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Block 9; Week 5-M > Kidney Path-Fung I > Flashcards

Kidney Path-Fung I Flashcards

1
Q

What are the functions of the kidney?

A 
Metabolism:
Excretion of H2O, Na+, Ca2+, P
Maintain acid-base balance
Excretion of toxic metabolic waste products
Endocrine:
Secrete erythropoietin, prostaglandins
Regulate vitamin D metabolism
Regulate blood pressure:
Secrete renin
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2
Q

How many lobes does the kidney have? where do they come together?

A

10-18, come together @ cortex; separated in the medulla

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3
Q

What is contained in the cortex & medulla?

A

cortex–nephrons

medulla-collecting tubules

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4
Q

WHat is found in the hilum of the kidney?

A

blood vessels

fatty tissue

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5
Q

Describe the blood supply of the kidney.

A

aorta–>renal artery–>interlobar artery–>arcuate artery–>interlobular artery (into the cortex)–>afferent arteriole–>glomerulus–>efferent arteriole–>peritubular network->interlobular vein

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6
Q

What other important vessel comes off of the arcuate artery?

A

vasa recta, dip down & surround the tubules in the medulla. participates in the countercurrent multiplier system that concentrates urine.

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7
Q

Where does the urine go?

A

CT–>duct of belleni–>renal calyx/pelvis

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8
Q

Slide 12

A

X

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9
Q

Slide 12

A

X

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10
Q

WHat does diffuse glomerular injury mean?

A

involving all glomeruli

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11
Q

What does focal glomerular injury mean?

A

involving a proportion of the glomeruli

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12
Q

What does global glomerular injury mean?

A

involving the entire glomerulus

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13
Q

What does segmental glomerular injury mean?

A

affecting a part of the glomerulus

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14
Q

Describe the structure of the Bowman’s capsule?

A

visceral epithelium surrounding glomerulus is flattened & continuous w/ the parietal cuboidal epithelium.
Space b/w visceral & parietal is Bowman’s space.

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15
Q

What is another name for the visceral epithelium of the Bowman’s Capsule?

A

podocytes

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16
Q

Describe the filtration barrier for the glomerulus.

A 
Capillary endothelium (fenestrated)
Basement membrane:
Lamina interna
Lamina densa (neg. charge)
Lamina externa
Visceral epithelium = podocytes, have primary & secondary (foot) processes w/ filtration slits b/w them.
17
Q

What does the mesangium do?

A

this is the connecting tissue w/i the glomerulus, connecting the capillaries.
has functions: phagocytosis, secretion of vasoactive things, laying down matrix similar to the basement membrane.

18
Q

What is supposed to go thru the filtration slits?

A

water, not proteins.

19
Q

What are the 3 layers of the glomerular basement membrane? Which things compose it?

A 
lamina interna, densa, externa
Type IV collagen 
Laminin
Heparan sulfate
Fibronectin
Entactin
Glycoproteins
20
Q

When the glomerulus is injured, what are the 4 possible adaptive mechanisms?

A

Hypercellularity
Basement membrane thickening
Hyalinosis
Sclerosis

21
Q

When you see hypercellularity following glomerular injury….what has proliferated?

A

mesangial cells
endothelial cells
leukocytes have also infiltrated

22
Q

Where do you see deposits in IgA nephropathy?

A

deposits in the mesangium

23
Q

What are the 3 forms of immune related glomerular injury?

A
  1. in situ-Heymann
  2. in situ–Anti-GBM
  3. circulating
24
Q

Describe in situ Heymann glomerular injury.

A

antigen-antibody complexes form on the subepithelial side. Granular pattern produced on immunofluorescence. See subepithelial immune complexes on electromicrograph.

25
Q

Describe in situ Anti-GBM glomerular injury.

A

antibody binds collagen in the basement membrane of the glomerulus. Continous pattern w/o discrete deposits. Linear pattern produced on immunofluorescence. See NO deposits on electromicrograph b/c it is diffuse.

26
Q

Describe circulating glomerular injury.

A

with this, immune complexes can deposit anywhere!

27
Q

Glomerular injury can lead to which conditions?

A
  • Nephritic syndrome
  • Nephrotic syndrome
  • Rapidly progressive glomerulonephritis
  • Chronic renal failure
  • Asymptomatic hematuria
28
Q

What is azotemia? What are the 3 types?

A

Azotemia: elevation of blood urea nitrogen (BUN) or creatinine (Cr)
Pre-renal
Renal
Post-renal

29
Q

What are the explanations for causes of pre-renal, renal, or post-renal azotemia?

A

pre-renal: volume depletion
renal: glomerular, tubular disease
post-renal: obstruction, hydronephrosis

Block 9; Week 5-M (5 decks)

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