[PATHO] ASSESSMENT 1 REVISION Flashcards
Bilateral suppurative inflammation of pelvicalyceal system
pyelonephritis
gross picture of pyelonephritis (4)
1-inflamed pelvicalyceal system
2-suppuration foci
3-yellow streaks radiating from papillae
4-abscesses in cortex
MICRO picture of pyelonephritis (3)
1-parenchyma congested & infilt by neutrophils
2-neutrophils collect in interstitium & tubular lumen forming 3-abscesses
fever, rigors
frequency, dysuria
loin tenderness
proteinuria
RBCs cast
inflamed pelvicalyceal system
suppuration foci
congested parenchyma
neutrophilic infiltration
pyelonephritis
obstruction leads to recurrent inflammation & scarring of kidneys
can be bilateral/unilateral obstructive lesion
chronic obstructive pyelonephritis
superimposition of UTI
congenital vesicoureteral reflux and intrarenal reflux
unilateral/bilateral
can lead to chronic renal insufficiency
chronic reflux associated pyelonephritis
GROSS picture of chronic pyelonephritis (4)
-uneven scarring of kidneys
-scarring of pelvicalyceal system
-papillary blunting
-calyceal deformities
MICRO picture of chronic pyelonephritis (7)
1-uneven interstitial fibrosis
2-lymphocytic, plasma cells, neutrophils
3-tubular dilation
4*Pink PAS +ve casts
*thyroidization of tubules
5-arteriolosclerosis (2ry to HTN)
6-glomerulosclerosis (2ry to nephron loss)
7-inflammation + fibrosis of calyceal wall
CRF
uremia
bacteriuria
polymorphs
casts
proteinuria
hypertension
calyceal destruction & deformities
thyroidization of tubules
Pink PAS+Ve casts
pyelonephritis
-replacement of papillae with caseous material
-caseating granulomatous inflammation
-sterile pyuria
-hematuria
-mild proteinuria
TB pyelonephritis
Pink PAS +ve casts
chronic pyelonephritis
thyroidization of tubules
chronic pyelonephritis
loins tenderness
pyelonephritis
calyceal destruction & deformities
pyelonephritis
sterile pyuria
TB pyelonephritis
-IgE mediated inflammation
-eosinophilia
-eosinophilic casts
-fever
-skin rash
-follows use of antibiotic, diuretics
drug induced interstitial nephritis
eosinophilic casts
drug induced interstitial nephritis
-papillary coagulative necrosis
-necrotic yellow-brown papillae
-CRF
-HTN
-anemia
-follows use of analgesics
analgesic nephropathy
injury caused by covalent binding & oxidative damage
analgesic nephropathy & drug-induced interstitial nephritis
MC cause of acute renal failure
acute tubular necrosis
IgE mediated damage
drug induced interstitial nephritis
papillary coagulative necrosis
analgesics nephropathy
WBCs cast
pyelonephritis
oliguria
uremia
fluid overload symptoms
patchy all throughout
necrosis of PCT epithelial cells
proteinaceous casts
interstitial edema
anoxic acute tubular necrosis
oliguria
uremia
fluid overload symptoms
patchy distally
diffuse proximally
necrosis of PCT epithelial cells
proteinaceous casts
interstitial edema
toxic acute tubular necrosis
fluid overload symptoms
acute tubular necrosis
symmetrically contracted kidneys
red brown kidneys
diffusely granular
glomeruli scarring
complete glomerulosclerosis
tubular atrophy
proteinuria
HTN
azotemia
nephrotic symptoms
microscopic hematuria
poor prognosis
chronic kidney disease
diffuse mesangial matrix increase
GBM thickening
proteinuria
can lt nephrotic $
associated w/ long standing diabetes
diffuse diabetic glomerulosclerosis
hyaline nodules in mesangium containing lipid & fibrin
proteinuria
can lt nephrotic $
associated w/ long standing diabetes
nodular diabetic glomerulosclerosis
(Kimmelstiel-Wilson lesion)
diabetes mellitus may lead to (4)
diabetic glomerulosclerosis
arteriolosclerosis
papillary necrosis
pyelonephritis
pale eosinophilic deposits detected by congo red
proteinuria
GBM destruction by amyloid fibrils
nephrotic $
amyloid nephropathy
Dna-anti DNA complexes
lupus nephritis
eosinophilic deposits detected by congo red
amyloid nephropathy
Kimmelstiel-Wilson lesion
nodular diabetic glomerulosclerosis
proliferation of endo,epi & mesangial cells
subendothelial deposits
granular IF
necrosis
hematuria
nephritic + nephrotic $
HTN
CRF
DNA-anti DNA complexes deposits
lupus nephritis
cause of death in lupus nephritis
renal failure
IF of lupus nephritis
granular
most Igs
all complements
Class I lupus nephritis
minimal mesangial LN
Class II lupus nephritis
mesangial proliferative LN
Class III lupus nephritis
focal LN
Class IV lupus nephritis
diffuse LN
Class V lupus nephritis
Membranous LN
Class VI lupus nephritis
advanced sclerosing LN
most serious and commonest form of lupus nephritis
Class IV
involves >50% of glomeruli
hypercellularity
capillary wall thickening
leukocytes
crescents
wire loop appearance
DNA-anti DNA complexes
Class IV lupus nephritis
wire loop appearance
Class IV lupus nephritis