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Systemic Pathology (Spring 2015) > L5: Path of the Urinary System (Farina) > Flashcards

L5: Path of the Urinary System (Farina) Flashcards

1
Q

functional unit of kidney

A

nephron

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2
Q

renal dz may affect:

A

glomeruli, tubules, interstitium and/or blood vessels

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3
Q

glomeruli fx

A
  • selective filter for molecules based on size, charge, and shape
  • mesangial cells phagocytose macromolecules and immune complexes; contract to autoregulate glomerula blood flow
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4
Q

tubules fx

A
  • selectively secrete or reabsorb water and organic/inorganic solutes
  • can regenerate as long as BM remains intact for scaffolding for regenerating epithelial cells
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5
Q

endocrine fxs of the kidney: erythropoietin

A
  • stimulates erythrocyte production

- prod. by endothelial cells

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6
Q

endocrine fxs of the kidney: renin

A

-released in response to Na depletion or low blood V. converts angiotensinogen to angiotensin I

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7
Q

vitamin D action occurs in what organ

A

kidney

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8
Q

horseshoe kidney

A

kidneys fused at one pole, roughly near midline

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9
Q

polycystic kidney disease (PKD)

A
  • autosomal dominant**
  • ~38% of Persian cats affected
  • also see hepatic cysts in a few cases
  • kidney dysfx at 3-10yo
  • 98% cases can be diagnosed at U/S at 10mo
  • arise from any segment of the nephron
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10
Q

papillary necrosis

A
  • common in horses (esp. in dehydrated horses treated with bute)
  • NSAIDs** inhibit prostaglandin synthase –> dec. production of PGE2, (which maintains vasodilation in juxtamedullary nephrons) –> ischemia and subsequent necrosis
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11
Q

hydronephrosis

A

dilation of renal pelvis/calyces

-typically occurs 2ary to obstruction

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12
Q

hydroureter

A

dilation of ureters

-typically occurs 2ary to obstruction

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13
Q

glomerulonephritis path.

A
  • circulating immune complexes deposited in or adjacent to glomerular BM or Ab formed against glomerular BM
  • immune complexes may be deposited subendothelially, in the BM, or subepithelially
  • IC best formed in conditions with slight Ag excess
  • complement fixation, leukocytic infiltration and prod. of inflamm. mediators by mesangial cells may contribute to glomerular injury
  • filtration barrer becomes compromised –> protein loss to urine
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14
Q

types of glomerulonephritis (GN)

A

1) Membranous: thickened glomerular BM
2) Proliferative: inc. numbers of mesangial cells
3) Membranoproliferative: combo of 1 and 2

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15
Q

conditions commonly assoc. with GN

A

Chronic Inflammatory stimuli:

  • viral diseases
  • chronic bacterial infections
  • parasitic and protozoal diseases
  • autoimmune diseases
  • neoplasms
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16
Q

Glomerular amyloidosis

A
  • usually reactive systemic amyloidosis
  • can be assoc. with chronic inflamm. or idiopathic origin
  • Shar Peis, Abyssinian cats
  • extensive amyloid deposition –> compromise of the filtration barrier –> proteinuria
  • progressive renal insufficiency and proteinuria
17
Q

amyloid

A
  • derived from serum amyloid A (SAA), an acute phase protein

- stained with Lugol’s iodine (brown) or Congo red

18
Q

Embolic nephritis/glomerulitis

A
  • bacteria lodge mainly in glomerular and peritubular capillaries –> microabscess
  • usually limited to cortex
  • horse: Actinobacillus equuli most common cause
  • pig: Erysipelothric rhusiopathiae
  • cattle: Trueperella pyogenes
19
Q

Acute tubular necrosis - ischemic

A
  • due to hypotension (shock)
  • focal necrosis along nephrons, esp. proximal tubules
  • distal tubules may also be affected
  • glomeruli usually unaffected
  • disruption of tubular BM –> no scaffolding for tubular epithelial regeneration
20
Q

