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Systemic Pathology I > Pathology of the Renal System: Overview of Renal Pathology > Flashcards

Pathology of the Renal System: Overview of Renal Pathology Flashcards

1
Q

What is the normal ratio of cortex to medulla in domestic species?

A

Normal Ratio of cortex to medulla in domestic species is about 1:3.

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2
Q

What species have a unilobar or unipyramidal kidneys?

A

Unipyramidal (unilobar): Cats, dogs, horses, sheep, and goats

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3
Q

What species have a multipyramidal (multilobar) kidneys?

A
  • Multipyramidal (multilobar): Pigs and cattle
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4
Q

What is the renal medulla composed of?

A

Renal medulla is composed mostly by collecting ducts and tubules.

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5
Q

What is another term for the renal crest?

A

Renal papilla

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6
Q

What makes up the hillus?

A
  • Renal artery and vein is what makes up the hillus
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7
Q

What animal species is the only one with external lobulation of the kidney?

A

Bovine

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8
Q

What is a multilobulated kidney like?

A

Each lobe is like a kidney

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9
Q

Is kidney A normal or abnormal? Kidney B?

A
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10
Q

What are the four structural units of renal architecture?

A
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11
Q

What is the functional unit of the kindey? What is included in this ?

A
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12
Q

What part of the kidneys receives blood supply first? What next?

A
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13
Q

What is the order of blood supply through the kidney vasculaure?

A
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14
Q

Why is the kidney called an end artery organ? What is the significance of this?

A
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15
Q

In a normal kidney can you see glomeruli?

A

No

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16
Q

What is indicated in blue in this image?

A
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17
Q

What is being indicated in blue in this image? What is this structure?

A

Renal corpuscle is the structure. The area in blue is called the urinary space

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18
Q

What are messangial cells and what do they do?

A
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19
Q

What is visceral epithelium?

A
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20
Q

What is the glomerulus?

A
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21
Q

What is the difference between proximal and distal tubules?

A

Proximal tubules have brush borders in order to increase the surface area.

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22
Q

What are the components of the glomerular filtration barrier?

A
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23
Q

What is the function of the glomerular filtration barrier?

A
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24
Q
A
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25
Q

What is important about the renal architecture?

A
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26
Q

What is the typical appearence of kidneys that have experienced chronic kidney disease?

A

shrunken and scarred kidney

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27
Q

What is the function of the kidneys in the body?

A
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28
Q

How is maintenance of normal concentrations of salt, water and electrolytes achieved?

A

Regulated by the glomerular filtration barrier and resorption/ secretion of molecules within tubular system

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29
Q

How is the regulation of acid-base balance achieved?

A

This is primarily through reclaimation of bicarbonate

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30
Q

What are the hormones produced by the kidneys?

A

Erythropoietin, Renin and Prostaglandins

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31
Q

What is the function of erythropoietin? What happens if there is an absence of it?

A

Function is to stimulate bone marrow to produce erythrocytes. Without this you will have a non regenerative anemia.

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32
Q

What is the function of Renin?

A

RAAS

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33
Q

What is the function of prostaglandins? Where does it act?

A

Prostaglandins act in the renal medulla and are important for renal blood flow regulation. It keeps blood vessels open and prevent ischemic damage.

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34
Q

How does the kidneys convert vitamin D to its active form? Why is it important?

A

Its important for ca++/ phos metabolism. Vit D facilitates calcium absorption in the intestines,

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35
Q

What pressure is required for adequate renal perfusion?

A

60 mmHg

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36
Q

When is renal disease detected?

A

Re nal disease is detected if any of these requirements are not met, and the outcome is always appropriately the same:
There is imbalance of salt and water, and of acids and bases, and there is retention of wastes.

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37
Q

What is seen with water and salt imbalance?

A

Edema

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38
Q

What is seen with waste retention?

A

Elevated BUN / Creatinine

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39
Q

What is the most commonly used index of failure of the kidneys?

A

The most commonly used index of failure is the amount of urea and/or creatinine that is retained!

