Path 2 Glomerular Disease Flashcards Preview

Test 9 > Path 2 Glomerular Disease > Flashcards

Flashcards in Path 2 Glomerular Disease Deck (44):
1

Normal glomerular measurement

BM and podocytes are same width

2

Inside v outside lining gaps

-Fenestrae inside between Endothelial cells
-Filtration slits outside between Epithelial cells (podocytes)

3

Nephrotic syndrome

Increased BM permeability
-Proteinuria, hypoalbuminemia
-Generalized edema
-Hyperlipidemia and hypercholesterolemia

4

Minimal change disease

Lipoid nephrosis (nephrotic syndrome)
-Age 2-6
-No immune complex deposition
-Tx with steroids

5

Minimal change disease gross appearance

Lipid laden cortices

6

Minimal change disease histology (3)

-Normal glomeruli
-Lipid accumulation in proximal convoluted tubules
-Fusing of foot processes (epithelial)

7

Focal segmental glomerulosclerosis

Sporadic partial glomerular scarring
-Same clinical as MCD
-Older patients, can't Tx with steroids
-IgM and C3 immune complex deposition

8

Focal segmental glomerulosclerosis

-Primary
-Secondary (HIV, heroin, IgA nephropathy)

9

Membranous GN

Nephrotic syndrome in teenagers and young adults
-IgG, C3 immune complex deposition
-Doesn't respond to steroids

10

Membranous GN stain

PAS

11

Minimal Change Disease stain

Fat stain

12

Membranous GN histology (3)

-Thickened capillary loops
-Spike and dome appearance
-Granular immunofluorescence

13

Membranous GN EM

Thickened BM with immune complex nodules

14

Membranous GN etiology

-Idiopathic
-SLE, infections, drugs, malignancy

15

Diabetic nephropathy

Nephrotic syndrome

16

Diabetic nephropathy glomerulus histology (4)

Kimmelstiel-Wilson nodules
-Fibrin caps
-Increase in mesangial matrix
-Diffuse glmerulosclerosis

17

Diabetic nephropathy extra-glomerulus histology (2)

-Sclerosed afferent & efferent arterioles
-Armanni-Ebstein lesions (glycogen in tubules) in chronic hyperglycemia

18

Diabetic nephropathy EM (2)

-Markedly thickened BM
-Mesangial matrix accumulation

19

Amyloidosis

Nephrotic syndrome
-Subendothelial and mesangial deposits

20

Amyloidosis EM

Criss-cross fibrillary pattern

21

Amyloidosis histology (2)

-Congo Red stain
-Birefringence under polarized light

22

Lupus Nephropathy Class I

No observable renal involvement

23

Lupus Nephropathy Class II

Mesangial glomerulonephritis

24

Lupus Nephropathy Class III

Focal proliferative glomerulonephritis
-Less than half of glomeruli involved, but individual damage can be extensive

25

Lupus Nephropathy Class IV

Diffuse proliferative glomerulonephritis

26

Lupus Nephropathy Class V

Membranous glomerulonephritis
-Intra and extramembranous immune complex deposition

27

Lupus Nephropathy histology (5)

-Extensive inflammatory glomerular scarring
-Subendothelial and mesangial immune complex deposition
-Wire loop lesions
-Tubular reticular structures
-Fingerprint patterns pathognomonic

28

Nephritic syndrome

Inflammatory rupture of glomerular capillaries
-oliguria
-hematuria (w/RBC casts)
-azotemia
-HTN

29

Acute Proliferative Poststreptococcal GN

Prototypical nephritis
-IgG/C3 Immune complexes between epithelial foot processes -> PMN attack -> hemorrhage
-Complete recovery in all children, 60% adults
-Analogous to rabbit "serum sickness"

30

PSGN gross appearance

Petechial hemorrhages covering surface of kidney

31

PSGN histology

-Glomeruli enlarged, hypercellular (mesangial, endothelial, PMN), "bloodless"
-Granular immunofluorescence

32

PSGN EM

Subepithelial immune complexes

33

PSGN lab levels

-Decreased serum C3
-Increased ASO titer

34

Rapidly Progressive GN
-mechanism, cause, prognosis

Cresentic GN
-Proliferation of parietal epithelial cells of bowmans capsure
-Can be complication of PSGN
-Renal failure over weeks to months

35

Crescentic GN (RPGN) types

-ANCA positive
-ANCA negative
-Anti-GBM (Goodpasture)
-Immune complex (ASO, SLE, IgA)

36

Goodpasture syndrome

Antiglomerular BM antibodies
-attacks glomeruli and alveoli
-linear immunofluorescence for IgG

37

Alport syndrome - cause, histology, clinical

Type IV collagen mutation (alpha-5 chain)
-Rarefaction and splitting of BM lamina densa
-Hereditary nephritis, nerve deafness, ocular disorders (cataracts, lens dislocation)

38

Berger disease

IgA nephropathy
-IgA deposits in mesangium
-Recurrent hematuria in youth, often benign

39

IgA nephropathy as a component

Henoch-Schonlein purpura
-Skin purpura
-GI pain & bleeding
-Joint arthritis
-Kidney IgA nephropathy

40

Membranous GN v Membranoproliferative GN

BM v BM and Mesangium

41

Membranoproliferative GN histology (4)

-Tram-track BM (doubled)
-Lobular pattern
-Mesangial proliferation (hypercellular)
-Collapse of capillaries

42

Type 1 Membranoproliferative GN

Immune complex nephritis
-unknown antigen
-striking tram-track

43

Type 2 Membranoproliferative GN

Dense Deposit Disease
-C3 nephritic factor
-Serum C3 markedly reduced

44

Chronic GN

End-stage kidney
-Marked renal failure
-HTN
-Small pale kidneys
-Hyaline arteriolosclerosis
-Interstitial fibrosis