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Tubulointerstitial
Glomerular
-proteinuria
Salt losing nephritis
Nephritic
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Nephrotic
Rarely seen
Hypertension
Hematuria
massive proteinuria
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[RBC > 3RBC/Hpf]
(>3.5g/day)
Lipiduria
for 3 consecutive urine
(waxy casts)
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specimen
Natural anticoagulants
RBC Casts
Protein C, S
lost ? Fibrinogen
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AT-III
Hematuria
Hypercoagulable
Synthesis
(APRE-Liver)
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glomerular
extraglomerular
m/c Idiopathic Hypercalcemia
Dysmorphic
Isomorphic
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Nephritic RBC
RBC
nephrotic
edema(mild)
edema (Severe)
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Initiating-protein loss
Na+/H2O Retention
Cause of edema - Na+/H2O Retention
? Hydrostatic pressure > Osmotic
Pressure.
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Nephritis
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Nephrotic
Pediatric - PSGN
Ped - Minimal change Disease
Lipoid necrosis
Adult - IgA nephropathy
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Adult FSGN (23%)
Overall- IgA nephropathy
Elderly- MGN-(30/of adults)
Overall-FSGS
Nephrotic >2 nephrotic
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2° nephrotic m/c Cause - DM
Genetics
Overall FSGS > DMT
1) NPHS-1 gene
2) NPHS-2 gene
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Nephrin defect
Podocin
Congenital Nephrotic Syndrome
Steroid Resistant
Finnish Type
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nephrotic Syndrome
-a/w FSGS
ii) AR-FSGS
iii) a-Actinin-4 gene:
IV] TRPC-6 gene - Transient
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Receptor Potential Calcium-6 gene
Imutation
AD- FSGS
Adult onset-FSGS
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VEC- Podocytes
mesangial cells - modified
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macrophages
1) Subepithelial - PSGN.
MTGN.
RPGN m/c S.Edeposits among 3 types of RPGN
2) Subendothelial. Between endothelium Basement membrane
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NTPGN - I
Lupus nephritis (with wire loop lesion)
3) Intramembranous - Between 2 layers of Basement membrane !
NTPGN-II
4) Mesangial matrix - IgA Nephropathy.
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Post-Streptococcal glomerulonephritis-
Group-A-ß-hemolytic Streptococci.
PSGN
Rheumatic Heart disease
Strains-1, 4, 12
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1,3,5,6,18
Both pharyngitis (m/c)
only pharyngitis
skin infection
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Incubation
(1-3) days
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1-3 weeks
IgA nephropathy
(1-21days)
Berger's disease
PSGN
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Colored - Normal
Transient
Hypocomplementemia
IgA1 -rephitogenic
only upto 6-weeks
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-mesangial deposits
Normal complement
CD-IN
1) IMT
2) EMT
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3) IFL
electron EM
(microscopy)
Hybracellular
Subepithelial Humps
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glomeruli
Humpsign
(exocapillary bendanfilary
Immunofluorescence
proliferation) maximum
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PSGN >mpqN
excapillary. Inflammatory
Lumpy Bumpy
cells N- outside
immunofluorescence
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capillaries
PSGN > RPGN -II (PSGN
Acute-Resolve
associated
(CRP) least PSGN
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RPGN-II (PSGN)
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Glomerulonephritis
Most characteristic
Prognosis-correlate to number of crescents
[>50% - Poor prognosis]
Component
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Crescent
cytokine
endothelial damage
Procoagulant Release
Fibrin
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Fibrin+ monocyte
Parietal epithelial
attach to monocytes
cell
activated monocytes
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M/Ifactor - Fibrin
cytokines
RPGN
I
II
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III (m/c)
Anti-GBM Ab
Immune Complex
Pauci immune
Goodpasture
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HSP; PSGN
No deposits
Syndrome
SLE
ANCA associated
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Ab against
IFL Granular
a3 of Type-IV collagen
C-ANCA
P-ANCA
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Type-II HSR
polyangiitis
PAN
Lung affected first > Renal
with granulomatosis
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NO ANCA
(Wegener's)
m/c - LOD- Renal failure
C-ANCA>P-ANCA
P-ANCA
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microscopic
IFL. Linear Ribbon like (IgG)
PAN
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Good pasture Syndrome
Ribbon Candy appearance
IgG- Bullous pemphigoid
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SLE Nephritis. WHO
I - Minimal.
II - Mesangial
III - Focal
IV - Diffuse proliferative
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V - Membranous
VI - Sclerosing
Wire loop lesion
Subendothelial deposits
IV > II III
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Renal vein thrombosis m/c associated with MTGN
V > IV > III > II , I(not seen)
I wireloop lesion- active + poor prognosis.
