Dobson Renal Path #5

Question 1

What is nephrosclerosis associated with?

Answer 1

Hypertension, this can be a cause and a consequence of nephroscleorsis

Question 2

What is fibromuscular dysplasia?

Answer 2

• focal irregular thickening in medium and large arteries
• There are segments of vessels walls that are thickened with medial and intimal hyperplasia and fibrosis which results in luminal stenosis
• Adjacent vessel segment on angiography shows string of beads

Question 3

What causes thrombotic microangiopathy (TTP and HUS)?

Answer 3

• Damage to the capillaries or arterioles in tissue beds that result in thrombi formation. These create abnormal flow producing microangiopathic hemolytic anemia &/or produce microvascular occlusion

Question 4

What bacteria is typical HUS associated with? Who gets it, what does it present with?

Answer 4

• E. coli O157:H7 which produces shiga like toxin
• Occurs at any age but usually kids and older adults
• Follows prodrome of flu like or diarrheal sx with sudden onset of bleeding, severe oliguria and hematuria with microangiopathic hemolytic anemia and thrombocytopenia

Question 5

Describe the causes of atypical HUS.

Answer 5

• Factor H deficiency, this breaks down the alternative pathway C3 convertase and protects cells from damage by uncongtrolled complement activation
• Antiphospholipid syndrome associated with SLE-microangiopathy follows chronic course
• Pregnancy or post partum, occuring after uneventful pregnancy, poor prognosis
• hypertension
• Chemotherapy
• Radiation

Question 6

How do you diagnose renal artery disease?

Answer 6

Arteriography

Question 7

Sickle cell nephropathy

Answer 7

• Hematuria and diminishedconcentrating ability
• Patchy papillary necrosis associated with cortical scarring
• Proteinuria is also common

Question 8

What is this?

Answer 8

Nephrosclerosis