Renal Pathology 3

Question 1

What is the most common type of GloNeph Worldwide?

Answer 1

IgA Nephropathy

Question 2

What is seen on micro in IgA Neph?

Answer 2

LM: Mesangial Proliferation
IF: Mesangial IgA
EM: Mesangial deposits

Question 3

What is Alport Syndrome?

Answer 3

Defect of GBM due to mutation of gene for a5 chain ofCollagen TIV X-Dominant: In males, Fe carry
Sensoneural Deafness
Microscopic Hematuria
Progresses to Renal Failure
Proteinuria on progression

Question 4

What is seen on micro in Thin GBM disease?

Answer 4

LM: Normal
IF: Normal
EM: thin GBM

Question 5

What is seen in Lupus Nephritis?

Answer 5

Granular immune complex deposit of IgG, IgA, IgM, C3, C4

ONLY GM Disease with ALL Ig Deposition

Question 6

How does diabetic Nephropathy present?

Answer 6

Proteinuria, nephrotic synd, chronic Renal failure

Question 7

What is seen in Amyloidosis in the Kidneys?

Answer 7

Amyloid gets trapped in: Glomeruli, BV, Tubules

GBM becomes leaky to proteins => Nephrotic Synd

Question 8

What are the 2 types of Acute Tubular Necrosis?

Answer 8

Ischemic

NephroTOXIC

Question 9

What are the causes of NephroTOXIC Acute tubular Necrosis?

Answer 9

Dr: Aminoglycosides, Ampho B, Gentamycin
Mercury
Carbon Tetrachloride
Radiocontrast dyes
Myoglobin in Rhabdomyolysis

Question 10

What drugs cause drug induced HSR?

Answer 10

Synthetic Penicillins
Rifampin
Ibuprofen
Thiazide Diuretics

Question 11

What is presentation of Drug induced HSR?

Answer 11

2 weeks later: Fever, eosinophelia, rash, and acute renal failure

Question 12

What is Ascending Pyelonephritis?

Answer 12

Ascending from Reflux or Obstruction
Hematogenous
Acute: Neutrophils
Chronic: Lymphocytes, scars

Question 13

What causes Acute Pyelonephritis?

Answer 13

Infections of the pelvicalyceal system and renal parenchyma

Question 14

How is acute pyelonephritis diagnosed?

Answer 14

WBC (neutrophil)casts, Urine culture

Question 15

What is the presetaion of Acute Pyelonephritis?

Answer 15

Pain in the Costo-vertebral angle +other signs of infection

Question 16

What is Charicteristic of Chronic Pyelonephritis?

Answer 16

Insidious or Recurrent acute
Gradual loss of Renal function
Leads to Scarred Kidney w/ chronic Inflammation

Question 17

What is Thyroidization in Chronic Pyelonephritis?

Answer 17

Dilated Tubules with intraluminal eosin staining proteinaceous material

Question 18

Where is a papillary adenoma usually found?

Answer 18

ALWAYS in the CORTEX

Question 19

What disease is Tuberous Sclerosis associated with?

Answer 19

Tuberous Sclerosis

Question 20

What is the gross appearance of Papillary adenoma?

Answer 20

Pale Yelow, well circumscribed nodules

Question 21

What is an Angio-myo-lipoma?

Answer 21

Thick walled vessels
Smooth muscle
Fat

Question 22

What are the risk factors of Renal Cell Carcinoma?

Answer 22

TOBACCO
Chronic Renal Failure and ACQUIRED CYSTIC RENAL DISEASE
Obesity
HTN
Unopposed estrogen therapy
Asbestos
Heavy metals

Question 23

What are the symptoms of Renal Cell CA?

Answer 23

Hematuria 50-60%
Abdominal Mass (25-40%)
Flank pain
HTN
Weight loss
Fever

Question 24

What structure is INVADED by RCC?

Answer 24

RENAL VEIN!!!

Question 25

What is Clear Cell RCC?

Answer 25

Loss of tumor supressor gene VHL

Question 26

What is Papillary RCC?

Answer 26

Activation of Pro-oncogene MET

Question 27

What is Chromophobe RCC?

Answer 27

Loss of multiple chromosomes resulting in hypodiploidy | Best prognosis among Clear and Papillary

Question 28

What is the Gross Appearance of Clear Cell RCC?

Answer 28

Solitary Unilateral Lesion Yellow-Orange Margins sharply defined Grey-White necrosis and hemorrhagic Discoloration

Question 29

What is the microscopic appearance of Clear Cell RCC?

Answer 29

Tumor cells have a rounded or polygonal shape Clear or granular Cytoplasm Abundant Capillaries

Question 30

What is seen on micro of Chromophil (Papillary) RCC?

Answer 30

Papillary structures that enclose clusters of foamy macrophages Eosinophilic cytoplasm atypical nuclei Sparse Macrophages

Question 31

What is the difference between Clear Cell RCC and Papillary RCC?

Answer 31

CCRCC: Abundant clear Cytoplasm + Abundant Capillaries PapRCC: Eosinophilc pink cytoplam Sparse Capillaries

Question 32

What syndrome is associated with increased RCC?

Answer 32

Von Hippel Lindau Syndrome

Question 33

What is the Most common malignancy of Ealry childhood 2-4yo?

Answer 33

Wilms tumor

Question 34

What causes Wilms tumor?

Answer 34

LOF mutation of tumor supressor genes WT1 or WT2 on Chr 11

Question 35

What is the presentation of Wilms Tumor?

Answer 35

Huge, palpable flank mass, and Hematuria

Question 36

What is the key lesion in ALport syndrome?

Answer 36

Basket weave lesion

Question 37

What is the Stain and appearance of Amyloidosis in the kidney?

Answer 37

Congo Red | Apple green birefringence