Introduction to Renal Pathology
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| Lamination in the GBM at EM is diagnostic of ? | Hereditary Alport's Disease
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| What are cryoglobulins | circulating immune complexes that precipitate in serum or plasma at 4-10 degrees C and re-dissolve upon warming to 37C
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| What is a well known renal disease that is Autosomal Dominant with defect located in chromosome 16 | Adult polycystic disease
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| What are extra-renal problems associated with Alport disease | Deafness and leukocyte abnormalities
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| What is the result of hyperfiltration through select nephrons due to persistent decreased regional blood flow | Sclerosisor hyalinization of glomeruli and loss of function
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| Is the charge of the glomerular filter positive or negative | Negative: it is a major barrier to the filtration of anionic proteins
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| What is the hepatic response to hypoalbuminemia | increased cholesterol and increased a2 globulin
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| Nephrotic Syndrome: edema, proteinuria, children>adults, no hematuria, no elevation in creatinine and Highly Responsive to Steroids | Minimal Change Disease
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| Minimal Change Disease is associated with what marker | HLA B12
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| When you see "fusion" of epithelial cell foot processes think? | Minimal Change Disease
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| 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
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| Nephrotic syndrome with microscopic hematuria, later creatinine rise, black>white patients affected, poor response to steroids? | Focal Segmental Glomerular Sclerosis
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| Why might an early biopsy of focal segmental glomerulosclerosis miss the diagnosis | because deep cortical glomeruli are affected first
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| what would you see on immunofluorescence with FSGS | IgM and C3 in the sclerotic lesions in the glomerulus
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| What is the etiology of Membranous Nephropathy | In Situ immune complex deposition
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| what is the characteristic finding with Membranous Nephropathy | On silver stain you see highlights of spikes of GBM between the immune deposits
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| What is the peak age of Membranous Nephropathy | 4th or 5th decade rare in children
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| What do you see on Immunofluorescence with membranous nephropathy | granular deposits of IgG and C3 along GBM
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| Are steroids effective in treating Membranous GN | In Stage I patients respond to corticosteroid in Stage II 50% respond to steroid treatments
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| Nodular Diabetic Glomerulosclerosis is also known as? | Kimmelstiel-Wilson Disease (bad prognosis)
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| Kimmelstiel Wilson Disease is often associated with what retinal finding | microaneurysms
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| What is the earliest change noted in Diabetic Glomerulosclerosis | Diffuse thickening of the GBM
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| 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
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| Does Diabetic arteriosclerosis affect the afferent or efferent arterioles | Both
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| If you have a Congo Red Positive with Apple Green Bi-refringence under polarized light think? | Amyloidosis
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| AL Amyloid is secondary to? | monoclonal gammopathies associated with light chain deposition (lamda most common)
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| AA amyloid is associated with? | chronic inflammatory diseases associated with deposition of acute phase proteins (SAA)
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| What are some diseases associated with AA amyloid | Rheumatoid arthritis, Chronic infections (TB), Some Neoplasms (Renal Cell Carcinoma and Hodgkin's)
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| What are the EM findings of Amyloid | Amyloid fibrils are non-branching with a uniform diameter of 8-12nM with a tangled appearance
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