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Renal Pathology
Downstate
59
Medical
Graduate
03/16/2011

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Cards

Term
what 5 clinical characteristics define the nephrotic syndrome?
Definition
massive proteinuria, edema, hypoalbuminemia, hyperlipidemia, and hypercoaguability
Term
where do neutral immune complexes (IC) deposit? positive IC? negative IC?
Definition
neutral -> mesangium. positive -> subepithelium. negative -> subendothelial.
Term
subepithelial humps, hypercellular; dx?
Definition
PSGN
Term
crescents and linear deposition on IF; dx?
Definition
Goodpasture's or anti-basement membrane disease causing RPGN type I
Term
pt with hx of pharyngitis shows crescents in glomeruli under light microscopy; dx?
Definition
RPGN type II
Term
crescents and negative IF; dx?
Definition
RPGN type III (due to Wegner's or Churg-Strauss)
Term
proteinase 3 = __-ANCA; dx?
Definition
c-ANCA; Wegner's
Term
child with hx of URI presents with edema, no hematuria, and no HTN; dx?
Definition
minimal change disease (lipid nephrosis)
Term
can be caused by captopril, gold, Hodgkin's, HBV, syphilis, malaria
Definition
MGN
Term
pt with hx of HCV presents with HTN. EM shows tram tracks. IF shows depositions of IgG, C1q, and C4. dx?
Definition
MPGN type I
Term
pt with hx of HCV presents with HTN, proteinuria. EM shows dense deposit disease. Ag is C3 nephritic factor. dx?
Definition
MPGN type II
Term
young black male with hx of HIV presents with hematuria, proteinuria, and HTN. LM shows collapsed glomeruli and wrinkled BM. dx?
Definition
FSGS (HIV nephropathy)
Term
Young Asian adult presents with proteinuria. Biopsy shows mesangial proliferation and mesangial depositions. Pt had a hx of URI (or GI infection). dx?
Definition
IgA Nephropathy (Berger's)
Term
secondary to cirrhosis or celiac disease; dx?
Definition
Berger's
Term
child with purpura, polyarthritis, hematuria, and occult blood; dx?
Definition
Henoch-Schonlein
Term
child presents with sensorineural defect, ocular defects, and hematuria. EM shows a thin BM. pathogenesis? dx?
Definition
path: mutation in alpha chain 3, 4, or 5 in collagen type IV. dx: Alport's syndrome
Term
alpha 3 or 4 mutation in collagen type IV; asymptomatic proteinuria or hematuria; dx?
Definition
thin basement membrane disease
Term
what microscopic changes indicate chronic glomerulonephritis? (4)
Definition
tubular atrophy, nodular sclerosis, arteriole sclerosis, thyroidization of tubules
Term
ddx for tubuloreticular structure
Definition
SLE, HIV, HCV
Term
IF shows IgG, IgA, IgM, C3, and C1 deposits; dx?
Definition
lupus nephropathy "full house"
Term
describe microscopic findings in class III SLE. class IV SLE?
Definition
class III: fibrinoid necrosis, wire loop lesions; <50% involvement of glomeruli. class IV: active lesions, sclerosis, crescents; >50% involvement
Term
SLE involves what organs? HSP?
Definition
SLE: kidney, joint, skin, lungs. HSP: kidney, joint, skin, GI.
Term
Kimmelsteil-Wilson nodules, fibrin caps, capsular drops; dx?
Definition
diabetic nephropathy
Term
thick BM, mesangiolysis, hyalinizing arteriolar sclerosis of afferent and efferent arterioles; dx?
Definition
diabetic nephropathy
Term
linear IF ddx
Definition
Goodpasture's, amyloidosis/light chain disease, diabetic nephropathy with IgG deposition
Term
waxy, pink deposits everywhere in glomerulus; EM shows "pick up sticks"; dx?
Definition
amyloidosis
Term
thick BM, punctate deposits on EM; linear and lobular on IF
Definition
light chain disease
Term
kidney shows granular surface on gross; elastica duplication on biopsy; dx?
Definition
benign nephrosclerosis
Term
pathogenesis of Goldblatt Kidney in males and females
Definition
males: plaques. females: fibromuscular dysplasia. both cause unilateral renal a. stenosis
Term
diarrhea, shistocytes, thrombotic emboli; dx?
Definition
typical HUS
Term
fibrinoid necrosis, "flea bitten" kidney, onion skinning of arterioles, no diarrhea; dx?
Definition
atypical HUS; malignant HTN
Term
young black male with CKD presents with papilledema, scotomas, no diarrhea; dx?
Definition
malignant HTN
Term
pathogenesis of TTP
Definition
lack of ADAMTS13 -> vWF multimers -> thrombi
Term
polyuria, nocturia, salt wasting, metabolic acidosis; dx?
Definition
tubulinterstitial nephritis
Term
renal pathologies caused by NSAIDs (3)
Definition
ATN, AIN or TIN, MGN
Term
female with hx of UTI presents with renal stones, anemia, and hematuria; dx?
Definition
analgesic abuse -> TIN
Term
concoction of analgesic abuse
Definition
phenacetin, aspirin, caffeine, acetaminophen, codeine
Term
child with chronic vesicoureteral reflux shows thyroidization of tubules; dx?
Definition
chronic pyelonephritis
Term
TIN that occurs post-chemotx; dx?
Definition
acute urate nephropathy
Term
TIN assc'd with gout; dx?
Definition
chronic urate nephropathy
Term
TIN with large hyaline casts and granulomas; dx?
Definition
multiple myeloma
Term
tubulitis is a sign of...
Definition
transplantation rejection
Term
signs of chronic obstructive uropathy
Definition
polyuria, nocturia
Term
most common renal tumor in children
Definition
Wilms tumor
Term
blatema, sarcoma, carcinoma; biopsy shows metanephric remnants; dx?
Definition
Wilms tumor
Term
WAGR syndrome and chromosome?
Definition
Wilms tumor, aniridia, GU abnormalities, retardation; 11p
Term
Denys-Drash syndrome and chromosome?
Definition
Wilms tumor, intersex disorder, glomerulosclerosis; 11p
Term
Beckwith Weidmann syndrome and chromosome?
Definition
Wilms tumor, hemihypertrophy, macroglossia, gigantism, hypoglycemia; 11p
Term
most common renal cell carcinoma
Definition
clear cell carcinoma
Term
chromosome affected in...
1. clear cell carcinoma
2. papillary carcinoma
3. VHL
Definition
clear - 3; papillary - 7; VHL -3
Term
dx via Hale's stain
Definition
chromophobe carcinoma
Term
mahogany brown tumor, hot pink cells; dx?
Definition
oncocytoma
Term
risk of berry aneurysms; dx?
Definition
adult PKD
Term
autosomal dominant or recessive?
1. adult PKD
2. child PKD
3. VHL
4. Alport's
Definition
1. dominant
2. recessive
3. dominant
4. X-linked recessive
Term
hemangioblastomas of retina and cerebellum + renal cell carcinoma and cysts; dx?
Definition
VHL
Term
"spikes" on EM and LM; dx?
Definition
MGN (or class V lupus nephritis)
Term
papillary necrosis on LM; ddx? (3)
Definition
analgesics, acute pyelonephritis, lupus nephritis
Term
HBV ->? HCV ->?
Definition
HBV->MGN. HCV->MPGN
Term
depositions...
1. IgG, C3
2. IgA, C3
3. C3 only
4. IgG, C1q, C4
5. IgG, IgM, IgA, C3, C1q
Definition
1. PSGN
2. Berger's
3. MPGN type II
4. MPGN type I
5. lupus nephritis "full house"
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