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Age-5-20
XL dominant(m/c)
o/f: eye - Anterior lenticonus, Lens subluxation
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leonor - Sensorineural Deafness.
Renal - Hematuria.
Renal ab? a5 Type-IV Collagen. [XLD]
Autosomal disorders- ab against. a3, a4 chain
Electron microscopy-only-diagnostic
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earliest - Thinning of BM.
Nephrotic :
Thickening (Irregular)
Rupture Splitting of Lamina densa.
Heat by lamellation
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Basket-weave
Megalin Ab - Heyman's Nephritis
G. Membranous GN - model
Mouse
30% Drugs.
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10/Idiopathic
Death
Malignancies - Ca-Colon
Leukemias/ Lymphoma
Ca-Breast
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MTGN.
Minimal change
Disease
--- Content provided by FirstRanker.com ---
Membranous glomerulonephritis
Hep-c: m/c-a/w- 1) Cryoglobulinemic GN
ii) MTGN
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iii) TPGN
Hep-B- m/c/a/w- bed MTGN
adult mpgN
Overall - MTGN
Tembranous GN
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Lim - Capillary Basement membrane Thickening
luNT:
No Rupture of Basement membrane
effacement of foot process
(i) effacement
--- Content provided by FirstRanker.com ---
of foot process.
ii) Spike odome
NTCD (effacement+rem)
appearance on
MTGN
--- Content provided by FirstRanker.com ---
(silver staining).
mpgN
Best Seenin - IT with
7SGN
silver stain
--- Content provided by FirstRanker.com ---
Diabetic Nephropathy
Subepithelial deposits
with intact BM.
effimembraneus B
deposits.
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II
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activation of Both
Only Alternate
Complement
classical
classical
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complement
Receptor def
alternate
alternate
complement
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IgM
IgG
No IgG
Intramembranous
Both types
--- Content provided by FirstRanker.com ---
Subendothelial
Partial Lipodystrophy
Double Contour/
Tram-Track/Splitting of Basement
I > II > III
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membrane
Duetomesangial interposition.
(Between Bintendothelium)
FSGS:
1) Idiopathic
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2) Scarring Sickle cell anaemia.
3) Heroin Abuse
4) HIV m/kiFSGS - Hiv associated Worse prognosis
HIV-AN
worse prognosis Kollapsing type (Histological
--- Content provided by FirstRanker.com ---
3) MTIN
variants
4) TTPOIN
dx for HIV-AN Tubuloreticular inclusion within
Em endothelial cells
--- Content provided by FirstRanker.com ---
5) Reflux Nephropathy).
6) HTN Nephropathy
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Dal ablation
Renal agenesis
Hallmark - Visceral epithelial damage
Damage inform of. Hypertrophy o necrosis
--- Content provided by FirstRanker.com ---
Diabetic Nephropathy).
MI: Duration of disease.
microscopy
earliest Capillary Basement membrane
thickening
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m/c- Diffuse glomerulosclerosis
m/specific- Kimmelstiel-Wilson-nodular Sclerosis.
Nodular Sclerosis-Capsular
Drops
Fibrin Caps
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Papillary necrosis
Necrosis of Blood vessels
projecting like papillae
into lumen
due to microangiopathic features
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Glycogen
--- Content provided by FirstRanker.com ---
Pamanyebstein Cells
Vascular:
Benign Nephrosclerosis.
Malignant Nephrosclerosis
Gross : B/L Symmetrical
--- Content provided by FirstRanker.com ---
Gross- Kidney - variable Size
contraction of kidney.
(Small/large)
ME:
Rupture of arteriolar
--- Content provided by FirstRanker.com ---
capillaries.
petechial Hemorrhages
Hyaline arteriosclerosis.
Flea Bitten
malignant HTN
--- Content provided by FirstRanker.com ---
Infiendocarditis.
HUS.
Malignant
Vasculitis.
ME
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Dueto
pressure exerted by Blood flow
Tunica media Smooth muscle proliferation
1) Hyperplastic arteriosclerosis
Fibrinoid Necrosis: 2) Fibrin + immune complexes.
--- Content provided by FirstRanker.com ---
3) Onion-skin
--- Content provided by FirstRanker.com ---
of kidney)
AR-PKD
AD-PKD
Pediatrics
Adults
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PKHD-1
PKD 1> PKD 2
polycystin-1->
Fibrocystin
extra Renal- m/c
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Hepatic fibrosis+ Cysts.
Hepatic cysts > Colonic
diverticulosis
Cysts not seenin
Intestine>Brain > Lungs
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(very Rare) (Rare)
Nocysts
Berry's Aneurysm
M/CCOD - Hypertensive Crisis
Nephrocalcinosis.
