Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

REGUB > L5: Pathology 2 > Flashcards

L5: Pathology 2 Flashcards

1
Q

What is pyelonephritis?

A

infection + inflammation of the kidney (renal pelvis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the main causes of acute pyelonephritis?

A
  1. Ascending UTI
  2. Haematogenous (septicaemia, infective endocarditis…)
  3. Urinary Tract Obstruction/Stasis of Urine
    - e.g. renal calculi, hydronephrosis, vesicoureteral reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the vesicoureteral reflux? What is it usually caused by?

A
  • urine flows back up to the kidneys
  • may cause hydronephrosis
  • possible cause: horizontal ureter path
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vesicoureteral reflux can lead to what?

A

a UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When looking at histology/tissue samples of acute pyelonephritis - what will be seen?

A
  • pus in tubules**
  • PMNs (neutrophils) in interstitium + tubules
  • mainly affects the cortex (spares the glomeruli)

note: AP affects the kidney focally (so acute renal failure is not common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What parts of the kidney does pyelonephritis normally affect (especially when healing by fibrosis/scarring)?

A

the poles (upper and lower papilla)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some of the features/characteristics of chronic pyelonephritis?

A
  • asymmetrical scarring of kidneys
  • thyroidisation of tubules
  • glomerular hypertrophy (blunting of calyces)
  • secondary focal + segmental glomerular sclerosis
  • vascular changes
  • predisposition to struvite calculi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List the 2 special types of chronic pyelonephritis

A
  1. Xanthagranulomatous

2. Malakoplakia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is chronic xanthogranulomatous pyelonephritis?

A
  • inadequate macrophage destruction of e. coli

- aggregation of FOAMY macrophages around e. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is chronic malakoplakia pyelonephritis?

A
  • inadequate macrophage destruction of e. coli
  • accumulation of macrophages that have calcified structure
  • looks like a RCC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is acute tubulo-interstitial nephritis (TIN)? What are the possible causes of TIN?

A
  • immunological, inflammatory condition
  • begins in the interstitium and invades the tubule
  • possible causes: drug-induced, allergic, hypersensitivity, familial, immune complex disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some DRUGS that cause acute tubulo-interstitial nephritis?

A
  1. PPIs
  2. Antibiotics (Penicillins*, Sulphonamides…)
  3. NSAIDs
  4. Molecular Agents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common drug that causes acute tubulo-interstitial nephritis?

A

PPIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Does acute tubulo-interstitial nephritis or acute pyelonephritis cause acute renal failure?

A

TIN may cause renal failure

uncommon for AP to cause renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When looking at a histological specimen of acute TIN, what will be seen?

A

eosinophils in the interstitium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sarcoidoisis may cause acute tubulo-interstitial necrosis - on a histological specimen, what would be seen?

A

granulomas

17
Q

What is hydronephrosis? (definition)

A

a dilatation of the renal pelvis, calyces, and/or the proximal ureter due to a distal obstruction to the outflow of urine

18
Q

What are the possible causes of hydronephrosis? [3]

A
  • PUJ obstruction (neuromuscular abnormality)
  • tumours
  • calculi
19
Q

What will happen to the structure of the kidney in hydronephrosis?

A
  • dilation of renal pelvis + calyces
  • flattening of papilla
  • atrophy of renal cortex
20
Q

List the 5 types of renal calculi

A
  1. Calcium (Phosphate or Oxalate)
  2. Magnesium Ammonium Phosphate
  3. Uric Acid
  4. Cystine
  5. Oxalate (malabsorption syndromes/anti-freeze ingestion)
21
Q

What is the most common type of renal calculi?

A

Calcium (Phosphate or Oxalate)

22
Q

What is the treatment for renal calculi?

A

Lithotripsy (blasted w/ high level ultrasound beams to break it up)

or conservative management

23
Q

What is the pathogenesis of calcium renal stones?

A

usually normal serum calcium - patient’s kidney does not handle calcium properly

24
Q

What are the common causes of oxalate renal stone formation?

A
  • malabsorption syndromes

- anti-freeze (ethylene glycol) ingestion

25
Q

What are the pre-renal causes of acute renal failure?

A

the abrupt drop of perfusion of the kidneys…

  • hypovolaemia (e.g. shock causes acute tubular necrosis)
  • congestive cardiac failure
  • sepsis
  • hepatic failure (hepatorenal failure)
  • renal artery stenosis (bilateral!)
  • NSAIDs (can cause arteriole constriction)
26
Q

What are the renal causes of acute renal failure?

A
  • glomerular nephritis (acute and crescenteric)
  • vascular causes (vasculitis, thrombosis, emboli - BILATERAL)
  • tubulo-interstitial nephritis
  • acute tubular necrosis (toxic causes such as drugs - e.g. Gentamicin)
  • tubule obstruction w/in kidney (e.g. casts)
27
Q

What are the post-renal causes of acute renal failure?

A
  • ureter obstruction (e.g. calculi, tumour)
  • bladder obstruction (e.g. calculi, tumour)
  • prostate obstruction (e.g. BPH w/ inflammation)
  • retroperitoneal obstruction (e.g. mets in nodes)

NEEDS TO BE BILATERAL

28
Q

If there are dysmorphic RBCs present in the urine, what is the cause of the patient’s acute renal failure?

A

glomerulonephritis

29
Q

If there are non-dysmorphic RBCs present in the urine, what are the possible causes of the patient’s acute renal failure?

A

tumour, calculi, infection

30
Q

If there are WBCs present in the urine, what are the possible causes of the patient’s acute renal failure?

A

tubulo-interstitial nephritis (TIN)

31
Q

If there are granular casts present in the urine, what are the possible causes of the patient’s acute renal failure?

A

acute tubular necrosis

32
Q

Upon urinalysis, if the urine is normal, what are the possible sources/causes of the patient’s acute renal failure?

A

pre-renal or post-renal causes

33
Q

List some of the risk factors for developing acute pyelonephritis

A
  • female
  • pregnancy
  • immunosuppression
  • kidney scars
34
Q

What is thyroidisation of the tubules and what condition is it a/w?

A
  • eosinophilic casts in the tubules that resemble thyroid tissue
  • a/w chronic pyelonephritis
35
Q

List some of the possible causes of acute tubulo-interstitial nephritis (TIN)

A
  • drug-induced
  • allergic
  • hypersensitivity
  • familial
  • immune complex disorders
36
Q

Shock is a cause of pre-renal acute renal failure. What can it lead to? Give 1 histological features

A

can lead to acute tubular necrosis

- presents with granular casts (mitochondria aggregates)

37
Q

Give an example of an antibiotic that can cause acute tubular necrosis and lead to acute renal failure

A

Gentamicin

REGUB (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions