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Renal > Renal Exam II Path > Flashcards

Renal Exam II Path Flashcards

1
Q

2 major processes for tubular injury

A

ischemic and toxic (aki) or inflammatory (tubulointerstitial nephritis)

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2
Q

what are the 4 causes of AKI

A

ischemia, direct toxic injury to tubules, hypersensitivity reaction, urinary obstruction

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3
Q

focal tubular epithelial necrosis at multiple points

A

ischemic AKI

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4
Q

when can you see tubulorrhexis, what is it?

A

ishchemic AKI - rupture of basement membranes

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5
Q

this causes occlusion of tubular lumens

A

brown granular casts

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6
Q

the Tamm hors fall protein composes?

A

hyaline casts

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7
Q

3 main substances that cause toxic AKI

A

mercuric chlrodie, carbon tetrachlroide, ethylene glycol

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8
Q

where do you see injury during toxic AKI

A

proximal convoluted

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9
Q

This causes large acidophilic inclusions within cells, cells can be sloughed into lumen and have calcification

A

mercuric chloride

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10
Q

this substance causes accumulation of neutral lipids

A

carbon tetrachlroide

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11
Q

this causes marked ballooning and hydropic or vacuolar degeneration of proximal convoluted tubules

A

ethylene glycol

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12
Q

what type of crystals are see in with ethylene glycol ingestion

A

calcium oxalate crystals

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13
Q

what are the clinical findings of AKI

A

oliguria, increased BUN and creatine, hyperkalemia, metabolic acidosis

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14
Q

What drugs cause acute tubulointerstitial nephritis

A

penicillins, dirutetics, NSAIDS

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15
Q

what are clinical presentations of tubulointerstitial nephritis

A

eosinophilia in urine, edema, rash,

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16
Q

this is characterized by chronic tubulointerstitial nephritis and renal papillary necrosis

A

analgesic nephropathy

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17
Q

what people generally get analgesic nephropathy

A

women, recurrent headaches, muscle pain, neurotic patients, factory workers.

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18
Q

what are the three types of irate nephropathy in people with hyperuricemic disorders

A

Acute uric acid nephropathy, Chronic irate nephropathy, nephrolithiasis

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19
Q

this is likely to occur in those with leukemias or lymphomas undergoing chemo (collecting ducts)

A

acute uric acid nephropathy - precipitation of uric acid crystals

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20
Q

this forms birefringeent needle like crystals and induce a typhus within distal tubules and collecting ducts

A

chronic urate nephropathy (gout)

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21
Q

hypercalcemia is caused by

A

hyperparathyroidism,multiple myeloma, vitamin d intox, metastatic cancer, excess calcum intake

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22
Q

where is the earliest damage with nephrocalcinosis seen?

A

mitochondiral distortion

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23
Q

someone preparing for a colonoscopy might get?

A

acute phosphate nephropathy

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24
Q

what is light chain cast nephropathy?

A

bence jones proteins combine with urinary glycoprotein under acidic conditions to form large tubular casts that obstruct lumen and induce inflammation

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25
Q

multiple myelomas can cause

A

light chain cast nephropathy

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26
Q

pink- bus amorphous masses?

A

bence jones tubular casts

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27
Q

sclerosis of renal arterioles and small arteries

A

benign nephrosclerosis

28
Q

medial and intimal thickening with hyaline deposition?

A

hyaline arterolosclerosis (benign)

29
Q

malginant

A

intimal thickening - onion skinning

30
Q

diabetics and african americans are at risk for?

A

benign nephrosclerosis

31
Q

affects young males

A

malignant hypertension

32
Q

pinpoint petechial hemorrhages (flea bitten appearance)

A

malignant hypertension

33
Q

consumption of contaminated food

A

typical HUS

34
Q

diarrhea positive

A

typical HUS

35
Q

diarrhea negatie

A

atypical HUS

36
Q

inherited mutations of complement-regulatory protein

A

atypical HUS

37
Q

what is injuried in HUS

A

endothelium

38
Q

TTP trigger

A

adamts13 dysfunction resulting in increased von willebrand factor

39
Q

what is the main morphological finding in thrombotic renal diseases?

A

double counters/ tram racks

40
Q

what generally causes diffuse cortical necrosis?

A

obstretic emergency

41
Q

what is the morphology of of diffuse cortical necrosis?

A

massive ischemic necrosis limited to the cortex

42
Q

most renal infarcts are due to embolism from?

A

left atrium and ventricle

43
Q

3 reasons why kidneys are favored sites for infarct development?

A

extensive blood flow to kidneys

end organ nature of arterial blood supply, limited collateral

44
Q

hydronephrosis

A

dilation of renal pelvis and calyces associated with progressive atrophy of kidney due to obstruction

45
Q

most common type of renal calculi

A

calcium oxalate

46
Q

formed after proteus infections that cause alkaline urine

A

struvite (magnesium, ammonium, phosphate)

47
Q

what shape do struvite stones form?

A

staghorn calculi

48
Q

Uric acid stones are radio opaque? t/f

A

false - they are radioluscent so can’t be seen

49
Q

stones formed in ppl with leukemia

A

uric acid

50
Q

stones caused by a genetic defect int enal reabsorption

A

angulated cystine

51
Q

Benign tumors of the kidney are

A

Renal papillary adenoma, angiomyolipoma, oncocytoma

52
Q

this is a tan/mahogany brown tumor that is well encapsulated

A

oncocytoma (large nucleoli

53
Q

tumor of vessels, smooth muscle, fat?

A

angiomyolipoma

54
Q

angiomyolipoma is generally seenw ith

A

tuberous sclerosis

55
Q

males or females are more likely to get renal cell carcinoma?

A

males, smokers.

56
Q

what is a autosomal dominant familial variant of renal cell carcinoma

A

Von Hippel Lindau Syndrome (loss of VHL 3p gene)

57
Q

most common type of renal cell carcinoma

A

clear cell

58
Q

where do the cells for clear cell carcinoma come from?

A

proximal tubule

59
Q

papillary carcinoma / chromophil carcinoma

A

foamy macrophages and intracellular hemosiderin

60
Q

trisomy of 7,16, loss of Y

A

sporadic papillary carcinoma

61
Q

just trisomy 7

A

familial form of papillary carcinoma

62
Q

where does chromophobe renal carcinoma arise from?

A

intercalated cells of collecting ducts

63
Q

what are the gross findings of renal cell carcinoma

A

well-circumscribed, tan brown

64
Q

Collecting duct (bellini duct)

A

arise from collecting duct cells in medulla

65
Q

HOBNAIL CELLS

A

collecting duct bellini duct (poor prognosis)

Renal (1 decks)

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