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CPR II Exam II > (4.1) Renal Pathology II/III (Putthoff) > Flashcards

(4.1) Renal Pathology II/III (Putthoff) Flashcards

1
Q

What is this a hallmark of?

A

Membranoproliferative Glomerulonephritis (MPGN)

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2
Q

What are the major clinical characteristics of membranoproliferative glomerulonephritis (MPGN) type 1?

A
  • Children/Young adults
  • Mild hypertension
  • 50% of MPGN 1 pts. develop chronic renal failure over 10 year time span
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3
Q

What are the major clinical manifestations of membranoproliferative glomerulonephritis (MPGN) type I SECONDARY?

A
  • Almost exclusively in ADULTS
  • Is a reflection of renal glomerular disease in pateints with (Hep C, SLE, Malignancies)
  • 50% will experience chronic renal failure in 10 years
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4
Q

What is the other name for “membranoproliferative glomerulonephritis II”?

A

Dense deposit disease

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5
Q

What are the clinical manifestations of membranoproliferative glomerulonephritis II?

A

Primarily occurs in children

Less common than MPGN 1

Hematuria is a more dominant clinical finding

Severe renal disease and poorer prognosis than MGPN Type 1

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6
Q

If you have LOW complement levels and a glomerulonephritis syndrome… what do you most likely have?

A

MPGN II

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7
Q

What is this pattern of immunofluorescence a hallmark of?

A

IgA Nephropathy

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8
Q

What type of disease is berger?

A

Renal IgA nephropathy – no systemic disease

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9
Q

What type of disease is Henoch - Schonlein purpura (HSP)?

A

IgA nephropathy associated with systemic disease

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10
Q

What are the clinical manifestations of Henoch-Schonlein purpura (HSP)?

A

Skin (purpuric) manifestations

IgA nephropathy

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11
Q

What is the population associated with IgA nephropathy?

A

Caucasians

Asians

Older children and young adults

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12
Q

Over time with chronic glomerulonephritis, trichrome stains will reveal…

A

Sclerosing/obliteration of glomeruli

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13
Q

What are the (6) forms of primary glomerular diseases that progress to chronic glomerulonephritis?

A

90% = Crescentic GN

50-80% = Focal segmental glomerulosclerosis

50% = Membranoproliferative GN

30-80% = Membranous nephropathy

30-50% = IgAN

90% = Crescentic GN

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14
Q

NOW ON SECOND POWERPOINT SET

A
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15
Q

What are the (2) forms of hereditary nephritis?

A

Alport syndrome

Thin basement membrane disease

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16
Q

What is the appearance of alport syndrome on EM?

A

Irregular thickening basement membrane, lamination of the lamina densa

“Moth-earten” “frayed” appearance

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17
Q

What are the clinical manifestations of thin basement membrane disease (benign familial hematuria)?

A
  • Hematuria due to thinned glomerular basement membranes
  • Pts have asymptomatic microscopic hematuria
  • Renal function is unremarkable
  • Anomaly is due to gene mutations in alpha3 or alpha4 chains in type IV collagen
  • MOST PTs are HETEROZYGOUS
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18
Q

Summarize the mechanism of

Type I DM

Type II DM

A

Type I DM = Autoimmune disease

Type II DM = Peripheral resistance to insulin

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19
Q

What are the two major processes that play key pathophysiologic roles as diabetic glomerular lesions develop?

A

Metabolic defect linked to hyperglycemia

Hemodynamic effects associated with glomerular hypertrophy

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20
Q

What are histologic indications of diabetic nephropathy?

A

Thickened tubular basement membranes

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21
Q

What is this image an example of?

A

End Stage Diabetic Nephrosclerosis

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22
Q

What are the histologic hallmarks of diffuse proliferative lupus nephritis?

A

Marked increase in cellularity

Glomerular size is greatly enlarged

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23
Q

What is the worst type of lupus?

A

Diffuse lupus nephritis (class IV)

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24
Q

What are two common reasons for acute tubular injury?

A

Ischemia

Toxic injury

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25
Q

What are two UNCOMMON etiologies of acute tubular injury?

