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Anatomic pathology > Kidney > Flashcards

Flashcards in Kidney Deck (379)
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330

Lupus nephritis: Class VI.

Global sclerosis involving more than half of glomeruli.

331

Lupus nephritis: Definition of endocapillary proliferation (3).

Proliferation of mesangial and endothelial cells.

Inflammatory cells may be marginated.

Glomerulus appears lobulated and hypercellular.

332

Lupus nephritis: "Wire loops".

Large subendothelial deposits.

Best seen with trichrome stain.

333

Lupus nephritis: Definition of extracapillary proliferation.

Cellular crescents.

334

Lupus nephritis: Interstitial changes (2).

Acute: Plasmacytic inflammation and edema.

Chronic: Fibrosis and tubular atrophy.

335

Lupus nephritis: Vascular changes.

Variable.

336

Lupus nephritis: Silver stain (2).

Classes III and IV: Double contours.

Class V: Spikes and holes in the GBM.

337

Lupus nephritis: Direct immunofluorescence (2).

Granular distribution of all immunoglobulins and complement.

C1q is always present.

338

Electron microscopy of lupus nephritis:

A. Appearance of deposits.
B. Another abnormal structure.

A. May resemble fingerprints.

B. Tubuloreticular inclusions in endothelial cells.

339

Diabetic nephropathy: Early sign.

Microalbuminuria: Occurs more than 5 years before onset of diabetes.

340

Diabetic nephropathy: Stage 1 (2).

Light microscopy: Normal glomeruli.

Em: Thickened GBM.

341

Diabetic nephropathy: Stage 2 (2).

LM: Diffuse mesangial expansion.

EM: Thickened GBM; increased collagen in mesangium.

342

Diabetic nephropathy: Stage 3 (2).

LM: Diffuse nodular glomerulosclerosis (Kimmelstiel-Wilson lesion); abundant hyalinosis.

343

Diabetic nephropathy: Stage 4.

More than half of glomeruli are sclerotic.

344

Diabetic nephropathy: Types of hyaline lesion (3).

Fibrin caps (hyalinosis of capillaries).

Capsular drops.

Arteriolar hyalinosis.

345

Diabetic nephropathy: Interstitial changes (2).

Fibrosis and tubular atrophy.

346

Diabetic nephropathy: Vascular change.

Arteriolar hyalinosis involving afferent and efferent arterioles.

347

Diabetic nephropathy: Special stain.

Silver stain emphasizes sclerotic nodules.

348

Diabetic nephropathy: Direct immunofluorescence (2).

GBM, tubular BM: Linear IgG and albumin.

Areas of glomerular and vascular hyalinosis: C3 and IgM.

349

Electron microscopy of diabetic nephropathy:

A. Glomerular basement membrane.
B. Mesangium.

A. Diffuse and sometimes massive thickening.

B. Sclerosis; collagen fibrils.

350

Diabetic nephropathy vs. anti-GBM disease (2).

Diabetic nephropathy:

− Usually has no crescents.
− Linear deposition of albumin.

351

Fabry's disease: Affected organs (4).

Skin.

Nervous system.

Kidneys.

Gastrointestinal tract.

352

Fabry's disease:

A. Inheritance.
B. Gene and its product.
C. Pathogenesis.

A. X-linked.

B. AGAL; α-galactosidase A.

C. Accumulation of lipids in cells.

353

Fabry's disease:

A. Histopathology.
B. Special stain.

A. Lipid vacuoles in podocytes, tubular epithelial cells, and endothelial cells.

B. Toluidine blue reveals the inclusions.

354

Fabry's disease: Electron microscopy.

Lipids have lamellated appearance (zebra bodies).

355

Fabry's disease: Drug that can cause similar inclusions.

Chloroquine.

356

Renal amyloidosis: Presentation.

Nephrotic syndrome.

357

Renal amyloidosis: Immunoglobulin-derived amyloid (2).

AL, especially λ light chain.

Heavy chains.

358

Renal amyloidosis:

A. Most common genetic form.
B. Associated with chronic inflammation.
C. Associated with dialysis.

A. α-Fibrinogen.

B. AA (serum amyloid A).

C. β₂-microglobulin.

359

Renal amyloidosis: Other forms of amyloid (2).

Leukocyte chemotactic factor 2.

Transthyretin.