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40
Q

What are the consequences of impairment of each renal function?

A

Impairment of:
1.) Excrete metabolic waste = UREMIA
2.) Maintenance of normal concentrations of salt and water = EDEMA
3.) Regulation of acid-base balance = ACIDOSIS
4.)Production of hormones - Erythropoietin, Renin and Prostaglandins = ANEMIA, HYPERTENSION, ISCHEMIC NECROSIS
5.)5.Vitamin D to active form - 1,25 dihydroxycholecalciferol (1,25(oh)2d3) = HYPOCALCEMIA →→ HYPERCALCEMIA

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41
Q

When there is impairment of renal function, and there is issues with vitamin D conversion and calcium modulation, what is the processes that cause initial hypocalcemia, and later hypercalcemia?

A
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42
Q

What is the hallmark of kidney disease?

A

The impairment of Vit D conversion and issues with calcium phosphorus homeostasis.

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43
Q

Is this kidney undergoing acute or chronic renal failure?

A
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44
Q

Is this kidney undergoing acute or chronic renal failure?

A
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45
Q

At what point will you start to see signs of renal function impairment?

A
  • When renal function capacity is impaired approximately 75% or more
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46
Q

What are the typical characteristics post mortem of a kidney that has undergone acute renal failure?

A
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47
Q

What are the typical characteristics post mortem of a kidney that has undergone chronic renal failure?

A
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48
Q

What are the categories of types of acute renal failure?

A
  • Prerenal
  • Postrenal
  • Renal
    ( which further breaks down to acute glomerular nephritis, acute interstitial nephritis, acute tubular necrosis)
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49
Q

What is the causes of prerenal acute renal failure?

A

Decreased renal perfusion/ blood supply to the kidney. Can occur with hypotension (i.e septic shock, shock, hypovolemia, dec cardiac output, CHF, Dec arterial blood volume ( in case of vomiting and diarrhea)

50
Q

What is the causes of postrenal acute renal failure?

51
Q

What are the causes of the 3 types of renal- acute renal failure?

52
Q

What is the most common type of acute renal failure?

A

Acute tubular necrosis (nephrotoxins or ischemia)

53
Q

What are the hallmark clinical signs seen that indicate the patient is experiencing acute renal failure by tubular necrosis?

A

Oliguria and anuria

54
Q

How does tubular necrosis acute renal failure cause oliguria and anuria?

55
Q

What is seen in this image?

56
Q

What is seen in this image?How can you describe it? What is indicated by the blue line?

57
Q

What are you seeing in these two histologic slides of a kidney with acute renal failure via tubular necrosis?

58
Q

How does death occur in accute renal failure?

59
Q

What is seen in this image?

A

Lungs with pulmonary edema. Lungs are wet, you will see alot of foamy fluid inside if cut open. This is because of fluid retention/ edema.

60
Q

What is chronic renal failure? What is the typical causes?

61
Q

What are the hallmark clinical signs indicating chronic renal failure?

A

Polyuria and polydipsia
Increased urination and increased thirst

62
Q

What other signs can be present in patients with chronic renal failure?

63
Q

What is a hallmark sign of chronic renal failure?

64
Q

What can be seen in this histological slide of a kidney with chronic kidney disease?

65
Q

What characteristics are seen in this image and what kind of kidney disease (acute or chronic) is seen?

66
Q

What is azotemia? What kind of renal disease is it seen?

A

Azotemia: Biochemial abnormality characterized by elevation of
blood urea and/or creatinine, but without obligatory of clinical
manifestation of renal disease. Prerenal, renal, post-renal.

67
Q

What is uremia? What is often seen with it? What is the prognosis of a patient with uremia?

A

Uremia literally means urine in the blood. It is a clinical syndrome of
renal failure, caused by biochemical disturbances, and is often
accompanied by extrarenal lesions.
Prognosis is not good.

68
Q

What is seen in this image? What is the cause of these lesions?

