Picmonic: Renal Path

Question 1

Answer 1

Post-Strep Glomerulonephritis

• Nephritic
• Group A strep pyogenes
• Neutrophil hypercellularity
• IF: granular
• EML subepithelial immune complex humps
• Children
• Edema of face/extremities

Question 2

Answer 2

Rapidly Progressive Glomerulonephritis

• Nephritic
• Crescents: contain fibrin and C3b
• Macrophages
• Caused by Goodpasture, Wegener’s, MicroPolyang.
• poor prognosis :(

Question 3

Answer 3

Diabetic Glomerulonephropathy

• Non-enzymatic glycosylation of BM & arterioles causes hyaline arteriosclerosis
• Increased GFR
• Mesangial expansion (From hyperfiltration)
• Type IV collagen deposition
• Neprhotic-like syndrome

Question 4

Answer 4

Focal Segmental Glomerulosclerosis

• MCC Adult Nephrotic Syndrome
• Associated with HIV & IV drug use
• LM: Segmental sclerosis + hyanlinosis
  EM: Focal damage of visceral epithelial cells
  IF: -
• Microscopic hematuria; non-selective proteinuria
• Poor prognosis

Question 5

Answer 5

Bergers Disease / IgA Glomerulopathy

• MCC Nephritic Syndrome in children
• IgA deposits on mesangium, increased IgA plasma levels
• Also seen in Henoch-Scholein Purpura
• S/S: Pharyngitis, URI, Acute Gastroenteritis

Question 6

Answer 6

Membranoproliferative Glomerulonephritis

TYPE 1 MPGN:

• Subendothelial immune complexes (Hep C antibodies)
• IF: granular
• EM: double contour split BM due to ingrowth of mesangium

TYPE 2 MPGN:

• Dense Deposit Disease
• Circulating C3 Nephritic Factor

Question 7

Answer 7

Membranous Glomerulonephritis

• 2nd MCC Adult Nephrotic Synd (after FSGN)
• LM: Thickening of capillary and glomerular BM
  EM: spikes & dome appearance + subendothelial deposits
  IF: Granular
• Sometimes assoc w/ gold, tumors, HBV, lupus

Question 8

Answer 8

Minimal Change Disease

• MCC Child Nephrotic Syndrome
• EM: loss of foot processes
  LM: NORMAL
• Loss of negative charge –> selective loss of albumin
• Maybe triggered by recent infx or immune stimulus
• Tx: corticosteroids

Question 9

Answer 9

Nephritic Syndrome

• Inflammation of glomeruli
• Hematuria
• RBC casts (intrarenal)
• Azotemia (nitrogen increased)
• Oliguria
• HTN
• Proteinuria (<3.5g/day)

Question 10

Answer 10

Nephrotic Syndrome

• Massive proteinuria (>3.5g/day)
• Edema
• increased risk of infection
• Thromboembolus
• Hyperlipidemia
• Fatty Casts

Question 11

Answer 11

Alport Syndrome

• Genetic Nephritic Syndrome
• XD mutation in Type IV Collagen
• Split basement membrane (in kidneys, eyes, ears)
• Ocular Disorders & Deafness also seen