Pathomorph. II - urinary system pathology Flashcards
location of first ramifications of renal arteries
glomerulus
first part of kidney to suffer from hypotension
proximal convoluted tubule due to the fact the endothelial cells consume so much energy for the large amount of solute reabsorption
what is the smaller percentage of total kidney function required to survive
half of one kidney at minimum so 25%
pre-renal kidney disease is typically due to
hypotension
post-renal kidney disease is typically due to
obstruction of urine flow, urolithiasis
what electrolyte imbalance is typical to renal disease?
excessive plasma K+ leading to heart failure and metabolic acidosis
nonrenal lesions of uremia
severity depends on survival time in uremic state
endothelial necrosis and increase in permeability in general.
lower part of mouth due to salivary collection and saliva has increased ammonia content due to uremic state.
gastric and intestinal ulcers also common in some species.
erosion and ulceration difference
depth.
erosion is more superficial, affects the epithelial cells.
ulceration reachs past the basal membrane.
what type of anemia could renal disease cause and why?
non-regenerative because of a lack of erythropoietin due to renal degeneration, in combination with accelerated erythrocyte degeneration and lysis due to the same factors that cause endothelial degeneration (metabolic acidosis, uremia etc.)
how are Ca2+ and Phos changed during renal disease?
hyperphosphatemia due to poor glomerular filtration
Ca2+ mobilization from bones
additional info and EDIT needed here.
resulting in fibrous osteodystrophy
dystrophic and metastatic soft tissue calcification
dystrophic: Ca2+ deposition to the location of a prior lesion (due to altered pH in the lesion)
metastatic: all over the body
renal disease will involve both.
typical locations for soft tissue calcifications in renal disease (3)
gastric wall
intercostal spaces
lungs
staining for calcifications in histology
Von Kossa stainstaining for calcium histology
renal agenesis and hypoplasia difference
+ dysplasia
lack of development vs incomplete development
dysplasia = abnormal structural differentiation/organization
-plasia vs -trophic meanings
-plasia = refers to the number of cells
-trophic = refers to the size of cells
what are horseshoe kidneys
during embryogensis the two kidneys remain fused resulting in one large kidney with two ureters
describe renal cysts
primary or secondary due to renal dysplasia
they form in the nephron, can be single or multiple
can impede renal function or then not
the fluid inside is actually urine filtrate
aquired renal cysts
renal interstitial fibrosis (e.g. scarring from a previous lesion) or other renal disease that caues tubular obstruction which leads to cysts formation
are usually small (1-2 mm in diameter) and occur primarily in cortex
fibroblasts form what over time?
myofibroblasts form from fibroblasts over time
are capable of contraction because they contain myosin.
glucosuria will predispose
to bacterial infeciton the bladder which can result in emphysema in the bladder wall and near by lymph nodes due to gases produced by the bacteria
define suffusion
widespread bruising
What causes infarction in the kidney?
anything material that can cause emboli and any inflammatory state that might cause abberant coagulation to occur within vessels.
What 3 organs are most likely to suffer from infarction?
all organs with terminal vascularization; kidneys, cardiac muscle, brain.
what color is necrosis in necropsy?
usually yellowish
Where is necrosis most typically found in the kidneys?
medullary crest because it is the area to receive bloodflow “last” (due to the vascular anatomy) so O2 partial pressure and nutrient content of the blood is lower than previous segments.
What does meduallary crest necrosis predispose to?
the necrosis predisposes to mineral accumulation in the renal calyx and thus to the formation of concrements/calculi
SIRS
Systemic inflammatory response syndrome
an exaggerated defense response of the body to a noxious stressor (infection, trauma, surgery, acute inflammation, ischemia or reperfusion, or malignancy, to name a few) to localize and then eliminate the endogenous or exogenous source of the insult.
What are the 4 signs of SIRS?
- Body temperature over (38 degrees Celsius) or under (36 degrees C).
- Heart rate greater than 90 beats per minute.
- Respiratory rate greater than 20 breaths per minute or partial pressure of CO2 less than 32 mmHg.
- Leukocyte count greater than 12,000; leukocytosis.
define nefrosis
renal tubular necrosis
typically affecting the proximal convoluted tubule
What is a sign of tubular necrosis you can observe in urine sediment?
cylinders / casts
Drugs that can cause tubular epithelial necrosis? (4)
neomycin
oxytetracycline
minocyn
cytotoxic cancer drugs
also heavy metals (e.g. lead)
ethylene glycol
Types of icterus
pre hepatic
hepatic
post hepatic
name a cause of pre hepatic icterus
excess destruction of RBCs causing bilirubinemia overtakes the ability of liver to conjugate the bilirubin and excrete into the gut.
what is pathognomic upon renal histology, for ethylene glycol / antifreeze ingestion?
calcium oxalate aggregation in renal tubules shine when under UV light
name a cause of hepatic icterus
liver disease
name a cause of post hepatic icterus
biliary obstruction by a stone in the common bile duct or by carcinoma of the pancreas.
hypopreoteinemia causing diffuse whole body edema is more typically termed?
anasarca
what parasite can cause proliferative glomerulonephritis?
dirofilaria immitus (heart worm)
describe immune-mediated glomerulonephritis
antibody-antigen complexes are the perfect size to get caught up in the podocyte gaps in the glomeruli. when they’re caught, they set off inflammatory cascades due to complement factors (C3 etc.)
when the above occurs frequently or chronically, it can result in immune-mediated glomerulonephritis.
this is the most common cause of glomerulonephritis in small animals.
describe purulent glomerulonephritis
caused by blood-borne bacteria accumulating in the tiny vessels of the glomeruli
