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USMLE Step 1 Hail Mary
Terms in this set (12)
IgG and C3b
LM: enlarged, hypercellular glomeruli
IF: granular appearance ("starry sky, lumpy bumpy") on IF due to depositions IgG, IgM, C3
3-6 week's post GAS pharyngitis
Sx: COLA urine, peripheral/periorbital edema, HTN. Positive strep titers and decreased complement.
Type III hypersensitivity
LM and IF: crescent moon shape. Crescents made of fibrin and plasma protein (C3b) with glomerular parietal cells, monocytes, macrophages.
Rapidly progressive (crescentic) glomerulonephritis
- Goodpasture's: anti-GBM, type II hypersensitivity; antibodies to GFM and alveolar basement membrane (type IV) --> linear IF
RX: emergent plasmapharesis
LM: wire looping of capillaries
EM: subendothelial IgG based ICs
Diffuse proliferative glomerulonephritis
- common cause of death in SLE (wire LUPUS)
- similar to MPGN, often presents as concurrent nephritic/nephrotic syndrome
LM: mesangial proliferation
EM: mesangial IC deposits
IF: IgA-based IC deposits in mesangium
IgA nephropathy (Berger disease --> renal pathology of Henoch-Schonlein purpura)
- episodic gross hematuria that occurs CONCURRENTLY with respiratory or GI inections
Eye problems, glomerulonephritics, sensorineuronal deafness.
Basket-weave appearance on EM
Alport Syndrome (type IV collagen mutation)
- thinning of the glomerular basement membrane
- X linked dominant
- "can't see, can't pee, can't hear a bee"
"tram-track" appearance on PAS stain
- tram track appearance due to GBM splitting caused by mesangial ingrowth
- there are two types
- has the described appearance; due to sub-endothelial immune complex deposits with granular IF
- also called dense deposit disease
- associated with C3 nephritic factor, which stabilizes C3 convertase --> decreased serum C3 levels)
LM: normal glomeruli
EM: effacement of foot processes
Minimal change disease:
- most common nephrotic syndrome of children
- often idiopathic, may be triggered by recent infection, immunization, immune stimulus
- rarely may be secondary to lymphoma
Rx: excellent response to corticosteroids
LM: segmental sclerosis and hyalinosis
EM: effacement of foot processes
Focal segmental glomerulosclerosis
- most common cause of nephrotic syndrome in AA and hispanics
- can be primary or secondary to other conditions (HIV, sickle cell, heorin abuse, massive obesity, interferon treamtent, chronic kidney disease)
- inconsistent response to steroids, may progress to chronic renal disease
LM: diffuse capillary and GBM thickening
IF: granular as a result of immune complex deposition
EM: "spike and dome appearance" with sub-epithelial deposits
Membranous nephropathy (membranous glomerulonephritis)
- most common cause of nephritic syndrome in white adults
-can be primary (anti-phospholipase A2 receptor) or 2ndary (HBC, HCV, SLE, solid tumors)
Poor steroid response, may progress to chronic renal disease.
LM: conga red stain shows apple-green birefringence under polarized light due to amyloid deposition in the mesangium
- kidney is the most commonly involved organ
- associated with chronic conditions that predispose to amyloid deposition
LM: mesangial expansion, GBM thickening, eosinophilic nodular glomerulosclerosis
- has Kimmelstiel-Wilson lesions
1. non-enzymatic glycosylation of GBM --> increased permeability and thickening
2. non-enzymatic glycosylation if efferent arterioles --> increased GFR --> mesangial expansion
Most common cause of ESRD in US
Sets with similar terms
Nephritic + Nephrotic Syndrome
PATH: Congenital and Cystic Renal Diseases Part II
Kidney 3: Glomerular Diseases Part 2 - 2.16
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