Histo/Microscopy
What is the classic buzzword description of the GBM thickening and splitting that can be visualized under LM in MPGN?
”Tram-track” appearance
Minimal Change Disease is the most common cause of nephrotic syndrome in children. Although it is often idiopathic, what is the primary condition that MCD may follow?
Upper Respiratory Infection
Which nephrotic/nephritic syndrome is also referred to as ”Crescentic“?
RPGN
Which nephrotic/nephritic syndrome is positive for anti-PLA2R antibody?
Membranous Nephropathy
Which general category (i.e. nephrotic or nephritic) is associated with podocyte effacement?
Nephrotic Syndrome
Which condition is pathognomonic with Kimmelstiel-Wilson nodules?
Diabetic Glomerulonephropathy
Which nephrotic/nephritic condition is famously associated with Sickle Cell Disease?
Focal Segmental Glomerulosclerosis
Which nephrotic/nephritic syndrome is classically described as having a granular, “starry sky” or “lumpy bumpy” appearance on IF?
PSGN
Which 2 nephrotic/nephritic syndromes are classically associated with Hepatitis B?
Membranous Nephropathy & MPGN
Name 2 differences between PSGN and IgA Nephropathy.
IgA Nephropathy: nonspecific URI or GI infection, 2-3 days following infection
Which condition is associated with the classic “spike and dome” appearance on EM?
***Bonus: extra points if you can answer what the spikes and domes represent!
Membranous Nephropathy
***Spikes: thickened basement membrane
***Domes: immune complex deposits in BM
Which nephrotic/nephritic syndrome is associated with multiple myeloma?
Amyloid Nephropathy
Which nephrotic/nephritic condition has a higher prevalence in African American and Hispanic populations?
FSGS
Which nephrotic/nephritic syndrome is classically associated with heroin and HIV?
FSGS
Which nephrotic/nephritic syndromes lead to hypocomplimentemia (low C3)?
PSGN & MPGN
Which nephrotic/nephritic condition classically stains with Congo red, and what color/description is classically described on the Congo red stain?
Amyloid Nephropathy
***Apple-green birefringence under polarized light
Which two nephrotic/nephritic syndromes are associated with Systemic Lupus Erythematosus (SLE)?
Membranous Nephropathy & DPGN
Which nephrotic/nephritic syndrome presents with “wire looping” of capillaries on LM?
DPGN
Which nephritic/nephrotic syndrome is associated with solid tumors?
***Bonus: if you can name which cancers are most commonly associated, double points!
Membranous Nephropathy
***Lung, prostate, colon
Which 2 nephrotic/nephritic syndromes are associated with chronic NSAID use?
Membranous Nephropathy & Minimal Change Disease
Which 2 nephrotic/nephritic syndromes present with mesangial proliferation/expansion?
Diabetic Glomerulonephropathy & IgA Nephropathy
Which condition is associated with Hodgkin Lymphoma?
***Bonus: if you can explain why, extra points!
Minimal Change Disease
***Reed-Sternberg cells secrete cytokines leading to podocyte effacement and loss of negative charge GBM.
DOUBLE JEOPARDY
Name the IF patterns that would be visualized for each of the 3 types of RPGN, including potential causes (diagnoses) of each.
Type I: linear due to anti-GBM antibodies binding collagen (Goodpasture)
Type II: granular due to immune complex deposition (PSGN, DPGN, IgA Nephropathy)
Type III: negative/pauci-immune (Granulomatosis with Polyangiitis, Eosinophilic Granulomatosis, Microscopic Polyangiitis)
In Diabetic Glomerulonephropathy, the chronic hyperglycemia leads to non-enzymatic glycation and GBM thickening. These patients often have increased glomerular pressure, leading to non-selective proteinuria and glomerular hyperfiltration. Which arteriole is classically affected in this condition, and what is the term for when this arteriole is thickened?
Efferent
Primary efferent hyaline arteriolosclerosis
Alport syndrome is a genetic condition that leads to a defect in type IV collagen, whose symptoms can be remembered by the phrase “can’t see, can’t pee, can’t hear a bee.” Name the symptoms, and name the genes affected.
Can’t See: retinopathy, anterior lenticonus
Can’t Pee: glomerulonephritis
Can’t Hear a Bee: sensorineural hearing loss
Genes: COL4A3, COL4A4, COL4A5