Pathomorph. II - urinary system pathology

Question 1

location of first ramifications of renal arteries

Answer 1

glomerulus

Question 2

first part of kidney to suffer from hypotension

Answer 2

proximal convoluted tubule due to the fact the endothelial cells consume so much energy for the large amount of solute reabsorption

Question 3

what is the smaller percentage of total kidney function required to survive

Answer 3

half of one kidney at minimum so 25%

Question 4

pre-renal kidney disease is typically due to

Answer 4

hypotension

Question 5

post-renal kidney disease is typically due to

Answer 5

obstruction of urine flow, urolithiasis

Question 6

what electrolyte imbalance is typical to renal disease?

Answer 6

excessive plasma K+ leading to heart failure and metabolic acidosis

Question 7

nonrenal lesions of uremia

Answer 7

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.

Question 8

erosion and ulceration difference

Answer 8

depth.

erosion is more superficial, affects the epithelial cells.

ulceration reachs past the basal membrane.

Question 9

what type of anemia could renal disease cause and why?

Answer 9

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.)

Question 10

how are Ca2+ and Phos changed during renal disease?

Answer 10

hyperphosphatemia due to poor glomerular filtration

Ca2+ mobilization from bones

additional info and EDIT needed here.

resulting in fibrous osteodystrophy

Question 11

dystrophic and metastatic soft tissue calcification

Answer 11

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.

Question 12

typical locations for soft tissue calcifications in renal disease (3)

Answer 12

gastric wall
intercostal spaces
lungs

Question 13

staining for calcifications in histology

Answer 13

Von Kossa stainstaining for calcium histology

Question 14

renal agenesis and hypoplasia difference

+ dysplasia

Answer 14

lack of development vs incomplete development

dysplasia = abnormal structural differentiation/organization

Question 15

-plasia vs -trophic meanings

Answer 15

-plasia = refers to the number of cells

-trophic = refers to the size of cells

Question 16

what are horseshoe kidneys

Answer 16

during embryogensis the two kidneys remain fused resulting in one large kidney with two ureters

Question 17

describe renal cysts

Answer 17

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

Question 18

aquired renal cysts

Answer 18

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

Question 19

fibroblasts form what over time?

Answer 19

myofibroblasts form from fibroblasts over time

are capable of contraction because they contain myosin.

Question 20

glucosuria will predispose

Answer 20

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

Question 21

define suffusion

Answer 21

widespread bruising

Question 22

What causes infarction in the kidney?

Answer 22

anything material that can cause emboli and any inflammatory state that might cause abberant coagulation to occur within vessels.

Question 23

What 3 organs are most likely to suffer from infarction?

Answer 23

all organs with terminal vascularization; kidneys, cardiac muscle, brain.

Question 24

what color is necrosis in necropsy?

Answer 24

usually yellowish

Question 25

Where is necrosis most typically found in the kidneys?

Answer 25

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.

Question 26

What does meduallary crest necrosis predispose to?

Answer 26

the necrosis predisposes to mineral accumulation in the renal calyx and thus to the formation of concrements/calculi

Question 27

SIRS

Answer 27

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.

Question 28

What are the 4 signs of SIRS?

Answer 28

• 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.

Question 29

define nefrosis

Answer 29

renal tubular necrosis

typically affecting the proximal convoluted tubule

Question 30

What is a sign of tubular necrosis you can observe in urine sediment?

Answer 30

cylinders / casts

Question 31

Drugs that can cause tubular epithelial necrosis? (4)

Answer 31

neomycin
oxytetracycline
minocyn
cytotoxic cancer drugs

also heavy metals (e.g. lead)
ethylene glycol

Question 32

Types of icterus

Answer 32

pre hepatic
hepatic
post hepatic

Question 33

name a cause of pre hepatic icterus

Answer 33

excess destruction of RBCs causing bilirubinemia overtakes the ability of liver to conjugate the bilirubin and excrete into the gut.

Question 34

what is pathognomic upon renal histology, for ethylene glycol / antifreeze ingestion?

Answer 34

calcium oxalate aggregation in renal tubules shine when under UV light

Question 35

name a cause of hepatic icterus

Answer 35

liver disease

Question 36

name a cause of post hepatic icterus

Answer 36

biliary obstruction by a stone in the common bile duct or by carcinoma of the pancreas.

Question 37

hypopreoteinemia causing diffuse whole body edema is more typically termed?

Answer 37

anasarca

Question 38

what parasite can cause proliferative glomerulonephritis?

Answer 38

dirofilaria immitus (heart worm)

Question 39

describe immune-mediated glomerulonephritis

Answer 39

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.

Question 40

describe purulent glomerulonephritis

Answer 40

caused by blood-borne bacteria accumulating in the tiny vessels of the glomeruli