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
