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Year 2 Renal > Renal pathology III > Flashcards

Renal pathology III Flashcards

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1
Q

what 3 diseases are associated with asymptomatic isolated hematuria?

A
  • IgA nephropathy (Berger disease)
  • alport syndrome
  • thin GBM disease
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2
Q

what is the most common type of primary glomerulonephropathy worldwide?

A

IgA nephropathy

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3
Q

what are the symptoms of IgA nephropathy?

A
  • mild hematuria

- mild proteinuria

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4
Q

what are the LM, IF, and EM findings in IgA nephropathy?

A
  • LM: mesangial proliferation / hypercellularity
  • IF: mesangial IgA
  • EM: mesangial deposits
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5
Q

what is alport syndrome?

A

defect of the GBM due to mutation in the gene encoding the alpha-5 chain of type IV collagen

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6
Q

what is the inheritance pattern of alport syndrome?

A

X-linked dominant (incomplete - women can get it)

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7
Q

what are the symptoms of alport syndrome?

A
  • sensorineural hearing loss
  • renal failure / microscopic hematuria
  • proteinuria (indicates progression)
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8
Q

what are the key lesions of alport syndrome?

A
  • GBM thickening / splitting / LAMINATION

- “basket-weave” pattern

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9
Q

which disease is associated with a basket weave pattern on histology?

A

alport syndrome

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10
Q

what are the LM, IF, and EM findings in thin GBM disease?

A
  • LM: normal
  • IF: negative
  • EM: thin GBM
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11
Q

what are the secondary glomerulonephropathies?

A
  • SLE
  • diabetes
  • amyloidosis
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12
Q

in SLE there is granular immune complex deposition of what factors?

A
  • IgG
  • IgA
  • IgM
  • C3
  • C4
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13
Q

what is the only glomerular disease with all Ig deposition?

A

SLE

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14
Q

where does amyloid get trapped in amyloidosis?

A
  • glomeruli
  • blood vessels
  • tubules
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15
Q

what is the pathogenesis of kidney amyloidosis?

A
  • GBM becomes leaky to proteins and the patient gets nephritic syndrome
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16
Q

what stain is used to visualize amyloid? how does it appear?

A
  • Congo Red

- apple green biorefringence

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17
Q

what is the pathogenesis of acute tubular necrosis?

A

destruction of renal tubular epithelium

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18
Q

what are the two types of acute tubular necrosis?

A
  • ischemic

- nephrotoxic

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19
Q

what drugs are nephrotoxic?

A
  • aminoglycosides
  • amphotericin B
  • gentamycin
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20
Q

what heavy metal is nephrotoxic?

A

mercury

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21
Q

what organic solvents are nephrotoxic?

A

carbon tetrachloride

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22
Q

how is myoglobin nephrotoxic?

A

causes rhabdomyolysis (in heat stroke)

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23
Q
  • dilated tubules with flattened epithelium
  • necrotic debris in tubules

diagnosis?

A

acute tubular necrosis (ATN)

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24
Q

what is the cause of acute interstitial nephritis?

Study These Flashcards
A

drug induced hypersensitivity

25
what drugs cause acute interstitial nephritis? what is seen clinically after ingestion?
- synthetic penicillins - rifampin - ibuprofen - thiazide diuretics 2 weeks later: - fever - eosinophilia - rash - acute renal failure
26
what is the main pathogen associated with pyelonephritis?
e. coli
27
what is the cause of acute pyelonephritis?
infections of the pelicalyceal system and renal parenchyma
28
how does acute pyelonephritis present? how is the diagnosis made?
- presentation: pain in the costo-vertebral angle along with other signs of infection - diagnosis: pus (WBC) casts, urine culture
29
polymorphonuclear casts in tubules - diagnosis?
acute pyelonephritis
30
what are the key lesions in acute pyelonephritis?
- neutrophilic infiltrates in tubules | - neutrophilic casts in tubules
31
how does acute pyelonephritis differ from acute interstitial nephritis?
in acute pyelonephritis the inflammatory infiltrates include neutrophils
32
what is the main etiology of chronic pyelonephritis?
obstruction (congenital or acquired)
33
is chronic pyelonephritis more common in males or females?
females
34
what are the hallmark features of chronic pyelonephritis?
- pitting geographic scars | - thyroidization
35
- inflammatory infiltrate - fibrosis - pitting geopraphic scars diagnosis?
chronic pyelonephritis
36
atrophic tubules that resemble thyroid gland is associated with what renal disease?
chronic pyelonephritis
37
- pitting geographic scars - thyroidization these are hallmark features of what disease?
chronic pyelonephritis
38
papillary adenomas are always located in which part of the kidney?
cortex
39
angiomyolipomas are associated with what condition?
tuberous sclerosis
40
what are the signs and symptoms of tuberous sclerosis?
- mental retardation - multisystem hamartomas - angiomyolipomas
41
angiomyolipomas consist of what 3 structures?
- thick walled vessels - smooth muscle - fat
42
what are the main risk factors for renal cell carcinoma?
- tobacco - chronic renal failure - acquired cystic renal disease
43
what are the primary symptoms of renal cell carcinoma?
- hematuria | - abdominal mass
44
renal cell carcinoma strongly tend to invade what vessel early in the disease?
renal VEIN
45
what are the renal cell carcinoma histotypes? which is most common?
- clear cell (most common) - papillary - chromophobe
46
what is the gross appearance of renal cell carcinoma?
- yellow orange - sharp borders - gray-white necrosis and foci of hemorrhagic discoloration
47
what is the histological appearance of renal cell carcinoma?
- rounded or polygonal cells - clear or granular cytoplasm - abundant capillaries
48
- rounded or polygonal cells - clear or granular cytoplasm - abundant capillaries diagnosis?
renal cell carcinoma
49
what is the gross appearance of chromophil (papillary) renal cell carcinoma?
thick capsule with red / brown reactive changes and hemorrhage
50
what is the histological appearance of chromophil (papillary) renal cell carcinoma?
- papillary structures, many of which enclose clusters of foamy macrophages - abundant eosinophilic cytoplasm and mildly atypical nuclei - sparse capillaries
51
- papillary structures, many of which enclose clusters of foamy macrophages - abundant eosinophilic cytoplasm and mildly atypical nuclei - sparse capillaries diagnosis?
chromophil (papillary) renal cell carcinoma
52
von hippel lindau syndrome is characterized by what types of lesions? where?
cavernous hemangiomas in: - cerebellum - brain stem - eye
53
on hippel lindau carries a very high incidence of what type of cancer?
renal cell carcinoma
54
what is the histological appearance of urothelial carcinoma of renal pelvis?
papillary growth lined by urothelial cells mild nuclear atypia and pleomorphism
55
what is the most common renal malignancy of early childhood?
wilms tumor
56
wilms tumor is caused by what type of genetic defect? which genes? which chromosome?
- loss of function mutation of tumor suppressor genes WT1 or WT2 - chromosome 11
57
wilms tumor histology
epithelial component surrounded by metanephric blastema and tumor immature spindle cell stroma
58
epithelial component surrounded by metanephric blastema and tumor immature spindle cell stroma diagnosis?
wilms tumor
59
what is the difference between clear cell RCC and papillary RCC?
- clear cell RCC has clear cytoplasm and abundant capillaries - papillary RCC has eosinophilic cytoplasm and sparse capillaries

Year 2 Renal (38 decks)

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