renal and cancer peer tute Flashcards
what is the difference between PCT and DCT when identifying them on histology slid
PCT: simple cuboidal, brush border (looks hazy), more densely stained (more organelles - look more pink) DCT: smaller cells, no brush border, paler cytoplasm, larger lumen
causes of pre renal failure
shock (septic, cardiogenic, hypovolaemic, haemorrhagic)
dehydration
haemorrhage
renal artery stenosis
causes of post renal failure
obstruction!
- renal calculi
- prostate englargement
- tumour
causes of intra renal faiulre
- acute on chronic kidney failure
- acute renal disease
- acute tubular necrosis
- tubulointerstitial disease
- vascular disease
- myeloma
- acute pyelonephritis
what is glomerulonephritis
inflammatory injury (mostly immune mediated) to the renal glomeruli
consequences of glomerulonephritis
nephrotic syndrome
haematuria
renal impairment
what is nephrotic syndrome
leakage of protein –> proteinuria, hypoalbuminaemia and generalised oedema
4 important types of glomerulonephritis
IgA nephropathy
post-strep glomerulonephritis
membranous nephropathy
minimal change disease
which types of glomerulonephritis present with nephrotic syndrome and which present with nephritic syndrome
nephrotic = membranous nephropathy and minimal change disease
nephritic = IgA nephropathy and post-strep glomerulonephritis
classic presentation of someone with IgA nephropathy
- haematuria
- renal impairment
- few days after URTI
what do you see histologically by a light microscope in IgA nephropathy
mesangial hypercellularity and increased mesangial matrix formation
what do you see on an electron microscope in someone with IgA nephropathy
electron dense IgA deposits in the mesangium
classic presentation of someone with post-strep glomerulonephritis
- haematuria
- renal impairment
- 1-4 weeks after Strep pyogenes pharyngitis or impetigo
what mediates post-strep glomerulonephritis
IgG and C3 complement
classic presentation of membranous nephropathy
proteinuria and nephrotic syndrome
what causes membranous nephropathy
deposition of immune complexes on the epithelial side of the BM –> the complexes activate C’ and formation of MAC damages BM and allows protein leakage
what do you see histologically via light microscope in someone with membranous nephropathy
diffuse thickening of the capillary walls without increased cellularity
what do you see in an electron microscope in someone with membranous nephropathy
- thickened glomerular BM
- electron dense immune complex deposits
classic presentation of minimal change disease
proteinuria and nephrotic syndrome mostly in children
what can you see on light and electron microscopy in someone with minimal change disease
light = nothing
electron = fusion and effacement of podocyte foot processes
what is the most common cause of interstitial nephritis
adverse reaction to drugs
what is the classic presentation of interstitial nephritis
acute renal failure - sudden drop in urine output over 48 hours
what cell infiltrates in interstitial nephritis are indicative of drug allergy or infection
drug allergy = eosinophils
infection = lymphocytes
3 most common causes of chronic renal failure
diabetes
glomerulonephritis
hypertension
