UWSA 2 renal Q (spoiler)

[hyrule]

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To those of you who've done it, remember that GLomerulus microscopy pic in Block 4. How that supposed to be Goodpasture's? It looks like a giant mess to me. I thought you're supposed to see linear Immunoglobulin deposits against the basement membrane. You can't even see the basement membrane because it's covered with all the white stuff (is that just normal glomerular tissue btw?).
Thanks!

 

[silverpaw54]

LOL...I totally agree! The only reason why I got it right is cause I remember a similar question w/ the exact pic when going through UWorld.

 

[ArcGurren]

To those of you who've done it, remember that GLomerulus microscopy pic in Block 4. How that supposed to be Goodpasture's? It looks like a giant mess to me. I thought you're supposed to see linear Immunoglobulin deposits against the basement membrane. You can't even see the basement membrane because it's covered with all the white stuff (is that just normal glomerular tissue btw?).
Thanks!

The IF WAS linear, but it was a highly progressed disease close to renal failure, namely RPGN. You should have recognized that the crescent shape would have classified it as crescentic glomerulonephritis. There's a limited number of things associated with crescentic, and the only answer choice for which it worked was anti-GBM. I agree that they didn't have the other "typical" history for Goodpasture's (namely hemoptysis).

The "white stuff" is the parietal cell + fibrin + basement membrane mess which is growing into the glomerulus. Therefore the anti-GBM would stain linearly across the whole thing.

The renal question which annoyed me more was the one where it showed a stained section of kidney with a big black lump next to... something, and the answer was renin because it was apparently JGA cells. That was awful.

 

[hyrule]

good point. I can identify the crescents on microscopy however everytime I've seen goodpastures on immunofluorescence the key point was the linear BM. Didn't even know you could see crescents on immunofluorescence. I guess I need to familiarize myself with these weird black and white immunofluorescence pics. Any good sources other than google images? Goljan seems incomplete.

 

[xlr8]

yeah i remember that question, I did a thorough search on google images and couldnt really find anything similar to that for a goodpasture immunofluorescence.

but i think it was intentionally done to show you the relationship between RPGN's (Types I,II,II) and crescent formation