Acute tubular necrosis - toxic

A
  • tubules, esp. proximal tubules, very susceptible to a variety of toxins due to high metabolic activity and exposure to agents in large volume of ultrafiltrate they resorb**
  • leads to necrosis of proximal tubules +/- distal tubules
  • BM PRESERVED
21
Q

tubular degeneration

A
  • vacuolization of epithelial cells

- gives moth-eaten appearance

22
Q

tubular necrosis**

A
  • loss of cellular detail
  • nuclear karyorrhexis (nuclei small and dark), karyolysis (nucleus breaking apart), pyknosis (can’t see nucleus anymore)
  • inc. cytoplasmic eosinophilia
  • sloughing of epithelial cells
23
Q

tubular regeneration chars.**

A
  • increased cytoplasmic basophilia
  • piling/crowding of epithelial cells
  • nuclei with an open chromatin pattern and prominent nucleoli
  • mitotic figures
24
Q

Interstitial (tubulointerstitial) nephritis

A
  • chronic form common in older animals; cause usually not evident in these cases
  • acute cases: edema, leukocyte infiltration, focal tubular necrosis
  • chronic cases: leukocytic infiltrate, interstitial fibrosis, tubular atrophy
25
Q

leptospirosis affects what areas of kidney**

A

tubules, interstitium

26
Q

pyelonephritis

A
  • inflamm. of renal pelvis and parenchyma
  • usually results from ascending infection from the lower urinary tract, so usually concurrent ureteritis and cystitis
  • infectious agents similar to those that cause lower UTI
  • vesicoureteral reflex –>
27
Q

vesicoureteral reflux

A

retrograde flow up ureters during micturition

28
Q

Causes of Parasitic renal disease

A 
Stephanurus dentatus (kidney worm in pigs) --> encyst in perirenal tissue, communicate with renal pelvis for passage of eggs
Dioctophyma renale (giant kidney worm; minks, dogs, cats after eating fish) --> progressive destruction of renal parenchyma
29
Q

Renal Neoplasia: Adenoma

A
  • benign tumors from tubular epithelium**

- usually small, single nodules, incidental findings

30
Q

Renal Neoplasia: Adenocarcinoma

A
  • most common primary renal tumors in sheep, cattle, dogs**

- usually well-demarcated, compress remaining renal parenchyma, located at one pole of kidney

31
Q

Renal Neoplasia: Nephroblastoma

A
  • most common primary renal tumor of pigs and chickens** (also in fish)
  • usually in young animals
  • histo: primitive glomeruli, tubules and mesenchyme; may contain cartilage, bone, fat
32
Q

lymphosarcoma most common neoplasm to met to kidney**

A

:)

33
Q

non-urinary lesions assoc. with renal failure

A
  • gastric ulcers/uremic gastritis
  • ulcerative glossitis/stomatitis
  • mineralization of intercostal pleura
  • uremic pneumonitis
  • parathyroid hyperplasia
  • anemia
34
Q

Congenital Abnormalities

A
  • Ectopic ureter

- patent urachus (esp. foals)

35
Q

Urolithiasis

A
  • calculi in urinary passages (anywhere from renal pelvis to urethra)
  • predisposing factors: urine pH, hereditary factors, diet, UTIs
36
Q

Cystitis

A
  • bacteria from ascending infection from urethra (almost always rectal flora)
  • predisposing factors: loss of normal voiding mech, loss of acidic pH, glucosuria, proteinuria, mucosal trauma
  • females predisposed (wide/short urethra)
37
Q

emphysematous cystitis

A
  • rarely see in diabetic animals due to bacterial fermentation of urinary glucose into CO2
  • E. coli most common
38
Q

enzootic hematuria

A
  • mature cattle w/ persistent hematuria w/ hemorrhage and/or neoplasms in lower UT
  • chronic ingestion of toxic bracken fern
  • neoplasms include TCC, SCC, papilloma, fibroma/sarcoma, hemangioma/sarcoma, leiomyosarcoma
39
Q

neoplasia of the lower UT

A

Papilloma
-may become malignant TCC in dogs
TCC
-most often in bladder neck or trigone**; 50% met
Botyroid Rhabdomyosarcoma
-young large or giant breeds
-forms in skeletal m., which isn’t present in BL of adult dogs

Systemic Pathology (Spring 2015) (10 decks)

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