histo renal Flashcards
1
Q
kawasaki disease sx
A
strawberry tongue/ mouth inflammation cervical LN fever >5 days hand s and sole desquamation conjunctivitis
2
Q
who gets kawasaki disease
A
<5yo
3
Q
complication of kawasaki disease
A
coronary artery aneurysm
4
Q
who gets buergers disease
A
men <35yo who smoke
5
Q
pathology of Buerger’s disease
A
inflammation of arteries supplying the extremities e.g. radial and tibial- occlusion
6
Q
appearance of Buerger’s disease on angiography
A
corkscrew due to segmental occlusive lesions
7
Q
what is the triad of wegeners granulomatosis
A
saddle nose pulmonary haemmorhage cresenteric glomerulonephritis
8
Q
what are nasal sx of wegeners
A
epistaxis sinusitis saddle nose
9
Q
what are the pulmonary symptoms of wegeners
A
cavitations pulmonary haemmorhage
10
Q
what are the renal symptoms of wegeners
A
crescenteric glomerulonephritis
11
Q
triad of churg strauss
A
eosinophilia asthma vasculitis
12
Q
what autoantibody mediates churg strauss
A
p ANCA against MPO
13
Q
symptoms of microscopic polyangitis
A
pulmonary haemmorhage withglomerulonephritis
14
Q
autoantibody in microscopic polyangiits
A
pANCA against MPO
15
Q
what antibody mediates henoch scheinlich purpura
A
IgA
16
Q
what are the symptoms of Henoch scheinlich purpura
A
UTI that after 5 days is followed by a purpuric rash over lower limb extensors and buttocks glomerulonephritis colicky abdo pain arthritis orchiditis
17
Q
autoantibody for wegeners
A
c ANCA against PR3
18
Q
what renal diseases affect the glomerulus
A
nephrotic syndrome nephritic syndrome
19
Q
what renal diseases affect the tubules and interstitium
A
acute tubular necrosis tubulointerstitial nephritis
20
Q
what are the three subtypes of tubulointerstitial nephritis
A
acute pyelonephritis chronic pyelonephritis with reflux nephropathy interstitial nephritis
21
Q
what renal disease affect the renla blood vessels
A
haemolytic uraemic sndrome thrombotic thrombocytopenic purpura
22
Q
triad of nephrotic syndrome
A
proteinuria (>3g/24hrs) hypoalbuminaemia oedema (+hyperlipidaemia)
23
Q
buzzwords for nephrotic syndrome
A
frothy urine facial oedema in kids peripheral oedema in adults
24
Q
minimal change disease
A
primary cause of nephrotic syndrome paediatric condition
25
what is seen on light microscopy and electron microscopy of minimal change disease
no change on light microscopy loss of podocyte foot process on electron microscopy no immune deposits
26
treatment of minimal change disease
steroids very good prognosis
27
membrnous glomerular disease findings on light microscopy
diffuse glomerular basement membrane thickening
28
membranous glomerular disease findings on electron microscopy
loss of podocyte foot processes spikey subepithelial depositis
29
immunoflourescance findings on membranous glomerular disease
ig and complement in granular deposits along ENTIRE GBM
30
causes of membranous glomerular disease
SLE drugs malignancy
31
prognosis of membranous glomerular disease
pooor response to steroids 45% have ESRF after 2-20 years
32
causes of glomerulosclerosis
being afrocarribean HIV nephropathy secondary to obesity
33
findings on light microscopy in glomerulosclerosis
scarring and consolidation in ofcal areas of glomerulus hyalinosis
34
findings on electron microscopy in glomerulosclerosis
loss of podocyte foot processes
35
immunoflourescance findings in glomerulosclerosis
Ig and complement in scarred areas
36
prognosis in glomerulosclerosis
50% ESRF 50% respond to steroids
37
renal histological findings in diabetes
diffuse GBM thickening kimmenstial wilson nodules
38
what are kimmenstial wilson nodules
mesangial matrix nodules
39
pathology of kimmenstial wilson nodules
Nodules of pink hyaline material form in regions of glomerular capillary loops in the glomerulus. This is due to a marked increase in mesangial matrix from damage as a result of non-enzymatic glycosylation of proteins
40
definition of nephritic syndrome
inflammation of the glomerulus
41
buzzword for nephritic syndrome
coca cola urine
42
signs of nephritic syndrome
haematuria dysmorphic rbc/ rbc casts inurine proteinuria but not in nephrotic range raised urea and creatinine oliguria
43
causes of nephritic syndrome
opst infectious glomerulonephritis rapidly progessive crescenteric glomerulonephritis Buerger's disease Alport's syndrome beinign familial haematuria
44
acute post infectionous glomerulonephritis usual pathogen
group A alpha haemolytic strep strep pyogenes
45
findings in acute post infectious glomerulonephritis
haematuria proteinuria oedema hypertension
46
common infection preceding acute post infectious glomerulonephritis
strep throat or impetigo 1-3 weeks earlier
47
whatare the findings on blood in acute post infectious glomerulonephritis
reduced C3 raised ASOT titre
48
light microscopy findings in acute post infectious glomerulonephritis
increased cellularity of glomeruli
49
electron microscopy findings in acute post infectious glomerulonephritis
subendothelial humps
50
flouresacanc emicroscopy findings for acute post infectious glomerulonephritis
C3 and IgG granular deposits in GBM
51
Buerger disease alternative name
IgA nephropathy
52
pathology of Buerger disease
IgA immune complexdeposition in glomeruli
53
findings on biopsy of Buerger disease
IgA and complement in mesangium
54
preceding sundrome for Buerger disease
URTI 3 days earlier
55
symptoms of buerger disease
