Renal histopathology Flashcards

1
Q

Minimal change

A

LM: normal
Immuno: normal, possibly a bit of mesangial IGM
EM: effacement (flattening) podocyte foot processes

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2
Q

FSGS

A

LM: segmental solidification of the glomerular tuft, affected glomeruli capillaries are segmentally obliterated by accumulation of acellular matrix and hyaline deposits. Coarsely granular deposits of IgM and C3. No immune deposits or cellular proliferation in majority
EM: effacement foot processes (same as MCD)

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3
Q

collapsing variant FSGS associated with…

A

HIV

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4
Q

membranous GN

A

diffuse thickening GBM- subepithelial usually.

EM: stain C3 and IgG

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5
Q

MPGN= mesangiocapillary GN

A

mesangial hypercellularity
endocapillary proliferation
duplication of glomerular BM–> double contours
Ig + and C’ + on staining

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6
Q

Scleroderma renal crisis looks like

A

onion skin narrowing of arterioles
glomerular ischaemia
NO immune complex deposition
NO inflammatory changes

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7
Q

IgA nephropathy

A

MPGN with IgA dominant mesangial immune deposits
mesangial hypercellularity
Can see tram track appearance.
IF:

Immune complex mediated eg cryoglobulinaemia, SLE, HCV–>STAIN IgG and C1 (classical pathway)

Complement mediated: NO IgG but C3 (alternative pathway)

with hepatitis see subep and subend deposits

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8
Q

Post infectious

A

LM: inflammatory infiltrate and hypercellularity. Vessels ok. Big Gloms. A few crescents

Immuno: 1st 2 weeks IgG and C3 granular pattern of glomerular capillaries and mesangium. NOT IgA

EM: subepithelial immune deposits

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9
Q

Anti-GBM disease

A

This is type 1 RPGN:

Diffuse necrotising crescentic GN
Linear deposits of IgG (5-20%)

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10
Q

Lupus nephritis; focal proliferative, diffuse proliferative

A
subendothelial immune deposits/wire loops
hypercellularity
leukocyte infiltration
fibrinoid necrosis
full house of IF
hyaline thrombi
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11
Q

Class 1 lupus nephritis

A

LM normal
IF immune complex deposits
EM electron dense deposits

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12
Q

Class 2 lupus

A

LM: mesangial hypercellularity
IF: mesangial immune complexes

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13
Q

Class 5 lupus nephritis

A

thick BM

subepithelial immune deposits

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14
Q

What should you do if crescentic GN without immune complexes or anti GBM Ab?

A

Think pauci immune crescentic GN due to GPA, MRA, Churg Strauss

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15
Q

5 key features of HIV associated nephropathy

A
normal to large kidneys
massive proteinuria
FSGS findings on renal biopsy
normotension
elevated urea and creatinine
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16
Q

WHAT opioids can be used in renal impairment?

A

Fentanyl

Buprenorphine