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Urinary > Pathology Of Renal Disease (Ciancolo) > Flashcards

Pathology Of Renal Disease (Ciancolo) Flashcards

1
Q

The glomerular filtration barrier allows what sized and charge of molecules to pass?

A

Small and positively charged

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2
Q

Define glomerular filtration

A

Blood in the glomerular capillary loops is selectively filtered across the glomerular filtration barrier to create ultrafiltrate of plasma

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3
Q

Name the 3 main components of the glomerular filtration barrier

A

Capillary endothelium,
glomerular basement membrane,
podocytes

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4
Q

List 2 tidbits about glomerular capillary endothelium

A

It’s fenestrated
It’s covered by glycocalyx

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5
Q

List 2 tidbits about the glomerular basement membrane

A

It’s made of mostly TYPE 4 collagen

Also contains glycosoaminoglycans

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6
Q

List 2 tidbits about podocytes

A

Has foot processes

Has slit diaphragms (connect one foot process to the other)

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7
Q

Molecules pass through the glomerular endothelium via:

A

Fenestrations (trans cellular holes; like a colander!)

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8
Q

Glomerular endothelial cells are covered by:

A

A glycocalyx!

= a sugar coat that is (-) charged

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9
Q

The glomerular basement membrane has what charge overall?

A

Negative

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10
Q

Podocytes produce what to maintain endothelial cell health?

A

VEGF
(Vascular endothelial growth factor)

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11
Q

Podocytes are _____ epithelial cells

A

terminally differentiated
(They can’t really undergo mitosis!)

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12
Q

The slit diaphragm between the foot processes of podocytes is a ________ selective barrier

A

Size

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13
Q

The interdigitating foot processes of the podocytes attach to underlying:

A

Glomerular basement membrane

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14
Q

Mesangial cell function is:

A

Maintain structure of glomerular tuft

= tree trunk of the glomerulus!

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15
Q

True or false: mesangial cells are a part of the glomerular basement membrane

A

False

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16
Q

Mesangial cell functions include:

A

Synthesis and breakdown of ECM (collagens)

Produce cytokines (to bring inflammatory cells to glomerulus)

17
Q

True/False: Mesangial lesions are always clinically significant

A

FALSE

18
Q

What is a hallmark of glomerular disease?

A

Proteinuria

19
Q

4 classic signs of nephrotic syndrome are:

A
  1. Proteinuria
  2. Hypoalbuminemia/hypoproteinemia
  3. Edema/ascites
  4. Hypercholesterolemia

AZOTEMIA IS NOT A CRITERIA FOR DIAGNOSING NEPHROTIC SYNDROME

20
Q

What does a kidney pathology report describe when looking for glomerular lesions?

A
  1. Hypercellularity present?
  2. Is MESANGIUM expanded?
  3. Is there SCLEROSIS or HYALINOSIS
  4. Are IMMUNE DEPOSITS present?
  5. Is CAPILLARY WALL smooth or irregular?
  6. Are there adhesions (SYNECHIA) between capillary tuft and Bowman’s capsule?
21
Q

2 types of hypercellularity in glomerulus are:

A

Mesangial: in mesangial matrix

Endocapillary: too many nuclei in capillary loops

22
Q

True/false: mesangial and endocapillary hypercellularity are mutually exclusive

A

False

23
Q

Define synechia

A

Adhesions between glomerular tuft and Bowman’s capsule

24
Q

If you see synechiae (adhesions), you can say that:

A

Podocytes have been damaged

25
Q

Segmental sclerosis is defined as ____

And it causes _______

A

Scarring of the glomerulus

Collapse of the capillary lumens

26
Q

What causes hyalinosis in the glomeruli?

A

Extra pressure; plasma gets pushed into mesangium or glomerular basement membrane

27
Q

What happens when the glomerular basement membrane ruptures?

A

Material in circulation pours into Bowman’s space;

= crescents occur

28
Q

If you see crescents on renal histopath, is the prognosis good or bad?

A

BAD

seen often in pigs, rare to see crescents in small animal kidneys

29
Q

What are the 2 large categories of glomerular disease in animals?

A

Immune complex mediated glomerulonephritis

Non-immune mediated glomerulonephritis

30
Q

Immune complex mediated glomerulonephritis can be treated with _______

Non-immune-complex glomerulonephritis cannot be treated with ______

A

Immunosuppressive drugs

Immunosuppressive drugs

31
Q

What are the 3 main patterns seen with immune-complex glomerulonephritis?

A

Membranoproliferative glomerulonephritis

Membranous glomerulonephritis

Mesangioproliferative glomerulonephritis

32
Q

What are 4 main causes of non-immune-complex mediated glomerulonephritis?

A

Amyloidosis

Focal segmental glomerulosclerosis

Podocytopathy

GBM abnormalities

33
Q

What are 5 molecular mediators that PROMOTE fibrosis?

A

TGF-beta,
Angiotensin II,
Connective tissue growth factor,
FGF-23,
Smads

34
Q

What are 5 molecular mediators that are ANTI-FIBROTIC?

A

BMP-7
Smads
HGF
Some RAAS components

Urinary (8 decks)

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