Renal Path 2

Question 1

What does linear pattern + granular pattern suggest on kidney biopsy

Answer 1

Linear- Characteric findings in anti glomerular basement membrane disease (good pasture)

Granular- indicates immune complexes deposition in the glomerulus

-patterns are caused by antigen-antibody complexes

Question 2

What does electron microscopy do for dx kidney diseases

Answer 2

• detects submicroscopic defects in the glomerulus

- detects the sites of immune compels deposotion

Question 3

hypersensitive type in glomerular diseases

Answer 3

Type 3 hypersensitivity

Question 4

Immune complex mechanism of glomerular injury

Answer 4

immune complexes end up in kidney and create sub epithelial, basement membrane and sub endothelial deposits

Question 5

Anti GBM antibody mechanism of glomerular injury

Answer 5

presence of antibodies within the glomerular basement membrane
-with any alterations to the basement membrane, filtation activity of glomerulus drops sig and causes various symptoms

Question 6

Antibody against glomerular antigen mechanism for glomerular injury

Answer 6

AB against GBM antigens (alpha 3 chain of type IV collagen)

-cytokines damage podocytes

Question 7

Nephritic syndrome

Answer 7

proteinuria <3.5
Azotemia
*Glomerular injury due to neutrophils
hypertension due to salt retention
generalized edema

Question 8

Nephrotic syndrome features

Answer 8

Heavy protenuria (>3.5)
*glomerular inury due to cytokines
generalized pitting edema
increased risk of developing spontaneous peritonis
hypertension

Question 9

Causes of acute nephritic syndrome

Answer 9

• Acute post stretococcal glomerulonephrits
• non sreptococcal GN
• Goodpasture
• Rapidy progressive glomerulonephritis
• IgA Nephropathy

Question 10

Causes of nephrotic syndrome

Answer 10

• minimal change diease
• membranous GN
• membranoproliferative GN
• focal segmental glomerulosclerosis
• Focal GN
• IgA nephropathy
• systemic inf
• maligancy

Question 11

Symptoms of acute post streptococcal glomerulonephritis

Answer 11

Sudden apperence of: Edema, Hamaturia, Protteinuria,, Hypertension

-inflammation of the glomerulus is manifested by proliferation of cellular elements secondary to an immunological mechanism

Question 12

What is goodpasture syndrome

Answer 12

-glomerulomephritis with or without pulmonary hemmorge and presence of circulating anti-glomerular basement membrane antibodies

Question 13

Clinical pres of goodpasture syndrome

Answer 13

60-80% of pts have renal and pulmonary symptoms

• constitutional symptoms
• Hemoptysis (if affecting the lungs)
• Renal hematuria, edema, high blood pressure

Question 14

What is IgA nepropathy- how common, gender

Answer 14

The most common cause of GN in the world
Male>Female
IgA nephropathy is characterized by predominant IgA deposition in the glomerular mesangium

Question 15

Clinical features of IgA nephropathy

Answer 15

• Recurrent gross hematira (predominant nephritic pres first 48-72hrs
• associated with upper respiratory tract inf

Question 16

pathophysiology of IgA nephropathy (2)

Answer 16

1. can manifest as necorotizing glomerulonephritis and crescent formation
2. Tubular occlusion by RBCs causes mild glomerular inury

Question 17

Pathology of chronic renal failure and clinical features

Answer 17

-destructuion of renal parenchyma, mephrons or tubular damage

s/s- GFR decrease, azotemia, uremia, oliguria, acidosis

Question 18

4 stages of Chronic renal failure

Answer 18

1. decreased renal reserve (GFR 50%)

2 Renal insufficiency (75% of renal parenchyma damage)

3, (90% damage, GFR 10%)

4. End stage Kindney (GFR <5%)

Question 19

internal vs external urinary tract obstruction

Answer 19

internal- in the urinary tract and kidney

External- Involving external organs (growing lymph nodes or tumors compressing urinary tract)

Question 20

What is vesicouretal reflex

Answer 20

-occurs in 33% of prenatal hydronephrosis

• obstruction at distal level of urinary bladder and prostatic urethra leads to overflowing bladder
• as a result of overflowing bladder, urine can go back to ureter, dialate kidney pelvis and press on tissue of kidney

Question 21

complications of urinary tract obstruction (+ mc)

Answer 21

Hydrophroesis (mc)
Urolithiasis (renal stones)
-infection
-Renal insufficieny/failure

Question 22

causes of renal caliculi/stones

Answer 22

• hypercalciuria in abscence of hypercalcemia
• increased GI reabsorptopn of Ca
• Decreased urine volume
• primary hyperparathyroidsism

Question 23

Types of renal stones (+mc)

Answer 23

calcium stones (80%)
ca oxalate >50% (pure vegans chrones disease)
Ca phosphate 10-20% (children)