Puthoff Lecture 1 Flashcards by Alex Hamidi

What is Berger disease?

Damage is limited to where?

Renal IgA nephropathy

Glomerulus

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What is an IgG plasma malignancy with Kappa light chains?

What are the light chain deposits called?

Multiple myeloma

Bence-Jones

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HIV patients with FSGS most likely to develop what?

More common in who?

Collapsing variant

Blacks

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What disease shows a tri chrome stain (blue) with replacement of virtually all glomeruli?

Chronic glomerulonephritis

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Membranous Glomerulopathy has involvement with what?

MAC

IgG4

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Morphology of Membranous Glomerulopathy?

Spike and dome appearance on Silver stain

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People with CKD have a high prevalence of what?

Associated with what?

Increased risk for what?

Hyperhomocysteinemia

Folate deficiency

Stroke

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What disease is characterized IgA nephropathy and systemic disease?

What symptoms?

Henoch-Schonlein purpura (HSP)

Purpura, abdominal viscera

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What is the Pathogenesis of MPGN type II?

Means what?

C3NeF nephritic factor

Decreased serum C3
Increased C1q and C4

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What is described by uremia, persistent albuminuria, that may be clinically silent?

Chronic kidney disease

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What is the most common cause of ESRD?

2nd?

Diabetes

HTN

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What clinical finding characterizes MPGN type I?

Type II?

Proteinuria

Hematuria

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Name the 3 types of RPGN and give examples

1 - anti-GBM antibody (Goodpasture)
2 - immune complex (lupus)
3 - Pauci-immune (ANCA)

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What disease has characteristic “tram tracking”?

MPGN type I

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What disease shows Mesangial cellular proliferation and IgA deposition on IF?

IgA nephropathy

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What disease is characterized by in situ immune complex formation of PLA2R antigen?

Membranous nephropathy

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Morphology of RPGN?

3 main things

Crescent shape of visceral and parietal epithelial cells
Obliteration of urinary space
Infiltrates of macrophages and leukocytes

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DDD occurs how?

What type is it?

Primary renal disease in children

MPGN type II

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What are the 3 major pathologic responses of the glomerulus to injury?

Hypercellularity
BM thickening/deposition
Hyalinosis and sclerosis

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What is the most common cause of Nephro sclerosis in U.S. Adults?

Who is there a greater incidence in?

primary FSGS

Hispanics, Blacks

What defines uremia?

Azotemia plus clinical findings

What characterizes ESRD?

GFR

3 major characteristics of nephritic syndrome

Hematuria
HTN
Mild-moderate proteinuria

What disease is subepithelial humps found in?

Acute glomerulonephritis

Treatment for anti-glomerular BM disease?

Plasmapheresis

what does EM of RPGN show?

GBM disruption | Fibrin

What disease occurs mostly in older children and younger adult males with a family history component that has hematuria following a uri? Know associations with gluten enteropathy and liver disease?

IgA nephropathy

Diffuse proliferative GN is characterized by what?

Hypercellularity | Leukocyte infiltration

What are the 2 most common etiologies of nephrotic syndromes in systemic diseases?

DM | SLE

What are the 6 main nephrotic syndromes? Think of groups of 2 like in pathoma

MCD and FSGS Membranous and Membranoproliferative GN DM and systemic amyloidosis

Membranous Glomerulopathy changes to the structure of the kidney?

Effaced foot processes thickened GBM Subepithelial deposits (IgG)

MPGN type I has what clinical presentation? EM shows what? Light microscopy shows what?

Mixed - hematuria and proteinuria Subendothelial deposits Mesangial cell proliferation

Acute proliferative GN occurs in who and because of what?

Children ages 6-10 Due to Group A beta-hemolytic strep infection 1-4 weeks following pharyngitis

What are common causes of secondary MPGN type I? Prognosis?

Hep C SLE endocarditis Malignancy Dismal

What is characterized by the following morphology? Mesangial cell proliferation BM thickening and splitting Increased lobular architecture Influx of neutrophils?

MPGN type I

What are the EM findings of acute proliferative GN? IF findings?

Subepithelial humps Granular deposits of IgG, IgM, and C3

Idiopathic FSGS displays what? What kind of progression?

Higher incidence of hematuria, reduced GFR Proteinuria is nonselective CKD (50% w/in 10 years)

What disease are Mesangial deposits found in?

IgA nephropathy

Where do Bence-Jones deposit?

Tubules

Acute proliferative GN may be due to what bacterial infections?

Group A beta-hemolytic Staphylococcal

3 major characteristics of nephrotic syndrome?

Proteinuria (>3.5 g/day) Hypoalbuminemia Edema Also lipiduria

What disease is epimembranous deposits found in?

Membranous nephropathy | Heymann glomerulonephritis

What disease is subendothelial deposits found in?

Lupus nephritis | MPGN

What is described by a rapid decline in GFR, oliguria/anuria, and may result from glomerular, interstitial, vascular, or tubular injury?

Acute kidney injury

What manifestations are present in RPGN?

Acute nephritis Proteinuria Acute renal failure

Hematuria can be caused by what?

SCHITTT Slide 26 if you forget the mneumonic

mutation of NPHS1 is on what chromosome? Encodes for what protein? Causes what?

19 Nephrin Congenital nephrotic syndrome of the Finnish type (FSGS)

Increased risk to FSGS caused by what mutation on chromosome 22? Common in whom?

APOL1 African American