A

UREMIC GASTROPATHY (Dogs and Cats)
* Ulcers and hemorrhage secondary to vasculitis
* Mucosal calcification (less common) (can also be seen; cause is Alteration in Ca/P metabolism)

69
Q

What is seen in this image? What is the typical cause?

A
  • Mucosal calcification (less common)
    Alteration in Ca/P metabolism
70
Q

What is seen in this image?

A

Necrosis of blood vessel

71
Q

What is seen in this image? What animals is it typically seen in? What is the cause?

72
Q

What is seen in this image? What is the cause?

73
Q

What is seen in this image? What is the cause?

74
Q

What is seen in this image? What is the cause?

75
Q

What is seen in this image? What is the cause?

76
Q

What are the 3 mechanisms caused by renal impairment that are the causes of the extra renal lesions?

77
Q

What is seen in this image? What is circled in blue? What is circled in yellow? What is circled in orange?

78
Q

What is seen in this image? What is the cause? What other sign may be present in these patients?

79
Q

What is seen in this image? What is the cause?

80
Q

What is seen in this image?What is the cause?

81
Q

What is seen in this image? What is the cause?

82
Q

Where do you see uremic endocarditis usually?

83
Q

What is seen in this image? What is the cause?

84
Q

What is seen in this image? What is the cause? What is indicated by the blue line?

85
Q

What is seen in this image? What is the cause?

86
Q

In parathyroid hyperplasia, which cell is hyperplastic?

A

Chief cells

87
Q

What is seen in this image? What is the cause?

88
Q

What is seen in this image? What is the cause?

A

Rubber Jaw

89
Q

What is the cause of primary hyperparathyroidism?

A

parathyroid adenoma

90
Q

What is the cause of secondary hyperparathyroidism?

A
  • Nutritional (usually large animals with increased phosphorus diets)
  • renal
91
Q

What is seen in this image? What is the cause?

93
Q

What is renal agenesis? What breeds is it common in? Does it usually cause alot of problems?

94
Q

What is seen in this image? What is the cause?

95
Q

What is renal hypoplasia? What is the criteria for diagnosis?

96
Q

What is seen in this image? Why is one kidney larger than the other?

97
Q

What will you usually see if you have renal hypoplasia?

A

Complasia hypertrophy of the other kidney

98
Q

What is seen in this image? What is the cause?

99
Q

What are the characteristics of a kidney with renal dysplasia?

100
Q

What is renal dysplasia?

101
Q

What is juvenile nephropathy?

102
Q

What is familial/ breed nephropathy? What age is it developed at?

103
Q

What is seen in this image?

104
Q

What is seen in this image?

105
Q

What is seen in this image? What kind of stain is used?

106
Q

What is an ectopic kidney?

107
Q

What is seen in this image?

108
Q

What is seen in this image? What is the cause?

109
Q

What is seen in this image? What is the cause?

110
Q

What are the categories of renal cysts?

A
  • Congenital
  • Acquired
111
Q

What are the characteristics of congenital cytsts?

112
Q

What are the characteristics of acquired cysts?

113
Q

What kind of cyst is seen in this image?

114
Q

What kind of cyst is seen in this image? What is indicated by the blue circles?

A

Blue circles: mineralization and scarring

115
Q

What is feline polycystic kidney? What is the patter of inheritence? What breeds are predisposed?

116
Q

What is the genes affected in feline polycystic kidney disease? What do these genes do?

A

PDK -1 and PDK-2
-Mutation in PKD1 and PKD2 (encodes polycystin-1 and -2), which is part of the primary cilia of the tubular epithelial cells - This cilium senses fluid movement through the lumen

117
Q

What is the mechanism of polycystic kidney disease of persian cats?

118
Q

Where else can you see cysts in cats with polycystic kidney disease?

A
  • Cysts also present in pancreas and liver
119
Q

What do they cysts usually look like with Polycystic kidneys? Where do they occur?

120
Q

What is the mean age of cats developing signs of renal failure when having polycystic kidneys (persian)?

A

3 years is mean age

121
Q

What is seen in this image? What is the cause?

Systemic Pathology I (23 decks)

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