Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology > Renal Disease I > Flashcards

Renal Disease I Flashcards

1
Q

The ___ is a network of capillaries between ___ arteriole (bringing blood to the capillary bed) and ___ arteriole (drains blood away from capillary bed).

A

glomeruli; afferent; efferent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the capillary wall of the glomeruli consist of?

A

endothelium, basement membrane and epithelium (lining the urinary space)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The epithelial cells of the glomeruli have many finger-like processes that come from the cell body and contact the ___ membrane. A membrane connects adjacent processes (called the ___ ___) and is important in preventing ___.

A

basement; slit diaphragm; proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F. The capillary wall is permeable to albumin and larger proteins and impermeable to water and small molecules.

A

False, The capillary wall is permeable to water and small molecules and impermeable to albumin and larger proteins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What connective tissue supports the capillaries in the glomeruli?

A

mesangium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the filtrate from the glomeruli travel through?

A

tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is formed by collagen and blood vessels between the tubules and glomeruli?

A

interstitium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the capillary bed around some of the tubules? What vasculature supplies this area?

A

vasa recta

efferent arterioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define azotemia.

A

Elevation of the blood urea nitrogen (BUN) and creatinine levels, due to decreased filtration of blood through the glomeruli (decreased glomerular filtration rate).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define uremia.

A

Association of azotemia with clinical signs and symptoms, including gastroenteritis, peripheral neuropathy, pericarditis, dermatitis, hyperkalemia, and metabolic acidosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Match the following symptom with the major clinical renal syndrome.

a. acute nephritic syndrome
b. nephrotic syndrome
c. acute renal failure

  1. hematuria
  2. severe proteinuria
  3. oliguria/anuria
A

a - 1
b - 2
c - 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

___ ___ syndrome results from glomerular injury and is characterized by acute onset of hematuria, mild to moderate proteinuria, azotemia, and hypertension.

A

acute nephritic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F. Acute renal failure is a glomerular syndrome characterized by heavy proteinuria (> 3.5 grams per day), hypoalbuminemia, severe edema, hyperlipidemia, and lipiduria.

A

False, NEPHROTIC SYNDROME is a glomerular syndrome characterized by heavy proteinuria (> 3.5 grams per day), hypoalbuminemia, severe edema, hyperlipidemia, and lipiduria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What syndrome is characterized by acute onset of azotemia with oliguria (or anuria)?

A

Acute renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F. Autosomal dominant (adult) polycystic kidney disease is not a common as autosomal recessive (childhood) polycystic kidney disease.

A

False,

Autosomal dominant (adult) polycystic kidney disease is seen in 1 out of every 500-1000 people

Autosomal recessive (childhood) polycystic kidney disease is seen in 1 in 20,000 live births.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Adult polycystic kidney disease is an autosomal ___ disease characterized by multiple ___ expanding in both kidneys, gradual onset of renal failure in adult, urinary tract hemorrhage (hematuria), flank pain around the ___ decade, hypertension, and urinary tract infection.

A

dominant; cysts; 4th

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the defect associated with autosomal dominant polycystic kidney disease?

A

The defective gene is PKD1 (in 90% of families) located on chromosome 16. The gene encodes for polycystin-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What extrarenal pathology is seen in autosomal dominant polycystic kidney disease?

A

1/3 of patients have cysts in liver; saccular (“berry”) aneurysms may develop in the circle of Willis (30%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the defect found in autosomal recessive polycystic kidney disease?

A

mutations in PKHD1 gene with defective protein fibrocystin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

T/F. Almost ALL patients with autosomal recessive polycystic kidney disease have liver cysts and progressive liver fibrosis.

A

True.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F. In autosomal recessive polycystic kidney disease, the kidneys have numerous cysts that arise in every part of the tubular system.

A

False, In In autosomal DOMINANT polycystic kidney disease, the kidneys have numerous cysts that arise in every part of the tubular system.

In autosomal RECESSIVE polycystic kidney disease, there are numerous small uniform-size cysts from collecting tubules in cortex and medulla.

22
Q

How do immune complexes deposit on the glomerular basement membrane or mesangium?

A

circulating immune complexes that deposit in the glomerulus or circulating antibodies directed against glomerular components or non-glomerular antigens “planted” in the glomerulus.

23
Q

What technique uses H+E stain, PAS (basement membrane), trichrome (collagen) and Jones stains?

A

light microscopy

24
Q

T/F. Electron microscopy uses antibodies to immunoglobulin and complement, tagged with a fluorescent molecule, are used to identify immune complexes.

A

False, Immunofluorescence uses antibodies to immunoglobulin and complement, tagged with a fluorescent molecule, are used to identify immune complexes.

Electron microscopy identifies immune complexes, epithelial cell changes, basement membrane morphology and other changes.

25
Q

What are the four nephrotic syndromes?

A
  1. minimal change disease
  2. focal segmental glomerulosclerosis
  3. membranous nephropathy
  4. nodular glomerulosclerosis (diabetes mellitus)
26
Q

T/F. Minimal change disease is the most common cause of nephrotic syndrome in children.

