PAT 136

Question 1

the cut section of kidney with amyloidosis shows?

Answer 1

is pale yellow and shows brown waxy dots

Question 2

The result of amyloidosis of kidney

Answer 2

is ischemia and atrophy of tubules and increased connective tissue(fibrosis)

Question 3

clinical picture of acute tubular necrosis

Answer 3

1) Acute onset: of oliguria or anuria due to :
decreased glomerular filtration in ischemic causes or
tubular obstruction by necrotic cells and casts.
Death can occur due to renal failure or heart failure due to hyperkalemia
2) Later : there is a polyuria phase because:
the glomeruli resume their function, but the tubules are unable to concentrate
urine.
3) Past stages: Restoration of renal function
(if the patient is well supported) after tubular regeneration

Question 3

definition of acute pyelonephritis

Answer 3

A common suppurative inflammation affecting kidney and pelvis , caused by bacterial infection.
It is part of urinary tract infection (UTI), which can affect the lower (cystitis prostatitis, urethritis o upper (pyelonephritis) urinary tractor both

Question 4

Causes of acute pyelonephritis

Answer 4

gram-negative bacilli
(E-coli (commonest) followed by Proteus. Klebsiella

Question 5

Special factors Ascending infection pyelonephritis

Answer 5

✓ Urethral catheterization or other instrumentation.
✓ Female gender:
1. Female to male ratio 10:1 Because of shorter urethra in females,
2. absence of antibacterial properties found in prostatic fluid.
3. Pregnancy leading to urinary stasis & urethral trauma during sexual
intercourse
✓ Urinary tract obstruction and stasis of urine:
 e.g. by stones, tumor or congenital anomalies of kidney or ureters , prostatic
enlargement.
 In the presence of stasis, bacterial multiplication is increased.
✓ Presence of vesico-ureteral reflux and intra renal reflux, which may be
congenital or acquired

Question 6

Gross of acute pyelonephritis

Answer 6

The kidney :- is enlarged.
Capsule:- strips easily.
Outer surface :- is smooth and shows multiple abscesses.
Cut section :- shows small cortical abscesses ,streaks of pus and pus
filling renal pelvis and calyces.

Question 7

clinical picture of acute pyelonephritis

Answer 7

costovertebral angle (loin pain)
dysuria
urgency
bacteruria and pyuria with leucocytic casts

Question 7

Fate and complications of acute pyelonephrits

Answer 7

1) Mild cases Recovery.
2) Repeated attacks: may lead to chronic pyelonephritis
3) Pyonephrosis: (if associated with obstruction)
4) Papillary necrosis:
➢ Occurs mainly in diabetics and with urinary tract obstruction.
➢ There is necrosis of the tips of the renal pyramids.
➢ It may lead to acute renal failure.
5) Perinephric abscess: develops in severe cases

Question 7

Microscopic of acute pyelonephritis

Answer 7

Intra tubular polymorphs with interstitial edema and inflammation
These white cell casts (granular cell casts) pass in urine
With healing fibrosis occurs in the interstitium and inflammatory cells become dominated by lymphocytes and plasma cells

Question 8

thyroidization is related to

Answer 8

Chronic Pyelonephritis

Question 9

clinical features of Chronic Pyelonephritis

Answer 9

renal insufficiency
Hypertension
acute recurrent pyelonephritis

Question 10

It is one of the most common causes of acute kidney injury

Answer 10

Drug Induced Acute Tubule Interstitial Disease

Question 11

Complications of renal tuberculosis

Answer 11

1) Hematuria.
2) Chronic renal failure.
3) Spread : Direct mostly trans canalicular ,through ureters to urinary bladder.
4) Amyloidosis.

Question 12

benign Tumors of the Kidney

Answer 12

1. Renal papillary adenoma:
2. Angiomyolipoma.
3. Oncocytoma.
4. Squamous cell papilloma and hemangioma of the renal pelvis

Question 13

Clear cell carcinoma related to

Answer 13

Renal Cell Carcinoma