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Histopath > Renal > Flashcards

Renal Flashcards

1
Q

where does most reabsorption take place in the kidney

A

PCT

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2
Q

where are the glomeruli located

A

cortex

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3
Q

where does fine tuning of Na and K take place

A

DCT

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4
Q

which part is under control of ADH and determines how much H20 reabsorbed

A

CD

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5
Q

Two diseases of the glomerulus

A

nephrotic syndrome

nephritic syndrome

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6
Q

nephrotic syndrome is characterised by

A

proteinuria >3g/25h
oedema
hyperlipidaemia

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7
Q

swelling, frothy urine

A

nephrotic syndrome

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8
Q

most commonly seen in children, loss of podocyte foot processes. thought to be associated with immune process. >90% respond to steroids.

A

minimal change

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9
Q

common in adults
diffuse glomerular BM thickening
IgG and complement along the entire GBM
poor response to steroids
can be associated with SLE, infection, drugs, malignancy
STRONG association with abs to phospholipase A2 receptor on podocytes

A

membranous

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10
Q

common in adults, AC
consolidation and progressive scarring, hyalinosis
Ig and complement in scarred areas
1ry, but can be 2ry to obesity and HIV nephropathy

A

focal segmental glomerulosclerosis

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11
Q

a secondary cause of nephrotic syndrome that shows diffuse BM thickening and Kimmelstiel Wilson nodules

A

Diabetes

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12
Q

secondary cause of nephrotic syndrome. Histology shows apple green birefringence with cong red stain

A

Amyloidosis

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13
Q

chronic inflammation - RA, TB - and apple green birefringence

A

AA protein deposition amyloidosis

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14
Q

Ig light chain deposition i.e in MM, leading to apple green birefringence and nephrotic sydrome

A

AL amyloid protein deposition

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15
Q

macroglossia, heart failure, hepatomegaly

A

amyloidosis clues

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16
Q

coca cola haematuria, dysmorphic RBCs and red cell casts in urine,
+/- oliguria, increased urea and creatitine, HTN and proteinuria (mild)

A

Nephritic syndrome

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17
Q

occurs 1-3 weeks after strep throat infection with GAS. immune compkex deposition leads to red cell casts proteinuria, oedema and HTN.

A

post strep GN

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18
Q

Commonest GN in the world, caused by IgA immune complexes in the glomeruli
presents 1-2 days after a URTI with frank haematuria

A

IgA nephropathy

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19
Q

medical emergency which can rapidly progress to ESRF. characterised by nephritic syndrome with pronounced oliguria and renal failure.
presence of crescents in glomeruli.

A

Crescenteric GN

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20
Q

HLA-DR1 associated syndrome with crescents in glomeruli on light microscopy.
fluorescence microscopy shows LINEAR deposition of IgG in GBM.

A

Goodpastures - anti-GBM IgG

can also have lung involvement - pulm haemorrhage

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21
Q

nephritic syndrome with crescents in glomeruli, fluorescence microscopy shows a granular (lumpy bump) pattern of IgG complex deposition along the GBM and mesangium.
limited additional organ involvement usually.

A

Immune complex mediated crescenteric GN.

associated with SLE, IgA nephropathy and post-GN strep.

22
Q

crescenteric GN with a lack of/scanty immune complex deposition, may be associated with c-ANCA/p-ANCA, and vasculitits.

A

pauci-immune crecenteric GN

no immune complex/anti-GBM

23
Q

sensorineural deafness, eye disorders and nephritic syndrome. X linked.

A

Alports syndrome

mutation on type IV collage alpha 5 chain

24
Q

asymptomatic microscopic haematuria caused by diffuse thinning of the GBM.

A

Benign familial haematuria

AD inheritance, normal renal function

25
Q

Asymptomatic haematuria ddx

A
  1. Benign familial haematuria
  2. IgA nephropathy - more likely to cause frank haematuria, more likely to cause change in renal function, more common in asians
  3. Alport syndrome
26
Q

acute damage to the tubular interstitial cells leading to sloughing of the damaged cells, which go on to block tubules.
This causes reduced flow –> acute renal failure

A

Acute Tubular Necrosis

27
Q

Causes of ATN

A
  1. ischaemia - burns, sepsis, severe dehydration

2. nephrotoxins - drugs (NSAIDS, gent), radioactive contrast, myoglobin, heavy metals, light chains

28
Q

histopathology of ATN

A

necrosis of the short segments of tubules

29
Q

leukocytic casts in the urine

A

pyelonephritis

30
Q

hypersensitivity reaction, usually starts days after exposure with fever, skin rash, haematuria, proteinurian and eosinophilia.

A

acute interstitial nephritis

31
Q

thrombotic microangiopathy with schistocytes, anaemia, often in young children. thrombi confined to the kidneys. usually causes renal failure.

A

HUS

32
Q

thrombi occuring throughout the ciruclation, MAHA, low plts, neuro sx (headache, altered consciousness, seizures, coma) no renal failure

A

TTP

33
Q

rapid loss of GFR and tubular function leading to abnomrmal U&E, decreased GFR, increased CR and Urea.

A

acute renal failure

34
Q

complications of ARF

A 
metabolic acidosis
hypERkalaemia - reduced Na reaching the DCT - leads to decreased K+ secretion.
fluid overload
HTN
hypocalcaemia
uraemia
35
Q

pre-renal causes of ARF

A

failure of perfusion - dehydration, shock, haemorrhage, hypovolaemia, renal artery stenosis

36
Q

renal causes of ARF

A

failure of kidney intersitium
ATN
acute GN
thrombotic microangiopathy

37
Q

post renal causes of ARF

A

obstruction

renal stones, tumours, prostatic hypertrophy

38
Q

progressive and irreversible loss of renal function characterised by chronic prolonged symptoms of uraemia - fatigue, itching, anorexi and confusion

A

Chronic renal failure

39
Q

commonest causes of CRF

A

diabetes
GN
HTN and vascular disease

40
Q

autosomal dominant disorder in PKD1 and PKD2 genes leading to large multicystic kidneys with destroyed renal parenchyma.

A

APCKD

41
Q

extra-renal manifetations of APCKD

A 
berry aneurysms
liver cysts (PKD1)
42
Q

clinical features of APCKD

A

haematuria, flank pain, UTI. may have complications such as cyst rupture, infection and haemorrhage

43
Q

immune complex depsotiion leading to a number o different patterns of injury dependent on where the deposits are and how many there are. can lead to nephrotic syndrome, ARF, progressive chronic renal failure. ANA+ve,dsDNA+ve

A

SLE lupus nephritis

44
Q

painless haematuria, can be associ with von hippel lindau syndrome. 2% of all cancers.

A

renal cell carcinoma

45
Q

what percentage of CKD due to APCKD?

A

10%

46
Q

form of amyloid deposition in the kidneys in patients with multiple myeloma

A

AL

47
Q

abs to phospholipase A2 associated with which nephrotic syndrome?

A

membranous

48
Q

renal ca in pts with dialysis associated cystic disease

A

papillary ca

49
Q

round blue cells on histology, common cancer in children

A

wilms

50
Q

effacement of the podocytes is common characteristic of

A

nephrotic syndrome

Histopath (13 decks)

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