A

True.

27
Q

In minimal change disease, there is ___-appearing glomeruli by light microscopy; ___ immune complexes; electron microscopy demonstrates effacement of epithelial cell ___ processes

A

normal; no; foot

28
Q

T/F. Patients with minimal change disease have a good response to corticosteriod treatment.

A

True.

29
Q

What is one of the most common causes of nephrotic syndrome in adults that may be primary (idiopathic) or secondary to other glomerular diseases, loss or scarring of other glomeruli, or genetic?

A

focal segmental glomerulosclerosis

30
Q

What do you see under light microscopy in patients with focal segmental glomerulosclerosis? How about IF and EM?

A

LM - partial (segmental) sclerosis of some (focal) glomeruli characterized by increased mesangial matrix collagen with obliteration of capillary loops.

IF and EM - The idiopathic form has no immune complexes.

31
Q

T/F. Patients with focal segmental glomerulosclerosis have a good response to corticosteriod treatment.

A

False, they have a poor response to corticosteroid treatment and renal failure in 50% after 10 yrs.

32
Q

Which nephrotic syndrome is most common in adults age 30-50 and may be primary (disease limited to the kidney) or secondary to infection, malignancy, SLE, or drugs?

A

Membranous nephropathy (glomerulonephritis)

33
Q

Compare the pathology (LM, IF and EM) of membranous nephropathy and glomerular disease in diabetes mellitus.

A

Membranous -
LM - nearly normal
IF - immune complex deposits
EM- deposits on subepithelial side of the glomerular basement membrane

Diabetes-
LM - nodular glomerulosclerosis
IF - NO immune complexes
EM - thick glomerular basement membranes

34
Q

T/F. Patients with membranous nephropathy have a poor to moderate response to corticosteroid treatment, with 40% developing renal failure in 2-20 years.

A

True.

35
Q

In glomerular disease in diabetes, renal failure comes 2nd to what cause of death?

A

MI

36
Q

What other changes can be noted in glomerular disease in diabetes?

A
  1. hylaine arteriolosclerosis
  2. atherosclerosis
  3. nephrosclerosis
37
Q

What term is given for the formation of mesangial nodules in glomerular disease in diabetes?

A

nodular glomerulosclerosis or Kimmelstiel-Wilson lesion

38
Q

Nephritic syndrome is characterized by acute onset of what 3 conditions?

A
  1. hematuria
  2. oliguria and azotemia
  3. hypertension
39
Q

How is hematuria produced in nephritic syndrome?

A
  1. proliferation of cells within the glomeruli, accompanied by inflammatory cells
  2. inflammation severely injures capillary walls
  3. blood passes into the urine as well as reduced GFR
40
Q

What are the two causes of nephritic syndrome?

A
  1. acute postinfectious (poststreptococcal) glomerulonephritis
  2. IgA nephropathy
41
Q

What condition occurs in children 1-4 weeks after a bout of streptococcal pharyngitis (other infections as well)?

A

Acute postinfectious (poststreptococcal) glomerulonephritis

42
Q

What are the pathologic (LM, IF, EM) findings for acute postinfectious (poststreptococcal) glomerulonephritis?

A

LM - proliferation of endothelial and mesangial cells, inflammatory cells; may develop cellular crescents
IF - immune complex deposition, grandular
EM - immune complexes in glomerular basement membrane +/- mesangium

43
Q

What condition usually occurs in children and young adults with hematuria noted 1-2 days after non-specific upper respiratory tract viral infection that resolves and recurs?

A

IgA nephropathy

44
Q

Describe Henoch-Schonlein purpura.

A

when the glomerular disease is associated with 1. skin rash, 2. GI pain, and 3. arthritis

45
Q

This condition has mesangial deposition of immune complexes containing IgA (LM) and variable proliferation of mesangial (IF and EM) and endothelial cells. Occasionally there is epithelial cell proliferation with crescents.

A

IgA nephropathy

46
Q

Crescentic or Rapidly Progressive Glomerulonephritis is a clinical syndrome with characteristic ___ glomerulonephritis due to proliferation of epithelial cells with infilitration of ___.

A

crescentic; histiocytes

47
Q

What different disorders are associated with Crescentic or Rapidly Progressive Glomerulonephritis?

A
  1. Anti-GBM antibody disease (12% of cases)
  2. Immune complex disease (44% of cases)
  3. -immune, lack of anti-GBM or immune complexes (44% of cases)
48
Q

If glomerular disease is untreated what condition can occur? What happens to the kidneys?

A

Chronic (end-stage) renal disease

loss of glomeruli and tubules with fibrosis

49
Q

How is Chronic (end-stage) Renal disease detected?

A

at routine exam with proteinuria, hypertension, or azotemia

50
Q

How is chronic end stage renal disease treated?

A
  1. renal dialysis

2. kidney transplantation

Pathology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions