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Download PG Medical 2nd Year Pathology Renal Pathology Handwritten Notes

Download PG Medical ( Post Graduate Medical degree) 2nd Year Pathology Renal Pathology Handwritten Notes

This post was last modified on 02 August 2021

Medical PG Handwritten Notes 1st Year, 2nd Year, 3rd Year and 4th Year (Study Material)


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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

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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

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of foot process.

ii) Spike odome

NTCD (effacement+rem)

appearance on

MTGN

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(silver staining).

mpgN

Best Seenin - IT with

7SGN

silver stain

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Diabetic Nephropathy

Subepithelial deposits

with intact BM.

effimembraneus B

deposits.

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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

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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

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3) MTIN

variants

4) TTPOIN

dx for HIV-AN Tubuloreticular inclusion within

Em endothelial cells

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5) Reflux Nephropathy).

6) HTN Nephropathy

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Dal ablation

Renal agenesis

Hallmark - Visceral epithelial damage

Damage inform of. Hypertrophy o necrosis

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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

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Pamanyebstein Cells

Vascular:

Benign Nephrosclerosis.

Malignant Nephrosclerosis

Gross : B/L Symmetrical

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Gross- Kidney - variable Size

contraction of kidney.

(Small/large)

ME:

Rupture of arteriolar

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capillaries.

petechial Hemorrhages

Hyaline arteriosclerosis.

Flea Bitten

malignant HTN

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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.

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3) Onion-skin

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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.

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Medullary Sponge kidney

Medullary Cystic

Cysts at

Cysts at

Hilum

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corticomedullary

obstruction

Junction

Stasis

Tubulointerstitial disease

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Infection

Salt losing nephropathy

Nephro

calcinosis

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- strongly associated with smoking

Male> female.

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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

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(m/c)

ii) B/L Renal mass

iii) Abdominal pain

Wilms tumor: m/c-Abdominal mass.

Least Common- Hematuria >Fever.

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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)

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ii) Papillary.

PCT.

(Chromophilic) PCT.

iii) Chromophobe.

IV) Bellinic duct

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- Best prognosis.

worst prognosis*

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Bellinic

Chromophobe

PCT.

Clear

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Dialysis

loss of multiple

worse prognosis

associated

chromosomes

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apokbade

vacuoles

cystic kidney

(1,3,5,6,8)

stroma

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Both lipid

disease

extreme

Collagen

+ glycogen

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cytogenetics

Hypoctafleidy

deposition within

m/cCytogenetics

Trisomy-7

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tumormoss

Chromosome-3p(-)m/c)

16

Desmoplasia

VHL-(-).

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17.

(poor/prognosis)

Trisomy-7

+36

Hereditary type

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Desmoplasia mkin

38

a. of papillary RCC

Pancreatic Adenda

311.

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ii) MET. pactoncogene

mutation!

Pediatric

t(x:1)

Wilm's Tumor

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2-5 years

U/L (80-90%)

B-apo- Nefrogenic Rests formative domenuli

efibrous stroma)

Small,

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Triphasic Histology 1) Blastemahalls -

Polygonal

2)-8/thelial component [immature glomcutit tubules]

3) Stromal Component Fat

m/c Site mets- lungs

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Clear Cell Sarcoma variant (Raw) Bony mets

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Primitive Neuroectodermal Tumor

Neuroblastoma - NET

Sympathetic ganglia

Mc site - Adrenal medulla.

Age-2 years (18months)

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>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

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Electron microscopy

Dense Core granules - electron

microscopy

Shwanomium

Rosette, ependymoma

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stroma.

Pseudo

True

Homer Wright

Clear Space

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rosettes (medullo)

Retinoblastoma

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