Pathology 1 Flashcards
What causes glomerulonephritis?
non-infective; deposition of immune complexes
Where are the lesions foudn in glomerulonephritis?
primarliy glomerular, other secondary tubulointerstitial changes
What are the major features of glomerulonephritis histologically?
hypercellularity; thickening of the glomerular wall and crescent formation
What is pyelonephritis?
bacterial infection of renal pelvis, calyces, tubules and interstitum
What is the distribution of pyelonephritis?
patchy
What are the organisms responsible for pyelonephritis?
e.coli; pseudomonas; strep. faecalis
What is the commonest pathogenesis of pyelonephritis?
ascending infection- cystitis often present
What are teh risk factors associated with pyelonephritis?
young females; pregnancy; urinary tract obstruction; diabetes; vesico-ureteric reflux
What are the symptoms of chronic pyelonephritis?
often no previious hx of UTI- vague symptoms; HT and uraemia; large volume of urine
What is seen on imaging with chronic pyelonephritis?
coarse cortical scarring; distortion of calyces
What is the spread of tuberculous pyelonephritis?
haematogenous
What are the symptoms of pyelonephritis?
wt loss; fever; loin pain; dysuria
What is seen pathologically with tuberculous pyelo?
caseous foci- caseating granulomatous inflam
What are the main bugs in cystitis?
e.coli; klebsiella; proteus; pseudomonas
When can cystitis become necrotising?
if associated with outlet obstruction
What happens with prolonged bladder outlet obstruction?
hypertrophy of detrusor muscle and diverticulum formation
What is hydronephrosis?
dilatation of pelvicalyceal system wtih parenchymal atrophy
What are the main causes of hydronephrosis?
urinary tract obstruction and reflux
what causes bilateral hydronephrosis?
urethral obstruction; neurogenic disturbance; VUR; bilateral ureteric obstruction
What causes unilateral hydronephrosis?
calculi; neoplasms; pelvi-ureteric obstruction, strictures
What is the result of sudden and complete hydronephrosis?
urine production quickly ceases
What happens with gradual and partial hydronephrosis?
pelvicalyceal dilatation
What often follows hydronephrosis?
pyonephrosis
What is seen pathologically with severe hydronephrosis?
marked cortical thinning, atrophy and fibrosis
