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11 Cards in this Set
- Front
- Back
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Membranous glomerulonephritis (diffuse membranous glomerulopathy)
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Nephrotic. LM--diffuse capillary and GBM thickening. EM-- "spike and dome" appearance with subepithelial deposits. IF--granular. SLE's nephrotic presentation (see Image 86). Associated with certain drugs, infections, SLE, and solid tumors. Most common nephrotic syndrome of adulthood.
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Minimal change disease (lipoid nephrosis)
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Nephrotic. LM--normal glomeruli. EM--foot process effacement (see Image 85). Selective loss of albumin, not globulins, due to GBM polyanion loss. Associated with recent infections in children. Tx: corticosteroids.
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Amyloidosis
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Nephrotic. LM--Congo red stain, apple-green birefringence. Associated with multiple myeloma, chronic conditions, TB, and rheumatoid arthritis.
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Diabetic glomerulonephropathy
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Nephrotic. Nonenzymatic glycosylation (NEG) of GBM -> Increased permeability, thickening. NEG of efferent arterioles -> increased GFR -> mesangial expansion. LM--mesangial expansion, GBM thickening, nodular glomerulosclerosis (Kimmelstiel-Wilson lesion)
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Focal segmental glomerulosclerosis
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Nephrotic. LM--segmental sclerosis and hyalinosis. Associated with HIV.
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Membranoproliferative glomerulonephritis
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Nephrotic. Subendothelial ICs with granular IF. Type I EM-- "tram-track" appearance due to GBM splitting caused by mesangial ingrowth. Associated with Hep B > Hep C. Type II EM-- "dense deposits." Associated with C3 nephritic factor.
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Acute poststreptococcal glomerulonephritis
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Nephritic. LM--glomeruli enlarged and hypercellular, neutrophils, "lumpy-bumpy" appearance. EM-- subepithelial immune complex (IC) humps. IF-- granular. Children.
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Rapidly progressive (crescentic) glomerulonephritis (RPGN)
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Nephritic. LM and IF--crescent-moon shape. Crescent consists of fibrin and plasma proteins with glomerular parietal cells, monocytes, and macrophages. Several disease processes may result in this pattern, including: 1. Goodpasture syndrome--type II hypersensitivity; antibodies to GBM -> linear IF; 2. Wegener's granulomatosis (c-ANCA); 3. Microscopic polyarteritis (p-ANCA)
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Diffuse proliferative glomerulonephritis (due to SLE or MPGN)
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Nephritic. Subendothelial DNA-anti-DNA ICs -> "wire looping" of capillaries. Granular IF. Most common cause of death in SLE. Can present as nephrotic.
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Berger's disease (IgA glomerulopathy)
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Nephritic. Increased synthesis of IgA. LM and IF--ICs deposit in mesangium. Associated with URI or acute gastroenteritis.
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Alport's syndrome
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Nephritic. Mutation in type IV collagen -> split basement membrane. Assoicated with nerve disorders, ocular disorders, and deafness.
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