PATHOLOGY

Renal

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Matching: Glomerular pathology/nephritic syndrome

(item may be used more than once)
[note: LM = light microscopy; EM = electron microscopy; IF = immunofluorescence]
-?-membraneoproliferative glomerulonephritis EM: subendothelial humps, "tram track"
-?-Goodpasture's syndrome IF: linear pattern, anti-GBM antibodies
-?-IgA nephropathy (Berger's disease) IF and EM: mesangial deposits; mild disease; often postinfectious
-?-Alport's syndrome split basement membrane
-?-rapidly progressive glomerulonephritis LM and IF: crescent-moon shaped; rapid course to renal failure from one of many causes
-?-acute poststreptococcal glomerulonephritis LM: glomeruli enlarged and hypercellular, neutrophils, "lumpy-dumpy"; EM: subepithelial humps; IF: granular pattern; most frequently seen in children
-?-Alport's syndrome collagen IV mutation; nerve deafness & ocular disorders
-?-Goodpasture's syndrome hemoptysis, hematuria
acute poststreptococcal glomerulonephritis rapidly progressive glomerulonephritis Goodpasture's syndrome membraneoproliferative glomerulonephritis IgA nephropathy (Berger's disease) Alport's syndrome

Matching: Glomerular pathology/nephritic syndrome

(item may be used more than once)
[note: LM = light microscopy; EM = electron microscopy; IF = immunofluorescence]
-?-diabetic nephropathy LM: wire-loop appearance with extensive granular subendothelial basement membrane deposits in membranous glomerulonephritis pattern
-?-membranous gloerulonephritis LM: diffuse capillary & basement membrane thickening; IF: granular pattern; EM: "spike & dome"
-?-focual segmental glomerular sclerosis LM: segmental sclerosis and hyalinosis
-?-diabetic nephropathy LM: Kimmelstiel-Wilson lesions, basement membrane thickening
-?-minimal change disease (lipoid nephrosis) LM: normal glomeruli; EM foot process effacement
-?-focual segmental glomerular sclerosis more severe in HIV patients
-?-membranous gloerulonephritis a common cause of adult nephritic syndrome
-?-minimal change disease (lipoid nephrosis) most common cause of childhood nephritic syndrome; responds well to steroids
membranous gloerulonephritis minimal change disease (lipoid nephrosis) focual segmental glomerular sclerosis diabetic nephropathy SLE (5 patterns of renal involvement)

Matching: 4 major types of kidney stones

-?-cystine most often 2° to cystinuria; radiolucent
-?-ammonium magnesium phosphate (struvite) 2nd most common kidney stone; radiopaque and urease-positive bugs such as Proteus vulgaris or Staphylococcus
-?-uric acid strong association with hyperuricemia (eg, gout); often seen as a result of diseases with ↑ cell proliferation and turnover, such as leukemia & myeloproliferative disorders; radiolucent
-?-calcium constitute the majority of kidney stones (80-85%); stones are radiopaque; tend to recur
calcium ammonium magnesium phosphate (struvite) uric acid cystine

Renal cell carcinoma

Most common renal malignancy; most common in men ages -?-50 to -?-70; ↑ incidence in -?-smokers; associated with -?-von Hippel-Lindau and gene deletion in chromosome 3.

Wilms' tumor

Most common renal malignancy of -?-early childhood (ages 2-4); deletion of tumor suppression gene WT1 on chromosome -?-11; can be part of -?-WAGR (Wilms' tumor, Aniridia, Genitourinary malformation, mental-motor Retardation) complex.

Transitional cell carcinoma

most common tumor of -?-urninary tract sytem; often -?-recurs after removal; Associated with problems in your Pee -?-SAC (Phenacetin, Smoking, Aniline dyes, and Cyclophosphamide)

Anion gap acidosis

What does the mnemonic MUD PILES stand for?

M -?-Methanol
U -?-Uremia (chronic renal failure)
D -?-Diabetic ketoacidosis
P -?-Paraldehyde or Phenformin
I -?-Iron tablets or INH
L -?-Lactic acidosis (CN-, CO, shock)
E -?-Ethanol or Ethylene glycol
S -?-Salicylates

Matching

-?-pyelonephritis acute- affects cortex with relative sparing of glomeruli/vessels; white cell casts in urine are pathognomonic chronic- coarse, asymmetric corticomedullary scarring; thyroidization of kidney
-?-renal papillary necrosis associated with diabetes mellitus, acute pyelonephritis, chronic phenacetin use
-?-diffuse cortical necrosis acute generalized infarction of cortices of both kidneys; associated with obstetric catastrophes & septic shock
-?-acute tubular necrosis most common cause of acute renal failure; reversible, but fatal if left untreated; associated with renal ischemia, crush injury, toxins
pyelonephritis diffuse cortical necrosis acute tubular necrosis renal papillary necrosis

Acute renal failure

Variable Prerenal Renal Postrenal
Urine osmolality >55 <350 -?-<350
Urine Na <10 -?->20 >40
FENa -?-<1% >2% >4%
BUN/Cr ratio >20 -?-<15 >15
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