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Lecture 1

Introduction to Renal Pathology

Lamination in the GBM at EM is diagnostic of ? Hereditary Alport's Disease
What are cryoglobulins circulating immune complexes that precipitate in serum or plasma at 4-10 degrees C and re-dissolve upon warming to 37C
What is a well known renal disease that is Autosomal Dominant with defect located in chromosome 16 Adult polycystic disease
What are extra-renal problems associated with Alport disease Deafness and leukocyte abnormalities
What is the result of hyperfiltration through select nephrons due to persistent decreased regional blood flow Sclerosisor hyalinization of glomeruli and loss of function
Is the charge of the glomerular filter positive or negative Negative: it is a major barrier to the filtration of anionic proteins
What is the hepatic response to hypoalbuminemia increased cholesterol and increased a2 globulin
Nephrotic Syndrome: edema, proteinuria, children>adults, no hematuria, no elevation in creatinine and Highly Responsive to Steroids Minimal Change Disease
Minimal Change Disease is associated with what marker HLA B12
When you see "fusion" of epithelial cell foot processes think? Minimal Change Disease
If you have a chiild with minimal change disease and they do not respond to steroids think? Wrong diagnosis it is likely Focal Segmental Glomeruosclerosis
Nephrotic syndrome with microscopic hematuria, later creatinine rise, black>white patients affected, poor response to steroids? Focal Segmental Glomerular Sclerosis
Why might an early biopsy of focal segmental glomerulosclerosis miss the diagnosis because deep cortical glomeruli are affected first
what would you see on immunofluorescence with FSGS IgM and C3 in the sclerotic lesions in the glomerulus
What is the etiology of Membranous Nephropathy In Situ immune complex deposition
what is the characteristic finding with Membranous Nephropathy On silver stain you see highlights of spikes of GBM between the immune deposits
What is the peak age of Membranous Nephropathy 4th or 5th decade rare in children
What do you see on Immunofluorescence with membranous nephropathy granular deposits of IgG and C3 along GBM
Are steroids effective in treating Membranous GN In Stage I patients respond to corticosteroid in Stage II 50% respond to steroid treatments
Nodular Diabetic Glomerulosclerosis is also known as? Kimmelstiel-Wilson Disease (bad prognosis)
Kimmelstiel Wilson Disease is often associated with what retinal finding microaneurysms
What is the earliest change noted in Diabetic Glomerulosclerosis Diffuse thickening of the GBM
What is the immunofluorescence finding on Diabetic Glomerulosclerosis NONSPECIFIC linear highlighting of GBM giving a linear staining with antibody to IgG via Trapping NOT Autoantibodies
Does Diabetic arteriosclerosis affect the afferent or efferent arterioles Both
If you have a Congo Red Positive with Apple Green Bi-refringence under polarized light think? Amyloidosis
AL Amyloid is secondary to? monoclonal gammopathies associated with light chain deposition (lamda most common)
AA amyloid is associated with? chronic inflammatory diseases associated with deposition of acute phase proteins (SAA)
What are some diseases associated with AA amyloid Rheumatoid arthritis, Chronic infections (TB), Some Neoplasms (Renal Cell Carcinoma and Hodgkin's)
What are the EM findings of Amyloid Amyloid fibrils are non-branching with a uniform diameter of 8-12nM with a tangled appearance
Created by: UVAPATH3