RENAL FC Flashcards
2 key hemodynamic changes associated with diabetic nephropathy
Glomerular Hyperfiltration and Glomerular Hypertension
4 renal complications of diabetes
- Diabetes nephropathy.
- T4 RTA.
3.Increase Risk of Infections - Papillary Necrosis
How does hyperglycemia lead to formation of excess BM material?
AGE’s bind to RAGE.
T cells & MΦ = Excess BM material.
Vasc. SMC = synthesis of ECM .
Accumulation of ECM Proteins
Pre renal cause of acute kidney injury due to volume sequestration.
Pancreatits Peritonitis and Rhabdomyolysis
Gross Morphology of reflux associated chronic pyelonephritis
Scarred upper and lower poles with deformed and blunt calyces
Important renal manifestation of invasive cervical cancer
Bilateral hydronephrosis and renal failure
Morphology of analgesic nephropathy
Papillary necrosis associated with dystrophic calcification
2 microscopic features of chronic pyelonephritis
Thyroidization of tubules and Chronic Interstitial Inflammation and fibrosis
Morphology of ATN
Casts in tubular lumen
Mechanism of Drug induced AIN
Haptens -> bind to membrane -> IgE or Cell mediated Rx against tubular or cells in the BM
Radiological finding associated with acute pyelonephritis
Striated nephrogram
Deficiency in what enzyme necessary for breaking down bone within osteoclasts presents with RTA
Carbonic Anhydrase II.
Def triad= Osteopetrosis + Renal Tubular Acidosis + Cerebral Calcification
MC cause of AKI
ATN
Complications of Acute Pyelonephritis
- Papillary Necrosis
- Perinephric Abscess
- Pyonephrosis
- Sepsis
- Chronic Pyelonephritis
Why is the medulla Spared in diffuse cortical Necrosis
Vasa Recta that supply arterial blood to the medulla arise from JXM efferent arterioles which are before vessesls that supply the outer cortex
Morphology of obstruction associated chronic pyelonephririts
Diffuse scarring and Thinned out cortex
4 renal complications of sickle cell
- renal infarct
- hematuria
- Hyposthenuria (low solutes in urine)
- Papillary Necrosis
Intrinsic cause of AKI
- Drug induced ATN
- Occlusion of large vessels
- obstruction
- glomerular dz’s
2 Consequences of PUV
CKD and VUR
Diagnostic study of preference for VUR
voiding cystourethrography
MC cause of urinary obstruction in newborn male
PUV
Marker of renal dysfunction (other than Cr) less dependent on age, sex, race, and muscle mass
Cystatin C- Cysteine protease inhibitor produced by nucleated cells filtered but not secreted.
Secondary Hyperparathyroid Bone related consequence of CKD
Osteitis Fibrosa Cystica
Casts in CKD
Waxy Casts
Anemia seen in CKD
Normocytic Normochromic
Mut in ARPCKD and what it codes for
PDKH1 = fibrocystin
Precursor lesion of Nephroblastoma
Nephrogenic Cysts
What are nephrogenic cysts
Small foci of persistent blasternal cells (small blue cells) and increase risk in developing Wilms in contra lateral kidney
Microscopic finding in nephroblastoma
Blasternal- small blue cells.
Stromal- Spindle cells with smooth muscle/ fibroblast differentiation.
Epithelial-abortive tubules or glomeruli
Clinical significance of renal adenoma
Resemblance to Papillary RCC, Missing perinuclear halo
Molecular basis of neuroblastoma
N- Myc
MC type RCC
clear cell
Microscopic finding in Clear cell RCC
Tumors arranged in solid sheets to tubular or trabecular pattern with branching vasculature and clear cytoplasm
Clear Cell RCC arise from what cell
Proximal tubular epithelium
Papillary RCC arise from what cell
Distal Tubular epithelium
RCC Paraneoplasms
Hypercalcemia
PCV
Stauffers Syndrome
RCC Progrnosis
depth of invasion
Prognosis of Wilms
Anaplasma
Angiomyolipoma clinical complication
spon taneous hemorrhage
Neuroblastoma IHC
Chromogranin/synaptophysin
Neurofilament
Enolase
Neuroblastome microscopy
Homer Wright pseudorosette
Neuroblastoma UA
Elevated VMA and HVA
Neurocutaneous related to RCC
VHL
VHL associated syndrome
HIPPEL.
- Hemangioblastoma
- Increased risk of RCC
- Pheochromocytoma
- Pancreatic Lesions
- Eye Lesions
Neurocutaneous related to angiomyolipoma
Tubero Sclerosis
Cells of origin in Oncocytoma
Intercalated cells of collecting ducts
RF for TCC
Pee SAC
- Phenacetin
- Smoking / Schistosoma Hematobium
- Aryl Amines (dye) / Analgesics
- Cyclophosphamide
Bladder wall protrusion into Vagina
Cystocele
Conditions predisposing bladder to adenocarcinoma
Exstrophy of the bladder and Patent Urachus
Bladder morphology with obstruction
Detrusor sm hypertrophy and trabeculation
Urge Incontinence underlying defect
detrusor hyperactivity
Stress Incontinence defect
Super imposed stress on bladder, weak pelvic floor or urethral sphincter
Overflow Incontinence Defect
Obstruction
