Intro to Renal Pathology- Herrera

Question 1

kidney receives ____ of cardiac output

Answer 1

25%

Question 2

functions of kidney

Answer 2

A Wet Bed

Question 3

small kidney that formed abnormally

Answer 3

hypoplastic

Question 4

normal kidney that shrunk

Answer 4

atrophic

Question 5

Answer 5

kidney vasculature and glomeruli

Question 6

space b/t parietal (bowman’s capsule) and visceral epithelial cells (podocytes) of renal corpuscle

Answer 6

urinary space

Question 7

what is a good hallmark you are inside glomerular capillary

Answer 7

RBC’s

Question 8

visceral epithelial made up of what

Answer 8

podocytes

Question 9

direction of filtrate

Answer 9

fenestrated endothelia
glomerular basement membrane
filtration slits of podocytes

Question 10

first structure to react to stimuli and last one to go back to normal; holds capillaries in place

Answer 10

mesangial cells

Question 11

anything on top of capillary wall=

Answer 11

subepithelial

Question 12

below capillary wall=

Answer 12

subendothelial

Question 13

learn picture

Question 14

3 layers of glomerular basement membrane

Answer 14

1. lamina rara interna
2. lamina densa
3. lamina rara externa

Question 15

Answer 15

capillaries with RBC’s in them
mesangial cell on left side of pic
urinary space b/t capillaries

Question 16

collagen ___ makes up GBM

Answer 16

IV

Question 17

___ and ___ proteins participate in filtration slit diaphragms of podocytes

Answer 17

NEPH and FAT

Question 18

greater than 2 mesangial cells seen between capillaries

Answer 18

hypercellularity

Question 19

Contractile cells
Plasticity
Eat up and destroy what gets in
First structure that reacts and the last to come to normal

Answer 19

Mesangial cells

Question 20

3 parts of kidney to look at when diagnosing renal disease

Answer 20

1. glomeruli
2. tubules/interstitium
3. vasculature

Question 21

worse prognosis when disease reaches ____

Answer 21

vasculature (and the other 2 areas affected)

Question 22

______ glomerulopathy – Kidney (glomerulus) only or predominant organ involved

Answer 22

primary

Question 23

_____ glomerulopathy – Glomeruli injured in the course of systemic diseases

Answer 23

secondary

Question 24

presence of immune complexes; w/ or w/out inflammation

Answer 24

glomerulonephritis

Question 25

immune complexes can injure glomeruli by 2 ways:

Answer 25

be formed there circulate and get trapped there

Question 26

9 specific immunofluorescence slides to look at when doing renal biopsy

Answer 26

IgG IgM IgA C3 C1q kappa lambda albumin fibrinogen

Question 27

if one of the 9 immunofluorescence slides is +, what does that mean

Answer 27

renal disease is immune complex regulated

Question 28

classical pathway markers

Answer 28

C1q, C3

Question 29

alternate pathway markers

Answer 29

C3

Question 30

what to biopsy to look at kidney

Answer 30

medulla + CORTEX

Question 31

3 ways glomeruli respond to injury through hypercellularity:

Answer 31

mesangial and endothelial cells leukocytes crescent formation

Question 32

capillary wall breaks and proliferation of parietal epithelial cells

Answer 32

crescent

Question 33

another way glomeruli respond to injury

Answer 33

basement membrane thickening/thinning

Question 34

end stage damage to glomerulus; irreversible

Answer 34

hyalinosis/sclerosis

Question 35

GFR of ____ may progress to end-stage renal failure

Answer 35

30-50%

Question 36

3 mechanisms of progression of renal disease:

Answer 36

glomerulosclerosis proteinuria tubulointerstitial fibrosis

Question 37

Answer 37

top: segmental bottom: global

Question 38

Answer 38

L: focal R: diffuse

Question 39

uncorrectable bleeding uncontrolled HTN uncooperative patient

Answer 39

CI for renal biopsy

Question 40

2 indications for open biopsy

Answer 40

obesity single kidney

Question 41

gather 3 pieces during renal biopsy for what 3 tests:

Answer 41

light microscopy immunofluorescence electron microscopy

Question 42

"cherries" meaning

Answer 42

cortex is there

Question 43

stain

Answer 43

H&E

Question 44

stain

Answer 44

PAS (highlights BM and capillary walls)

Question 45

stain

Answer 45

silver (good for GBM)

Question 46

stain

Answer 46

trichrome (see fibrosis-bad progression)

Question 47

Answer 47

immunofluorescence

Question 48

what do you fix slide with to look under electron microscopy

Answer 48

gluteraldehyde

Question 49

Answer 49

CL: capillary w/ RBC MES: mesangial cell

Question 50

stain

Answer 50

EM (see endo, BM, podocytes)

Question 51

dark shadows in subepithelial

Answer 51

immune complexes

Question 52

more _____ in urine= more effaced podocytes

Answer 52

protein

Question 53

Answer 53

immune complex deposits

Question 54

increase in BUN and creatinine mean

Answer 54

kidneys malfunctioning (azotemia)

Question 55

increase amount of NH4+ in body such that it affects brain

Answer 55

uremia

Question 56

caused by altered permeability of capillary walls

Answer 56

proteinuria

Question 57

caused by rupture of capillary walls

Answer 57

hematuria

Question 58

caused by impaired filtration of nitrogenous waste products

Answer 58

azotemia

Question 59

reduced urine production

Answer 59

oliguria and anuria

Question 60

salt and water retention

Answer 60

edema

Question 61

caused by fluid retention and disturbed renal homeostasis of blood pressure

Answer 61

HTN

Question 62

Massive proteinuria Hypoalbuminemia (low in blood) Edema Hyperlipidemia hypercoagulability

Answer 62

nephrotic syndrome

Question 63

Podocytes will become_______(go away) w/ proteinuria

Answer 63

effaced

Question 64

Hematuria (RBC casts) Azotemia Oliguria Hypertension Mild proteinuria

Answer 64

Nephritic syndrome