A

Acute tubulointerstitial nephritis

Urniary obstruction

26
Q

Define:

Urinary tract infection

A

Infection anywhere along urinary tract from renal cortex to urethra

27
Q

Define:

Cystitis

A

Inflammation of the urinary bladder mucosa

28
Q

Define:

Acute pyelonephritis

A

Acute bacterial infection of kidney

29
Q

Define:

Chronic pyelonephritis

A

Recurrent or continuous long-term chronic infection of the kidney with resultant damage to pelvis/calyceal system and parenchyma that results in anatomical distortion

30
Q

What are the most likely gram-negative bacteria that cause UTIs?

A

E. coli

Proteus

Klebsiella

Enterobacter

31
Q

What does hydronephrosis mean?

A

Dilated ureter

32
Q

What is the etiology of benign neprhosclerosis?

A

Increasing age

Hypertension

DM

33
Q

What is the pathogenesis of benign neprhosclerosis?

A

Medial and intimal thickening in response to hemodynamic changes

Hyaline protein depositions in the arteriolar walls

34
Q

Malignant hypertension is…

A

A Clinical syndrome and Medical EMERGENCY

35
Q

What are the pathologic effects of malignant hypertension?

A

Ischemic kidneys

Elevated RENIN

Self-perpetuation cycle of damge and hypertension

36
Q

What is the gross appearance of a kidney that has undergone malignant hypertension?

A

“Flea-bitten” appearance of renal hemorrhages

37
Q

What is the definition of malignant hypertension?

A

Systolic >180

Diastolic >120

38
Q

What are the clinical manifestations of malignant hypertension?

A

Papilledema

Retinal hemorrhages

Encephalopathy

Cardiovascular abnormalities

Renal failure

39
Q

What is this?

A

Atherosclerosis

40
Q

What is this?

A

Fibromuscular dysplasia

41
Q

What are the classic features of thrombotic thrombocytopenic purpura (TTP)?

A

Fever

Neurologic symptoms

Microangiopathic hemolytic anemia

Thrombocytopenia

Renal failure (50% of patients)

Usually adults <40; more common in females

42
Q

What is this?

A

Diffuse cortical necrosis

43
Q

SLIDE DECK 3 NOW

A
44
Q

What are examples of congenital disorders of the kidney?

A

Agenesis

Hypoplasia

Ectopic kidney

Horseshoe kidney

45
Q

Renal cysts are:

Common/Uncommon?

A

COMMON!!!!

More than 50% of those over 50 have cysts in the renal parenchyma

46
Q

Memorize this table

A

I know it sucks but just do it

47
Q

Anotha one

A
48
Q

Name the disorder:

“This hereditary disorder is characterized by multiple expanding cysts of both kidneys that ultimately destroy the renal parenchyma and result in renal failure”

A

Autosomal dominant (adult) polycystic kidney disease (ADPKD)

49
Q

What is the gross appearance of ADPKD (autosomal dominant polycystic kidney disease)?

A

ENLARGED kidneys

Tons of cysts

50
Q

85% of ADPKD patient’s have a defective _______ gene

A

PKD1

51
Q

15% of ADPKD patient’s have a defective _______ gene

A

PKD2

52
Q

Autosomal dominant polycystic kidney disease (ADPKD)

40% have _______

A

Hepatic cysts

53
Q

Autosomal recessive polycystic kidney disease (ARPKD)

Population?

A

Children

54
Q

Autosomal recessive polycystic kidney disease (ARPKD)

Gross appearance?

A
55
Q

Autosomal recessive polycystic kidney disease (ARPKD)

What gene? What chromosome?

A

PKHD 1

Chromosome 6

56
Q

Autosomal recessive polycystic kidney disease (ARPKD)

What are the most common clinical subtypes?

A

Perinatal

Neonatal

57
Q

Another table to memorize

A

It feels like pier one imports with all these tables

58
Q

Multicystic renal dysplasia

Most cases have and absent…

A

URETER

59
Q

What does nephrolithiasis mean?

A

Kidney stones

60
Q
A

CPR II Exam II (21 decks)

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