--- Content provided by FirstRanker.com ---
Medullary Sponge kidney
Medullary Cystic
Cysts at
Cysts at
Hilum
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corticomedullary
obstruction
Junction
Stasis
Tubulointerstitial disease
--- Content provided by FirstRanker.com ---
Infection
Salt losing nephropathy
Nephro
calcinosis
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- strongly associated with smoking
Male> female.
--- Content provided by FirstRanker.com ---
3:1
Associated with - Testrogen
-DM/HTN
Larynx
-Asbestos
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Pharynx
boyeous
Stomach
Lung
Colon
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RCC
boyeous
Sporadic 90%
Hereditary(10%) - B/L
1]-Von Hippel Lindau
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Cerebellar Hemangioblastoma
Retinal Angiomas
B/LRCC.
AD, chromosome-3p
m/c Type-clean cell type.
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II) Hereditary Leiomyomatosis with B/L Renal CC: [AD]
papillary Rcc.
more aggressive / more metastasizing > Sporadic.
III) Birat - Hogg Dube Syndrome";
AD.
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m/c Rcc type-chromophobe.
Sickle call anaemia - Medullary RCC
--- Content provided by FirstRanker.com ---
(m/c)
ii) B/L Renal mass
iii) Abdominal pain
Wilms tumor: m/c-Abdominal mass.
Least Common- Hematuria >Fever.
--- Content provided by FirstRanker.com ---
iv) Angioinvasive - Venous System
[10/of RCC]
Metastasis. m/c site-lungs.
Paraneoplastic: m/c ? ESR*
Hypercalcemia
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Hypertension.
Amyloidosis-AA type.
- Cushing's disease (Rare).
Subtypes
i) Clear Cell (m/c)
--- Content provided by FirstRanker.com ---
ii) Papillary.
PCT.
(Chromophilic) PCT.
iii) Chromophobe.
IV) Bellinic duct
--- Content provided by FirstRanker.com ---
- Best prognosis.
worst prognosis*
--- Content provided by FirstRanker.com ---
Bellinic
Chromophobe
PCT.
Clear
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Dialysis
loss of multiple
worse prognosis
associated
chromosomes
--- Content provided by FirstRanker.com ---
apokbade
vacuoles
cystic kidney
(1,3,5,6,8)
stroma
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Both lipid
disease
extreme
Collagen
+ glycogen
--- Content provided by FirstRanker.com ---
cytogenetics
Hypoctafleidy
deposition within
m/cCytogenetics
Trisomy-7
--- Content provided by FirstRanker.com ---
tumormoss
Chromosome-3p(-)m/c)
16
Desmoplasia
VHL-(-).
--- Content provided by FirstRanker.com ---
17.
(poor/prognosis)
Trisomy-7
+36
Hereditary type
--- Content provided by FirstRanker.com ---
Desmoplasia mkin
38
a. of papillary RCC
Pancreatic Adenda
311.
--- Content provided by FirstRanker.com ---
ii) MET. pactoncogene
mutation!
Pediatric
t(x:1)
Wilm's Tumor
--- Content provided by FirstRanker.com ---
2-5 years
U/L (80-90%)
B-apo- Nefrogenic Rests formative domenuli
efibrous stroma)
Small,
--- Content provided by FirstRanker.com ---
Triphasic Histology 1) Blastemahalls -
Polygonal
2)-8/thelial component [immature glomcutit tubules]
3) Stromal Component Fat
m/c Site mets- lungs
--- Content provided by FirstRanker.com ---
Clear Cell Sarcoma variant (Raw) Bony mets
--- Content provided by FirstRanker.com ---
Primitive Neuroectodermal Tumor
Neuroblastoma - NET
Sympathetic ganglia
Mc site - Adrenal medulla.
Age-2 years (18months)
--- Content provided by FirstRanker.com ---
>50% - Cases presents with mets
m/c site - Bones/ Bonemarrow
Lungs Rarely affected
Microscopy - NET.
Nucleus -
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Salt & pepper nuclear chromatin.
cytoplasm - News Secretary granules.
schromaopain / Syrathophysin
Neurofilament / leucin-7/
Bombesin
--- Content provided by FirstRanker.com ---
Electron microscopy
Dense Core granules - electron
microscopy
Shwanomium
Rosette, ependymoma
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stroma.
Pseudo
True
Homer Wright
Clear Space
--- Content provided by FirstRanker.com ---
rosettes (medullo)
Retinoblastoma
newo)
--- Content provided by FirstRanker.com ---
This download link is referred from the post: Medical PG Handwritten Notes 1st Year, 2nd Year, 3rd Year and 4th Year (Study Material)