Pathology of the Renal System: Glomerular Diseases

Question 1

What is the structure of the glomerulus?

Answer 1

Question 2

What is the function of the glomerular filtration barrier?

Answer 2

Filter blood and form primary urine

Question 3

What size particles can pass through the glomerulus? What happens to these molecules?

Answer 3

Question 4

Why is the glomerulus so important? What happens if it is non functioning?

Answer 4

Important because it is needed in order to maintain ionic and osmotic homeostasis in the blood. If it is nonfunctional, stops working, or lesion is present, you will have loss of protiens / important molecules via the urinary space and excretion.

Question 5

What occurs to larger molecules that approach the glomerulus?

Answer 5

Question 6

What are indications of glomerular injury?

Answer 6

Proteinuria = the presence of abnormal quantities of protein in the urine ( 1st sign)
** tubular injury can also lead to proteinuria (small molecules only; aminoaciduria and also glucosuria)
- Albuminuria (edema)
- Loss of AT I I I (thrombus)
(protien loosing nephropathy)

Question 7

What is seen in these images? What may they indicate?

Answer 7

Question 8

What is seen in this image? What does this indicate? Where is it most commonly seen?

Answer 8

Hypercoagulable state: loss of antithrombin III

Question 9

What are the hallmarks of glomerular disease?

Answer 9

Question 10

What is the mechanism of hyperlipidemia in glomerular disease?

Answer 10

Question 11

What is glomerulitis? What is the usual cause?

Answer 11

Question 12

What is glomerulonephritis? What are the differences between the 2 kinds?

Answer 12

Question 13

What is the criteria of diffuse glomerulonephritis?

Answer 13

> 50% glomeruli affected

Question 14

What is the criteria of focal glomerulonephritis?

Answer 14

< 50 % glomeruli affected.

Question 15

What is the difference between global or segmental glomerulonephritis?

Answer 15

Global vs Segmental (entire glomerulus vs part)

Question 16

What is the difference between proliferative and membranous glomerulonephritis?

Answer 16

○Proliferative vs Membranous (proliferation of endothelial/
podocytes/mesangial cells along with inflammatory cells vs. thickening of the basement membrane/mesangial matrix

Question 17

What is the characteristics of glomerulitis? What is an example of this? what is the mechanism of injury?

Answer 17

Question 18

What is seen in these images? What are the likely causes?

Answer 18

Question 19

What are the causes of glomerulonephritis?

Answer 19

Question 20

What is the mechanism of immune mediated glomerulonephritis?

Answer 20

Question 21

Answer 21

Question 22

What is the mechanism of injury to glomerular structures?

Answer 22

Question 23

What is the outcome to the mechanisms of injury of glomerular structures?

Answer 23

Question 24

What are the histological patterns of glomerulonephritis?

Answer 24

• Membranous GN: Thickened glomerular basement membrane/mesangial matrix
  ○ Most common form in cats
• Proliferative GN: Characterized by hypercellularity
  ○ Proliferation of mesangial cells + podocytes + influx of WBCs
• Membranoproliferative GN: Combination of thickened GBM/matrix and proliferation of mesangial cells and podocytes
  ○ Most common form in dogs

Question 25

What is glomerulosclerosis?

Answer 25

end stage. Glomerular duct is replaced with fiberous connective tissue, normally shrunken and fibrotic.

Question 26

What kind of glomerulonephritis is seen here?

Answer 26

Not glomerulonephritis

Question 27

What kind of glomerulonephritis is seen here?

Answer 27

Question 28

What kind of glomerulonephritis is seen here?

Answer 28

Question 29

What kind of glomerulonephritis is seen here?

Answer 29

Question 30

What is seen in this image?

Answer 30

Question 31

What can be seen in this image? Why does it have this appearence?

Answer 31

Question 32

What species are affected by the different types of glomerulonephritis? What are example causes?

Answer 32

Question 33

What is amyloid?

Answer 33

Question 34

What are the types of amyloidosis?

Answer 34

Question 35

What is the typical location for amyloidosis in the glomeruli? What about in the medulla? What does it cause? What is the prognosis

Answer 35

Question 36

What are the gross lesion characteristics of glomerular amyloidosis? How do you stain these specimens?

Answer 36

Question 37

What is seen in this image? what is indicated by the blue circles?

Answer 37

Question 38

What is seen in this image? What causes the staining?

Answer 38

Question 39

What other sites can be affected by amyloidosis in the kindeys?

Answer 39

Tubules and interstitium

Question 40

How is amyloidosis confirmed?

Answer 40

Question 41

What is seen in this image?

Answer 41

Question 42

What is seen in this image?

Answer 42

Question 43

What is seen in this image?

Answer 43

Question 44

What is the downstream changes of glomerulonephritis?

Answer 44

1.)Glomerulosclerosis
2.) Tubular injury
3.) Interstitial Fibrosis

Question 45

What is the mechanism of glomerulosclerosis from glomerulonephritis?

Answer 45

Question 46

What is the mechanism of tubular injury from glomerulonephritis?

Answer 46

Question 47

How do protiens damage tubular epithelium?

Answer 47

Question 48

What is the mechanism of interstitial fibrosis from glomerulonephritis?

Answer 48

Question 49

What is seen in this image? What should you not confuse it with?

Answer 49

Do not confuse with amyloidosis. Dialated tubules contain amphamorphous material. This fluid is high in protien.

Question 50

What are these changes that are indicative of glomerular disease?

Answer 50

Hyaline casts (protien)

Question 51

What is the sequelae of chronic glomerular diseases?

Answer 51

Question 52

Answer 52