Renal

Question 1

How does the vasculature of the kidney influence lesions such as infarcts, renal cortical necrosis, renal papillary necrosis, glomerular disease?

Answer 1

Infarcts - pyramidal/wedge shape lesions

Cortical necrosis - Schwartzman reaction (widespread thrombosis of arterioles/capillaries), usually bilateral

Papillary necrosis - inner medullary ischemia

Glomerular disease - dots on surface of kidney

Question 2

What organs are most commonly affected by metastatic mineralization during renal failure?

Answer 2

Stomach
Tongue
Ribs
Lungs

Question 3

What is the clinical, gross, and histologic presentation of progressive Juvenile Nephropathy?

Answer 3

Syndrome of severe bilateral fibrosis occurring in young dogs (4 mo - 2 yr)

Causes PU/PD, similar signs to CKD

Gross and histologic lesions similar to chronic fibrosis

Varies with breed (Cockers, Shih tzu, Samoyed, Chow)

Question 4

What are causes of tubular necrosis? What are the different causes and ramifications (basement membrane involvement)?

Answer 4

Ischemic injury (post hypovolemic shock)
Hemoglobinemia 

If the basement membrane destroyed, it will scar

Question 5

Difference between interstitial nephrtis and glomerulonephritis?

Answer 5

Interstitial nephritis:
Usually lymphoplasmacytic
Gross lesions: enlarged, pale, smooth to finely granular capsular surface. Glomeruli may appear as tan dots.

Glomerulonephritis:
Usually causes by immune complexes
Acute - swollen, smooth pale kidneys, miliary pattern (red dots)
Chronic - shrunken, granular, thin, irregular cortex, glomeruli may appear as grayish dots, extensive fibrosis

Question 6

What is the pathogenesis of hydronephrosis and hydroureter? What are possible causes?

Answer 6

Hydronephrosis:
Urine produced refluxes in to the interstitium and is picked up by vasculature until system is eventually collapses due to pressure gradients. Leads to ischemia -> atrophy -> necrosis -> fibrosis

Causes: congenital anomaly, calculi, inflammation, neoplasia

Question 7

How do you differentiate chronic from acute lesions?

Answer 7

Acute: swollen

Chronic: shrunken, fibrotic

Question 8

Gross lesions associated with cystitis vs primary bladder neoplasia

Answer 8

Cystitis, acute: edema, erosions, ulcers, exudate

Cystitis, chronic: thickened mucosa, follicular or polypoid

Neoplasia: masses, usually at trigone

Question 9

Causes of multifocal renal hemorrhage

Answer 9

Vasculitis
DIC 
Herpesvirus (puppies)
Trauma
Bleeding disorders

Question 10

How do differentiate hematogenous vs ascending infection based on gross lesions

Answer 10

Hematogenous: diffuse spotting

Ascending: radial

Question 11

Histologic lesions associated with juvenile progressive nephropethy

Answer 11

Loss of normal architecture due to progressive fibrosis with no primary renal inflammation