Lab 9: Kidney/Ureter/Bladder Pathologies Flashcards
What condition is shown?
Horseshoe kidneys: isthmus connecting kidneys (congenital anomaly)
What is the most common congenital renal anomaly?
Horseshoe kidneys
What deficits are involved in this condition?
Kidney function is normal
horseshoe kidneys
What condition is this?
Bilateral renal agenesis (both kidneys are absent)
Besides kidneys, what other organ system is involved in this pathology?
There is small lung development
When both kidneys are absent, it leads to…
oligohydramnios with lung hypoplasia (small lung development)
bilateral renal agenesis
What is the mortality rate for those with this condition?
Not compatible with life
bilateral renal agenesis
What pathology is this?
Advanced polycystic kidney disease
What causes this condition in adults?
Autosomal dominant mutation in the polycystin 1 or 2 genes
polycystic kidney disease
Autosomal dominant mutation in the polycystin 1 or 2 genes will lead to what pathology in adults?
Polycystic kidney disease
What are some of the first presenting signs in an individual presenting with this condition?
Presents in young adults as progressively worsening hypertension, hematuria, and progressive renal failure
polycystic kidney disease
How does blood pressure affect kidney function?
High blood pressure means less blood to the kidneys, which diminishes function
How do the kidneys affect blood pressure?
Kidneys control water, sodium, and potassium in blood (extracellular fluid volume) through renin and aldosterone
Which kidney hormone increases blood pressure and which decreases it?
Renin will increase blood pressure
Aldosterone will decrease blood pressure
What are some of the characteristic signs in an individual with a kidney infection?
- Burning or pain while urinating
- Foul smelling urine
- Blood in urine
- Frequent urination
- Stomach/back pain
- Fever/chills
- Vomiting
Note the accumulation of acute inflammatory cells amongst the kidney tubules
What condition is this?
Acute pyelonephritis (kidney infection)
What is the major etiology of this condition?
Ascending infection from the bladder
acute pyelonephritis
In acute pyelonephritis, ___ indicate kidney involvement
leukocytic casts
How will a patient with this condition present?
Rapid onset of fever and flank pain
acute pyelonephritis
This is the gross appearance of which renal pathology?
Acute pyelonephritis
What is the yellow deposition on this kidney?
Purulent exudate
acute pyelonephritis
Diagnosis of this condition can be assisted with…
urine examination
acute pyelonephritis
White blood cells are seen to occupy tubules in this histologic preparation of acute pyelonephritis
What is the term for these occupied tubules?
Leukocytic casts
White blood cells are occupying the tubules of this kidney
What pathology is this?
Acute pyelonephritis
This was found in a urinalysis
What is it?
Leukocytic cast
acute pyelonephritis
This is a leukocytic cast found in urinalysis
What pathology is confirmed by this finding?
Acute pyelonephritis
Tubules contain an eosinophilic proteinaceous material that resembles thyroid follicles
What pathology is this?
Chronic pyelonephritis
What material has deposited in these kidney tubules?
Eosinophilic proteinaceous colloid-like material containing hemolyzed red blood cells, plasma proteins, and fibrin
chronic pyelonephritis
What is the term for this tissue beginning to resemble endocrine tissue?
Thyroidization of tubules (in the cortex) of the kidney
chronic pyelonephritis
Notice the obvious cortical atrophy as well as dilated calyces
What pathology is shown?
Chronic pyelonephritis
What does intravenous pyelogram demonstrate?
Contrast dye makes kidneys visible in plain film
How does the left hand intravenous pyelogram compare to the right?
Left: normal
Right: obstruction of the left ureter by way of a kidney stone with dilation of the calyces of the kidney (also termed hydronephrosis)
What are some ways that an obstruction can occur in the kidneys/ureters/bladder?
- Trauma
- Scarring
- Tumor or cyst
- Stones
What is obvious in this image when comparing sides?
Unilateral hydronephrosis
What presumably caused this condition?
Stone has lodged at distal end of the ureter
unilateral hydronephrosis
This is a gross image of what pathology?
Hydronephrosis (swelling)
What is a common cause of this condition in males?
Kidney stones (nephrolithiasis)
hydronephrosis
What are the common presenting signs in an individual with nephrolithiasis?
“Loin to groin” pain which is colicky in nature
What are some risk factors for nephrolithiasis?
- Familial and hereditary predisposition
- Inborn errors of metabolism: gout, cystinuria, primary hyperoxaluria
- Men more affected than women
nephrolithiasis
What are the most common type of kidney stones in terms of chemical makeup?
Calcium-based stones
nephrolithiasis
Which type of stones will occur in individuals who have had multiple kidney infections?
Struvite mineral stones
nephrolithiasis
Which stones are associated with metabolic conditions?
Errors in amino acid metabolism can produce a rare stone, cystine stone
nephrolithiasis
Which stones are associated with genetic conditions?
Those with gouty arthritis have a tendency to produce uric acid stones
What condition is this?
Renal cell carcinoma
What is the triad of symptoms that come with this malignancy?
Hematuria, palpable mass, flank pain
renal cell carcinoma
When does this condition typically present?
Later in life
renal cell carcinoma
Which of these pathologies remains within the renal capsule: renal cell carcinoma or nephroblastoma?
Nephroblastoma (Wilms tumor)
What condition is this?
Nephroblastoma (Wilms tumor)
What symptoms present with this condition?
A flank mass, hematuria, and hypertension
nephroblastoma (Wilms tumor)
What is the cause of this condition?
Associated with WT mutation (tumor suppressor gene)
nephroblastoma (Wilms tumor)
These are images of the bladder
What is visualized in pane A?
Foci of hemorrhage on hyperemic bladder mucosa
These are images of the bladder
What is visualized in pane B?
Foci of mucosal hemorrhage
These are images of the bladder
What is visualized in pane C?
PMNs infiltrating mucosa
These are images of the bladder
What condition is this?
Acute cystitis
What are some etiologies of this condition?
Infectious agents (as found in urinalysis)
acute cystitis
How does this condition present?
- Dysuria
- Urinary frequency and urgency
- Supra and retropubic pain
- “Coffee grounds” urine
acute cystitis
This is a bladder
What is shown by the arrow?
Hemorrhagic defect in the edematous mucosa of the bladder
interstital cystitis
What is a risk of having this condition?
Chronic bladder infection
interstitial cystitis
Indicated by the arrow is a hemorrhagic defect in the edematous mucosa of the bladder
What condition is this?
Interstitial cystitis
Where in the bladder do most tumors occur and in what pattern?
Posterior and lateral walls in a papillary pattern
What are the risk factors for developing this pathology?
- Smoking
- Age
- Bladder stones
- Chemotherapy
bladder cancer
What is seen at the arrow in this image of the bladder?
Large exophytic tumor within the lumen of the bladder
bladder cancer
What is the most common subtype of bladder cancer?
Transitional cell carcinoma arising from the lining of the bladder or urethra
How does this condition generally present?
Painless hematuria
What is a risk factor for squamous cell carcinoma in the bladder?
chronic cystitis
