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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
What are two UNCOMMON etiologies of **acute tubular injury?**
Acute tubulointerstitial nephritis Urniary obstruction
26
# Define: Urinary tract infection
Infection anywhere along urinary tract from **renal cortex** to **urethra**
27
# Define: ## Footnote **Cystitis**
Inflammation of the urinary bladder mucosa
28
# Define: **Acute pyelonephritis**
Acute bacterial infection of kidney
29
# Define: **Chronic pyelonephritis**
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
What are the most likely gram-negative bacteria that cause UTIs?
E. coli Proteus Klebsiella Enterobacter
31
What does **hydronephrosis** mean?
Dilated ureter
32
What is the etiology of **benign neprhosclerosis?**
Increasing age Hypertension DM
33
What is the pathogenesis of **benign neprhosclerosis?**
Medial and intimal thickening in response to hemodynamic changes **Hyaline** protein depositions in the arteriolar walls
34
Malignant hypertension is...
A **Clinical syndrome** and **Medical EMERGENCY**
35
What are the pathologic effects of **malignant hypertension?**
Ischemic kidneys Elevated **RENIN** Self-perpetuation cycle of damge and hypertension
36
What is the gross appearance of a kidney that has undergone **malignant hypertension?**
"Flea-bitten" appearance of renal hemorrhages
37
What is the definition of **malignant hypertension?**
Systolic \>180 Diastolic \>120
38
What are the clinical manifestations of **malignant hypertension?**
Papilledema Retinal hemorrhages Encephalopathy Cardiovascular abnormalities Renal failure
39
What is this?
Atherosclerosis
40
What is this?
Fibromuscular dysplasia
41
What are the classic features of **thrombotic thrombocytopenic purpura (TTP)?**
Fever **Neurologic symptoms** Microangiopathic hemolytic anemia Thrombocytopenia Renal failure (50% of patients) Usually adults \<40; more common in **females**
42
What is this?
Diffuse cortical necrosis
43
SLIDE DECK 3 NOW
44
What are examples of **congenital disorders** of the kidney?
Agenesis Hypoplasia Ectopic kidney Horseshoe kidney
45
Renal cysts are: Common/Uncommon?
COMMON!!!! More than 50% of those over 50 have cysts in the renal parenchyma
46
Memorize this table
I know it sucks but just do it
47
Anotha one
48
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"
Autosomal dominant (adult) polycystic kidney disease (ADPKD)
49
What is the gross appearance of ADPKD (autosomal dominant polycystic kidney disease)?
ENLARGED kidneys Tons of cysts
50
85% of ADPKD patient's have a defective _______ gene
PKD1
51
15% of ADPKD patient's have a defective _______ gene
PKD2
52
Autosomal dominant polycystic kidney disease (ADPKD) 40% have \_\_\_\_\_\_\_
Hepatic cysts
53
Autosomal recessive polycystic kidney disease (ARPKD) Population?
Children
54
Autosomal recessive polycystic kidney disease (ARPKD) Gross appearance?
55
Autosomal recessive polycystic kidney disease (ARPKD) What gene? What chromosome?
PKHD 1 Chromosome 6
56
Autosomal recessive polycystic kidney disease (ARPKD) What are the most common clinical subtypes?
Perinatal Neonatal
57
Another table to memorize
It feels like pier one imports with all these tables
58
Multicystic renal dysplasia Most cases have and absent...
URETER
59
What does **nephrolithiasis** mean?
Kidney stones
60

CPR II Exam II (21 decks)

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