
  • local seen in GAS
17
Q

immune complexes in mesangium?

A

IgA nephropathy (mild)

18
Q

sub endothelial immune complexes?

A

-membranoproliferative glomerulonephritis

19
Q

subepithelial immune complexes?

A

-membranous nephropathy (acute glomerulonephritis)

20
Q

anti-GBM disease

A
  • type 4 collagen in GBM becomes antigenic -> Abs bind to antigens -> LINEAR on IF
  • normally due to IgG or C3
  • ex. Goodpasture’s syndrome
21
Q

ANCA

A
  • Abs against NEUTROPHILS -> fast progression of GN

- seen in Wegener’s granulomatosis and Churg-Strauss

22
Q

EACA

A

-Abs against the ENDOTHELIUM -> vasculitis and GN

23
Q

IgA Nephropathy (berger)

A
  • IgA against the MESANGIUM
  • most common type of glomerulonephritis
  • treat w/ STEROIDS

-crescent formation due to mesangial proliferation

24
Q

Alport syndrome

A
  • X-linked
  • defect in type 4 collagen
  • thinning and splitting of GBM -> hematuria
25
Q

Thin Basement membrane disease

A
  • cause benign familial hematuria**
  • THIN GBM -> mild and good prognosis
  • alpha 3,4 gene mutations of type 4 collagen
  • CANNOT treat w/ steroids