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Pathology Renal > Renal > Flashcards

Renal Flashcards

1
Q

What type of casts will you see in tubulointerstitial inflammation, acute pyelonephritis, transplant rejection?

A

WBC casts

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2
Q

Type of casts in nephrotic syndrome

A

Fatty (“oval fat bodies”) casts

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3
Q

Granular “muddy brown” casts

A

Acute tubular necrosis

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4
Q

Most common cause of nephrotoxic acute tubular necrosis

A

Aminoglycosides

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5
Q

Common drug causes of acute interstitial nephritis

A

NSAIDs, penicillin, diuretics

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6
Q

See what immune cell type in acute interstitial nephritis

A

Eosinophils

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7
Q

Nephritic syndrome disorders

A

Acute postreptococcal glomerulonephritis, rapidly progressive glomerulonephritis, Berger’s IgA glomerulonephropathy, Alport Syndrome

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8
Q

Nephrotic syndrome disorders

A

Focal segmental glomerulosclerosis, Membranous nephropathy, minimal change disease, amyloidosis, diabetic glomerulonephropathy

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9
Q

Can be both nephritic and nephrotic

A

Diffuse proliferative glomerulonephritis, membranoproliferative glomerulonephritis

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10
Q

Signs/symptoms of nephrotic syndromes

A

Proteinuria (>3.5 g/day), edema, hyperlipidemia, fatty casts

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11
Q

Segmental sclerosis and hyalinosis on LM, effacement of foot processes on EM, most common cause of nephrotic syndrome in adults

A

Focal segmental glomerulosclerosis

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12
Q

LM shows diffuse capillary and GBM thickening, EM shows “spike and dome” subepithelial deposits, granular immunoflourescence

A

Membranous nephropathy

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13
Q

Typical nephrotic presentation of SLE

A

Membranous nephropathy

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14
Q

LM shows normal glomeruli, EM shows foot process efacement, preceded by a recent infection in kids

A

Minimal change disease

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15
Q

Selective loss of what in minimal change disease

A

Albumin (globulins are not lost)

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16
Q

Treatment for minimal change disease

A

Steroids

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17
Q

Nephrotic syndrome with apple-green birefringence on congo red stain

A

Amyloidosis

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18
Q

Subendothelial IC deposits with granular IF, tram track appearance due to splitting of GMB by mesangial ingrowth

A

Type 1 membranoproliferative glomerulonephritis (MPGN)

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19
Q

Type II MPGN characteristics

A

Intramembranous IC deposits; dense deposits

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20
Q

Type I MPGN associated with what diseases

A

HBV and HCV

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21
Q

Type II MPGN associated with what

A

C3 nephritic factor

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22
Q

How does diabetic glomerulonephropathy cause increased GFR

A

Nonenzymatic glycosylation of efferent arterioles leads to decreased outflow and thus increased hydrostatic pressure

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23
Q

How does diabetic glomerulonephropathy cause GBM thickening

A

Nonenzymatic glycosylation

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24
Q

Key microscopic feature of diabetic glomerulonephropathy

A

Kimmelstiel-Wilson lesions (thick, eosinophilic proteinacious node in glomerulus)

25
Q

Signs/symptoms of nephritic syndrome

A

Hematuria, RBC casts, oliguria, azotemia, HTN (due to salt retention), mild proteinuria (<3.5)

26
Q

Lumpy bumpy appearance, large hypercellular neutrophils, IgM, IgG, C3 deposits along GBM and mesangium, periorbital edema, cola-colored urine, seen in kids following sore throat

A

Acute postreptococcal glomerulonephritis

27
Q

Crescents of fibrin and plasma proteins on LM and IF, nephritic syndrome

A

Rapidly progressing (crescentic) glomerulonephritis (RPGN)

28
Q

Diseases that can cause RPGN

A

Goodpasture, granulomatosis with polyangitis (Wegener’s), microscopic polyangitis, Churg-Strauss

29
Q

Hematuria, hemoptysis, RPGN

A

Goodpasture

30
Q

c-ANCA positive RPGN

A

Wegener (granulomatosis with polyangitis)

31
Q

p-ANCA positive RPGN

A

microsopic polyangitis, Churg-Strauss

32
Q

Wire-looping of capillaries on LM, IgG and C3 deposition, granular IF, nephritic syndrome

A

Diffuse proliferative glomerulonephritis (DPGN)

33
Q

Most common cause of death in SLE

A

DPGN

34
Q

Related to Henoch-Schonlein purpura, IgA-based IC deposits in mesangium, often presents with URTI or acute gastroenteritis

A

Berger’s Disease (IgA nephropahty)

35
Q

Glomerulonephritis, deafness, eye problems

A

Alport Syndrome

36
Q

Cause of Alport Syndrome

A

Mutation in type IV collagen; x-linked recessive

37
Q

Kidney stones that precipitate at low pH

A

Calcium oxalate, uric acid and cystine stones

38
Q

Kidney stones that precipitate at high pH

A

Calcium phosphate, ammonium magnesium phosphate (triple stone, struvite stone)

39
Q

Toxic causes of calcium oxalate crystals

A

Ethylene glycol, vitamin C abuse

40
Q

Treatment for calcium stones

A

Hydrochlorothiazide (decreases calcium in tubules) and citrate

41
Q

Hexagonal crystals in urine

A

Cystine stones

42
Q

Gene deletion common in renal cell carcinoma

A

Chromosome 3; inherited may be with VHL syndrome

43
Q

WAGR

A

Wilm’s tumor, aniridia, genitourinary malformations, mental/motor retardation

44
Q

Deletion in Wilm’s tumor

A

WT2 on chromosome 11

45
Q

Painless hematuria

A

Transitional cell cancer (most commonly bladder)

46
Q

Associated problems with transitional cell carcinoma

A

Pee SAC; phenacetin, smoking, aniline dyes, cyclophosphamide

47
Q

Eosinophilic pyuria, azotemia

A

Drug-induced interstitial nephritis (tubulointerstitial nephritis)

48
Q

Causes of tubulointerstitial nephritis

A

Diuretics, penicillin derivatives, sulfonamides, rifampin)

49
Q

Key finding in acute tubular necrosis

A

Granular “muddy brown” casts

50
Q

Acute tubular necrosis associated with what disorders

A

Renal ischemia, crush injury, myoglobinuria, drugs, toxins

51
Q

Risk of what in the oliguric stage of acute tubular necrosis

A

Hyperkalemia

52
Q

Risk of what in the recovery (polyuric) stage of acute tubular necrosis

A

Hypokalemia

53
Q

Renal papillary necrosis associated with what

A

Phenacetin, diabetes mellitus, acute pyelonephritis, sickle cell trait and anemia

54
Q

Lab values in prerenal azotemia

A

Urine osmolality >500 mOsm/kg, urine Na 20

55
Q

Lab values in intrinsic renal and postrenal azotemia

A

Urine osmolarity 40 mEq/L, FENA >2%, BUN/Cr ratio <15

56
Q

Signs of uremia

A

Nausea, anorexia, pericarditis, encephalopathy with asterixis, platelet dysfunction

57
Q

Mutations in ADPKD

A

PKD1 or PKD2

58
Q

Associations of ADPKD

A

Berry aneurysms, mitral valve prolapse, benign hepatic cysts

59
Q

ARPKD associated with what

A

Congenital hepatic fibrosis

Pathology Renal (1 decks)

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