frank haemoaturia or peristent microsccopic haematuria
56
complications of buerger disease
ESRF
57
the three types of cresenteric glomerulonephritis
1. anti-GBM antibody 2. Immune complex deposition 3. ANCA associated/ pauci immune
58
type 1 cresenteric glomerulonephritis pathology
anti GBM antibod against COL4-A3
59
causes of type 1 cresenteric glomerulonephritis
goodpastures syndrome HLADRB1 association
60
findings in flourescance microscopy of type 1 cresenteric glomerulonephritis
linear IgG deposits
61
causes of type 2 cresenteric glomerulonephritis
SLE IgA nephropathy post infectious GN
62
microscopy of type 2 cresenteric GN
light: cresencts electrons: lumpy bumpy granular IgG deposits in GBM and mesangium
63
causes of type 3 cresenteric glomerulonephritis
panca micrscopic polyangiits canca wegeners granulomatosis
64
pathology of type 3cresenteric glomerulonephritis
pauci immune no ab anca mediated
65
what is alports syndrome
hereditary nephritis
66
inheritance of alports syndrome
x linked
67
triad of alports syndrome
sensorineural deafness, eye disorders and nephritic syndrome
68
presentation of alports disease
5-20yo nephritic syndrome that progresses to ESRF
69
common eye disorders in alports syndrome
lens dislocation cataracts
70
benign familial haematuria aka
thin basement membrane disease
71
genetic defect in benign familial haematuria
colagen IV alpha 4 chain
72
inheritance of benign familial haematuria
autosomal dominant
73
symptoms of benign familial haematuria
persistant asymptomatic haematuria
74
differentials for asymptomatic haematuria
benign familial haematuria Alport syndrome IgA nephropathy
75
pathology of ATN
damage to tubulointerstitial cells blcokage of tubules by casts reduced flow haemodynamic changes renal failure
76
histology of ATN
necrosis of short tubules
77
causes of ATN
ischaemic: sepsis, burns nephrotoxins: NSAIDS, gentamycin, myoglobin, heavy metals, contrast
78
acute pyelonephritis symptoms
renal angle tenderness fever dysuria haematuria flank pain leukocytic casts in urine
79
CHRONIC pyelonephritis with reflux nephropathy pathogenesis
recurrent bacterial infection causing scarring of the parencyma may be due to obstruction e.g. calculi or urine reflux
80
acute interstitial nephritis pathology
drug hypersensitivity reaction beginning days after exposure
81
symptoms of acute interstitial nephritis
eosinophilia haemauria prtoteinuria rash fever
82
another name for chronic interstiital nephritis
analgesic nephropathy
83
symptoms of chronic interstitial nephritis
HTN haematuria proteinuria anaemia
84
pathophysiology of renal thrombotic microangiopathy
formation of platelet and fibrin rich thrmbi these thrombi damage passing RBC and platelets results in platelet and RBC destruction
85
HUS pathogen
O157:H7 E coli
86
location of thrombi in HUS
confined to kidneys therefore results in renal failure
87
TTP thrombi location
in circulation esp CNS
88
extra sx in TTP in addition to MAHA and bleeding
neuro sx (headache, seizures, coma)
88
89
symptoms of thrombotic microangiopathies (renal)
reduced platelets: petechia, bleeding, haematemesis, melaena MAHA: pallor, jaundice
90
how to diagnose thrombotic microangiopathy (renal)
reduced Hb, reduced plt Coombes test NEGATIVE signs of haemolysis: raised bilirubin, LDH, reticulocytes fragmented RBC on blood smear
91
manifestions of renal failure
raised urea and serum creatinine
92
complication of renal failure
metabolic acidosis hyperkalaemia uraemia hypocalcaemia fluid overload HTN
93
prerenal causes of renal failure
hypoperfusion hypovolaemia- burns, pancreatitis, sepsis
94
renalauses of renal failure
ATN acute glomerulonephritis toxins thrombotic microangiopathy
95
post renal causes of renal failure
obstruction e.g. calculi or tumour
96
chronic renal failure defnition
pregressive irreversible loss of renal function results in symptoms of uraemia: fatigue, itching and confsuion
97
causes of chronic renal failure
DM HTN PKD chronic peylonephritis glomerulonephritis
98
pathology of polycystic kidney disease
destroyed renal parenchyma multiple kidney cysts liver cysts berry aneurysms
99
mutation in polycystic kidney disease
PKD1 on chr 16 PKD2 in chr 4
100
defective protein in polycystic kidney disese
polycystin 1/2
101
clinical features of polycystic kidney disease
flank pain haematuria UTI
102
complication of polycystic kidney disease
cyst infection cyst rupture cyst hammorhage
103
lupus nephritis
immune complex deposition in kidney may be asymptomtomatic, may cause nephrotic syndrome or renal failure deponding on how many glomeruli are involved
104
how many classes of lupus nephritis are tehre
6
105
class 1 lupus nephritis
immune complex deposition but no structural alteration
106
class4 lupus nephritis
\>50% glomeruli involved diffuse lupus nephritis
107
class 6 lupus nephritis
advances sclerosing \>90% of glomeruli
108
renal cell carcinoma types
clear cell chromophobic papilliary
109
clear cell renal carcinoma features
well differentiated
110
papilliary cell renal carcinoma features
dialysis associated cystic disease
111
chromophobic renal cell carcinoma
pale eossinophilic cells
112
RF for renal cell carcinoma
smoking HTN unopposed oestrogen heavy metals CKD
113
paraneoplastic syndromes assocated with renal cell carcinoma
HTN hypercalcaemia amyloidosis Cushing's disease polycythaemia
114
sx of renal cell carcinoma
costo-vertabralangle pain mass haematuria
