Puthoff Lecture 2 Flashcards
What phase of ATI shows hypokalemia?
Recovery
Ischemic necrosis causes what kind of damage and where?
Patchy
PCT, PST, TAL
Defect of thin basement membrane disease due to a mutation in what?
Alpha3 or alpha4 type 4 collagen
What is being describe with these classic features?
Fever Microangiopathic hemolytic anemia Thrombocytopenia Neurologic symptoms Renal failure (50% of Pts)
TTP
How long does the initiation phase of ATI last?
What symptom?
36 hours
Oliguria
Papillary necrosis is caused by what?
DM
Analgesic nephropathy
Obstruction
Tubulointerstitial nephritis is characterized by what?
Azotemia
Inability to concentrate the urine
Polyuria
What is associated with non-epidemic, non-diarrheal, inherited mutations of proteins that regulate complement?
Atypical HUS
End stage diabetic nephrosclerosis can produce what?
Diffuse granular pitted surface
Marked thinning of renal cortex
Xanthogranulomatous pyelonephritis is often associated with what?
Proteus
What is the following morphology describing?
Diffuse capillary BM thickening
Diffuse Mesangial sclerosis
Nodular glomerulosclerosis
Diabetic glomerulosclerosis
What is associated with bloody diarrhea due to E. coli and is an epidemic snydrome?
Typical HUS
What injury causes PCT cells to swell and show vacuolization?
Ethylene glycol
Atypical HUS mostly seen in whom?
Pregnant
Immunosuppressed
Malignant HTN
Where are the most mitochondria (highest energy requirements) located in the tubules?
PCT
Papillary necrosis with pale gray necrosis limited to the papilla is caused by what?
DM
Most patients are ______ for the defective gene in thin basement membrane disease
Heterozygous
Autosomal inheritance
What anatomic defects predispose to pyelonephritis?
VUR
Intrarenal reflux
Diffuse proliferative lupus nephritis is characterized by what morphologically?
Increase in cellularity
Enlarged glomerulus
Decrease in urinary space
What is described by the following morphology?
Hyaline arteriosclerosis, cortical adherence, compressed lumen?
Benign nephrosclerosis
50% of children with UTI have what?
VUR
What disease shows “wire loops” on light microscopy and subendothelial dense deposits on EM?
Lupus nephritis
What is associated with defects in ADAMTS13?
What involvement is most prominent?
Most common in whom?
TTP
Neurologic
Females under 40
What is the 2nd most common cause of renal artery stenosis?
Occurs most often in whom?
Fibromuscular dysplasia
Young women
Another name for diabetic glomerulosclerosis?
Kimmelstiel-Wilson Disease
What causes embolization of plaques from the aorta or renal artery after AA surgery, aortography or intra-aortic cannulization?
Atheroembolic renal disease
What is Seen in interlobular arteries containing cholesterol crystals which appear as rhomboid clefts?
Atheroembolic renal disease
What causes acute tubular injury?
Ischemia
Toxic injury
What causes renal artery stenosis and HTN in an ischemic kidney?
Increased production of Renin
What causes vasoconstriction within the tubules?
RAS
Endothelin
Decreased NO
Decreased PGI2
What is characterized by hematuria and hyposthenuria with patchy papillary necrosis?
Sickle cell nephropathy
What are predisposing conditions to pyelonephritis?
Diabetes
Pregnancy
What phase of ATI shows hyperkalemia?
Maintenance
What is the most common etiology of large vessel disease?
What vessels?
atherosclerosis
Renal artery and abdominal aorta
Clinical features of thin basement membrane disease?
Prognosis?
Asymptomatic hematuria
Excellent
What are the only 2 things that cause damage to the calyces?
Chronic pyelonephritis
Analgesic nephropathy
Toxic necrosis causes what kind of damage and where?
Continuous
PCT, PST
Patchy in TAL
Coagulative necrosis of both glomeruli and tubules caused by obstetric emergencies, septic shock, surgery complications, is what condition?
Diffuse cortical necrosis
Some people with analgesic nephropathy may develop what?
Urothelial carcinoma of the renal pelvis
What is the most common cause of benign familial hematuria?
Thin Basement Membrane Disease
What disease is described by the morphology of acute inflammation in tubules, cortical surface with yellow-gray areas of pus and abscess but spares the glomerulus?
Acute pyelonephritis
Inheritance pattern of Alport?
Defect in what?
X-linked
Type 4 collagen
What disease has hematuria, chronic renal failure, nerve deafness, lens dislocation, posterior cataracts?
Alport
What is a bacterial infection of the kidney parenchyma?
Acute pyelonephritis
What are the most common causes of UTI?
E. coli, Proteus, Klebsiella, Enterobacter
Pyelonephritis most often occurs how?
95% arise via ascending infection from bladder
What people may develop renal failure from benign nephrosclerosis?
Africans
HTN
DM
What disease has an EM that shows irregular thickening of the BM and appears “moth-eaten”?
Alport syndrome
The following morphology describes what?
Fibrinoid necrosis, “onion-skinning”, hyperplastic arteriolitis, “flea-bitten” appearance of renal hemorrhages?
Malignant nephrosclerosis
Papillary necrosis that is red-brown necrotic papilla sloughed into the calyx is caused by what?
Analgesic nephropathy
What results in polar scarring of the kidney?
VUR with chronic pyelonephritis
“Rosary sign” associated with what?
Fibromuscular dysplasia of the renal artery
What can sometimes cause acute pyelonephritis?
Polyoma virus
What disease is seen where blunting of the calyces occurs?
Chronic pyelonephritis
What vessel is majorly effected in malignant nephrosclerosis?
Afferent arteriole
