Renal: 3. Leonard : Glomerulonephritis Iii

Front 1

IF and EM: “ribbon-like” zone of increased density within the GBM and mesangial matrix

associated with?

Back 1

Type II MPGN: dense deposit disease

Front 2

proliferations of the pariatal glomerulous are known as crescents... what is this seen in?

Back 2

Type II MPGN: Dense Deposit Disease

also type I, RPGN, and Anti-GBM

Front 3

In Type II MPGN: Dense Deposit Disease, what antibody to what complement protein is typical for membranoproliferative glomerulonephritis.

Back 3

C3

can help distinguish Type II from type I MPGN

Front 4

Lupus is what kind of disease? What is the one of the more common features?

Back 4

Autoimmune

Nephritis

Front 5

in SLE ______ form to in situ antigens or circulating antigens; deposit in variety of glomerular locations

Back 5

Immune complexes

Front 6

what is a treatment for Lupus?

Back 6

immunosupression (corticosteroids)

Front 7

wire loop histo appearance =

Back 7

Lupus

Front 8

Most common form of GN in the world
?

Back 8

IgA Nephropathy (Berger Disease)

Front 9

who is most affected by IgA Nephropathy (Berger Disease)

Back 9

young men

Front 10

to be nephrotic, what criteria has to be met?

Back 10

>3.5 grams protein in urine per 24 hours

Front 11

Deposition of IgA-dominant immune complexes, with high levels of circulating IgA

Back 11

IgA Nephropathy (Berger Disease)

Front 12

in IgA Nephropathy (Berger Disease), where is IgA deposited

Back 12

the mesangium

Front 13

What is Goodpasture's disease? what is one of the problems normally seen in this?

Back 13

Kidney + pulmonary disease

kidney problem is Anti-GBM GN

Front 14

what do you treat Goodpasture's with?

Back 14

high-dose immunosuppressants

Front 15

what does Anti-GBM GN often follow?

Back 15

URI

Front 16

what happens in Anti-GBM GN

Back 16

Autoantibody directed against portion of type IV collagen molecule present in GBM

Front 17

what will be your major LM finding of Anti-GBM GN

Back 17

glomerular crescents >90%... feature of rapidly progressive glomerulonephritis

Front 18

if you see IF findings of diffuse linear staining of GBM for IgG what do you likely have?

Back 18

Anti-GBM GN

Front 19

what is the hallmark of Rapidly Progressive GN (RPGN)

Back 19

Crescents on light microscopy

Front 20

what are the 3 types of Rapidly Progressive GN (RPGN)

Back 20

TYPE I (ANTI-GBM ANTIBODY)
---Goodpastures

TYPE II (Immune complex)
--Lupus
--IgA nephropathy (Henoch-Schonlein purpura)

TYPE II (Pauci-immune)

Front 21

pts with Hereditary Nephridites present with?

Back 21

hematuria

Front 22

what are the 2 types of Hereditary Nephridites

Back 22

Thin basement membrane disease

Alport syndrome

Front 23

what is the most common cause of Hereditary Nephridites

Back 23

thin membrane disease

this is usually asymptomatic

Front 24

in Hereditary Nephridites, you have mutations in genes coding for alpha chains of ______

Back 24

type IV collagen

Front 25

EM shows what in Hereditary Nephridites

Back 25

thinning of the GBM

Front 26

pt has hematuria with progression to CRF (also nerve deafness, eye disorders)

Back 26

Alport syndrome

Front 27

what is the genetics underlying Alport syndrome

Back 27

Majority are X-linked (males express full form; females limited to benign hematuria)

Defective assembly of collagen type IV (GBM, BM of eye lens, cochlea)

Front 28

the EM finding of alternating thinning and thickening of GBM is seen in

Back 28

Alport syndrome

Front 29

Progressive renal failure
Oliguria, proteinuria, edema, azotemia, uremia, death
Anemia (deficient EPO), anorexia, general malaise
Most patients are hypertensive with cardiac and CNS effects

clinical symptoms of?

Back 29

Chronic Glomerulosclerosis (CGN)

Front 30

ppl who survive acute phase of RPGN generally develop....

Back 30

Chronic Glomerulosclerosis (CGN)

Front 31

Shrunken kidney with diffuse granular cortical surface is descriptive of?

Back 31

Chronic Glomerulosclerosis (CGN)

Front 32

arteriolar sclerosis, tubular atrophy, renal osteodystrophy are signs of?

Back 32

Chronic Glomerulosclerosis (CGN)

Front 33

12 yr old presents with periorbital, abdominal, and ankle swelling. She had been in good health until several months ago when she gained some weight and noted swelling in her legs. A Chest xray shows bilateral pleural effusions without evidence or lung disease. a urinalysis reveals heavy proteiunuria (8kg/24hr) there is no hematuria. a percutaneous needle biospy of the kidney reveals no morphological abnormality via LM. which of the following best describes the most likely medical condition responsible:

Amyloid nephropathy
Focal segmental glomerulosclerosis
Hereditary nephritis
Membranous glomerulophay
Minimal change disease

Back 33

her lipids would probably be?
high, and found in urine

answer: Minimal change disease

Front 34

2 conditions associated with amyloid nephrophathy

Back 34

multiple myeloma (AL)

Chronic inflammatory process (AA)
---think auto immune causing this

Front 35

Focal segmental glomerulosclerosis

Back 35

African American adult

Front 36

An 8 year old girl presents with headaches dizziness and malaise. PE shows edema. Her PB is 180/110 and 24 hr urine reveals oliguria, hematuria, and 2.7g protein. A kidney biopsy shows electron-dense sub-epithelial humps. What would be the most likely additional finding in this girl:

Kidney biopsy with no appreciable findings by LM and IF

Bilateral nerve deafness

serology positive for nephritic factor

a history of antecedent pharyngitis

progression to chronic renal failure despite aggressive corticosteroid therapy

Back 36

she probably has: Post infectious glomerulonephritis

Answer: a history of antecedent pharyngitis

a) associated with: minimal change disease or focal segmental glomerular sclerosis (FSGS)---not correct
b)Alports syndrome (x linked recessive, if a girl has it, it would be benign)

Front 37

EM finding of minimal change disease?

Back 37

podocyte foot process effacement