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Sammy1 - sammy10
#1
A 26 year old woman presents with increasing fatigue and malaise. She states that recently she develops a red facial rash whenever she goes outside on a suny day. Physical examination finds that she is afebrile, but her bp is slightly increased and slight peripheral edema is found. Lab evaluation finds slightly elevated BUN and creatinine, while dipstic examination of her urine reveals slight proteinuria with microscopic heamturia. Very rare granular and red cells casts are seen. lab examination is also positive for serum antinuclear antibodies, one of which is anti-double stranded DNA. A renal biopsy reveals diffuse proliferative GN and diagnosis of class IV lupus nephritis is made. Which of the following description best describes the histologic appearence of the nephritis mentioned?

A. Mesangial deposits form a 'holly leaf' pattern
B. Positive immunofluorescence forms a ' string of popcorn' pattern
C. Splitting of basement membrane forms a 'tram track' pattern
D. Thickening of basement membrane forms ' spike and dome' apperance.
E. Thickening of the glomerular capillaries form ' wire and loop apperance"
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#2
e.. wire loop ....lesions of lupus????
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#3
Jus posting my list here to immortalise it in this forum ..

SPIKE AND DOME : DIFFUSE MEMBRANOUS GNPATHY

HOLLY LEAF PATTERN : IGA NEPHROPATHY .. C3 deposits...

TRAM TRACKING : MPGN (thanks to Goljan Uncle) splitting of Basement as he says in his lecture

WIRE LOOP ...... DIFFUSE PROLIFERATIVE LUPUS.... I remember my teacher in Medicine .... most of the "wires" in medicine are "Blood Vessels".... So what proliferates? Blood Vessels.... Stage IV is Diffuse proliferative

STRING OF POPCORN : MEMBRANOUS NEPHROPATHY.... so If the question wud have asked Type II Lupus nephritis ... two answers ..... spike dome and string of popcorn ....... fun question sammy .. thanks!!!
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#4
Brilliant Piroxicam. Bravo..and thanks
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#5
dd diffuse proliferative class 4
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#6
eeeeee----SLE
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#7
oops i mean eeeee
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#8
EEEEE
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