Showkat/Nichols: Nephrotic syndrome 2

Question 1

In minimal change disease, how is the diagnosis made?

Answer 1

EM: podocyte effacement and detachment

both light and IF microscopy will be normal

Question 2

What is the treatment for minimal change disease? is it effective?

Answer 2

steroid therapy, yes (especially in children: >90%)

Question 3

In focal segmental glomerulosclerosis (FSGS), what is the tx? is it effective?

Answer 3

steroids, not really

Question 4

What solubility factor is implicated in primary FSGS?

Answer 4

suPAR

Question 5

What is associated with secondary FSGS?

Answer 5

reduced nephron mass

Question 6

On biopsy of pt with FSGS what will be seen on light microscopy? IF? EM?

Answer 6

• light: scarring, obliterated capillary lumen, areas of adhesion to Bowman’s capsule, hyalinosis
• IF: normal
• EM: podocyte effacement/fusion

Question 7

What is the target antigen in primary membranous nephropathy?

Answer 7

M-type PLA2

Question 8

What is seen on light microscopy in membranous nephropathy? IF? EM?

Answer 8

• light: diffuse thickening of GBM w/ normal cellularity
• IF: fine granular staining with IgG and complement
• EM: supEPithelial deposits (“spike and dome” pattern)

Question 9

In post-streptococcal glomerulonephritis, what is seen on light microscopy? IF? EM?

Answer 9

• light: diffuse endocapillary proliferation, infiltration of neutrophils (looks like “ants”), inflammation
• IF: diffuse granular deposition of C3 or IgG in capillary walls and mesangium
• EM: subEPithelial humps

Question 10

What are the main differences bw minimal change disease and FSGS?

Answer 10

1. age group (MCD- young, FSGS- old)
2. FSGS has HTN often
3. FSGS has kidney dysfunction (elevated BUN, creatinine)

Question 11

A mutation in what gene can increase risk of FSGS in AAs but can also confer resistance to some types of sleeping sickness?

Answer 11

APOL-1