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Hugh's MD1 Renal > Kidney Pathology > Flashcards

Kidney Pathology Flashcards

1
Q

What are more common in Australia, tubular or glomerulus diseases?

A

Tubular

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1
Q

What are three consequences of ATN?

A
  1. Reduced GFR
  2. Loss of electrolytic balance
  3. Accumulation of creatinine and urea in blood
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2
Q

Where are mesangial cells located in the glomerulus?

A

In the stalk that supports the capillaries

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2
Q

What are some causes of nephrotic syndrome/proteinuria?

A

Diabetes mellitus

Some forms of glomerulo-nephritis

Inherited syndromes

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2
Q

What does diffuse means in the context of GN?

A

All glomeruli in the kidney are affected

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2
Q

Which kidney disease is systemic lupus erythematosis commonly associated with?

A

Glomerulonephritis

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2
Q

How do kidneys with appear macroscopically in end stage renal disease?

A

Pale, atropied, nobbly, scarred

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3
Q

What is glomerulonephritis?

A

Acute or protracted damage to the glomerulus

Usually due to deposition of immune complexes that leads to complement activation

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3
Q

Do acute post infectious GN ever develop into chronic renal failure?

A

Yes, depends on how severe the initial injury is

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4
Q

When is GN likely to develop to chronic renal failure?

A

When the injurious stimuli remains present eg Lupus nephritis

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5
Q

What does the term global mean in the context of GN?

A

The whole glomerulus is affected

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5
Q

What are the most important causes of injury to kidney tubulointerstitium?

A

Ischaemia (or toxins rarely) = ATN

Infection = acute pyelonephritis

Acute or chronic tubulointerstitial nephritis

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5
Q

What are some causes of acute interstitial nephritis?

A

Allergic reaction to drugs

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6
Q

What is the histological abnormality in acute interstitial nephritis?

A

Immune cells in the interstitium - particularly eosinophils

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7
Q

What condition is more prevalent in forest Finns?

A

Inherited nephrotic syndrome: mutation in the Nephrin protein

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9
Q

What is the leading cause of chronic renal failure in Australia?

A

Diabetic nephropathy

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11
Q

What are some renal causes of acute renal failure?

A

Acute tubular necrosis

Acute glomerulonephritis

Acute interstitial nephritis

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13
Q

Why isn’t protein usually filtered?

A
  1. Negatively charged basement membrane
  2. Physical obstruction of the basement membrane and epithelials
  3. Fine proteins that connect the spaces between podocytes appendages
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14
Q

What happens to necrosed cells in ATN?

A

The fall off the basement membrane

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16
Q

What is the most common cause of acute glomerulonephritis in Australia?

A

IgA nephropathy

17
Q

T/F Glomerulonephritis only causes oliguria renal failure

A

False, it can cause haematuria or proteinuria too

18
Q

What can occur to the interstitium in renal disease?

A

Oedema

Expansion/fibrosis

19
Q

What are the symptoms of acute pyelonephritis?

A

Chills, fever, pain, lumber tenderness

Dysuria (Pain on urination)

20
Q

What is the GFR in end stage kidney disease?

A

<15mL/min/1.73m2

22
What are three way that the glomerulus can react to immune complex deposition?
1. Glomerulus cell proliferation 2. Immune cell infiltration 3. Basement membrane proliferation
23
What are the top three causes of end stage kidney disease in Australia?
Diabetes mellitus Glomerulonephritis Hypertension
24
What is the most common cause of acute tubular necrosis?
Ischaemia eg during hypotension
25
What parts of the kidney can be effected in pyelonephritis?
Renal parenchyma Calyses Renal pelvis
26
T/F Type III hypersensitivity is the second highest cause of damage to kidney tubules
False, infection is Type III hypersensitivity is much more of a problem in glomeruli
27
What is the pathogenesis in toxic acute tubular necrosis?
Mitochondrial function and oxidative phosphorylation are disturbed
28
What is Nephrotic syndrome another name for?
Severe proteinuria
29
If a patient presents with signs of kidney damage after antibiotic use what are the two differential diagnoses?
Post infective glomerulonephritis Acute interstitial nephritis
30
T/F ATN is irreversible
False, it is reversible
32
How do you differentiate different types of GN?
Clinical findings (eg blood tests etc) Light microscopy Immunostaining for ab subtype Electron microscopy
33
Why are tubule cells more susceptable to ischaemic damage than the glomeruli?
They have a greater O2 and blood demand than the glomeruli
34
T/F Renal function is lost in pyelonephritis
False, it's usually preserved
36
T/F Acute glomerulonephritis never progresses to chronic renal failure
False, it can eg in cases of IgA nephropathy
37
T/F Acute renal failure is a term for any acute kidney problem
False, it specifically refers to a reduced GFR as reflected by serum creatinine
38
Is it possible to differentiate the cause of damage in end stage kidney disease?
No, damaged kidneys will the look same at this point
39
When do you get 'crescents' in the glomeruli?
In severe, acute glomerulonephritis with necrosis They consist of monocytes and epithelial cells
40
Had do kidneys with pyelonephritis appear macroscopically when dissected?
White streakas = pus filled tubules
41
What are the signs of nephrotic syndrome?
Proteinuria Oedema (whole body) Hypoalbuminaemia Hyperlipidaemia
42
What causes hyperlipidaemia in nephrotic syndrome?
Liver damage of some sort
43
Which type of GN is crescent necrosis associated with?
None of them! It's non-specific
45
What are the 4 common aetiological agents of acute pyelonephritis?
E. coli Klebsiella sp. Proteus Pseudomonas
46
What is the most common cause of acute renal failure?
Acute tubular necrosis
47
What type of acute glomerulonephritis is most seen in NT Aboriginals?
Acute Post-infectious GN - typically after Grp A Strep
48
How do bacteria appear in H&E stains?
Purple
49
When do symptoms appear in end stage kidney disease?
When there is 10% of renal function remaining

Hugh's MD1 Renal (11 decks)

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