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Pathology 1st aid > Renal Path > Flashcards

Renal Path Flashcards

1
Q

RBC casts seen in

A

Glomerulonephritis
Ischemia
Malignant HTN

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2
Q

WBC casts seen in

A

Tubulointerstitial inflammartion
acute pyelonephritis
Transplant rejection

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3
Q

Fatty Casts seen in

A

Nephrotic Syndromes

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4
Q

Muddy Brown (Granular Casts) seen in

A

Acute tubular necrosis

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5
Q

Waxy casts seen in

A

advanced renal disease

chronic renal failure

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6
Q

Hyaline Casts

A

Non-specific

Can be normal finding

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7
Q

Nephritic Syndromes

A

Acute Postreptococcal GN
Rapidly Progressive GN
Berger’s IgA Glomerulonephropathy
Alport Syndrome

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8
Q

Nephrotic Syndromes

A 
Focal Segmental
Membranous
Minimal ∆
Amyloidosis
Diabetic Glomerulonephropathy
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9
Q

Mixed nephritic/nephrotic

A

Diffuse proliferative GN

Memranoproliferative GN

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10
Q

Nephrotic Characteristics

A 
Massive Proeinuria (> 3.5 g/day)
Hyperlipidemia
Fatty Casts
Edema
Inc. risk of infxn
Hypercoagulable State
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11
Q

Nepthritic Characteristics

A 
Inflammatory Process
Proteinuria (< 3.5 g/day)
Hematuria
RBC Casts
HTN
oliguria
azotemia
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12
Q

Effacement of foot processes
Hyalinosis and segmental sclerosis
HIV
Black pt.

A

Focal Segmental GN

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13
Q

Focal Segmental GN associated with

A

Black/Hispanic

HIV
Heroin
Massive obesity
Interferon Tx
Chronic Kidney disease--agenesis or removal
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14
Q

Nephrotic syndromes with foot process effacement

A

Focal Segmental

Minima ∆

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15
Q

Spike and Dome on EM with subepithelial deposits
Granular IF
Nephrotic Syndrome

A

Membranous Nephropathy

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16
Q

SLE kidney diseases

A

1–Diffuse Proliferative GN (nephritic)

Membranous (nephrotic)

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17
Q

Membranous Nephropathy associated with

A

SLE
Solid Tumors
Rx
Infxn

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18
Q

1 Nephrotic Syndrome in adults

A

Membranous

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19
Q

1 nephrotic syndrome in kids

A

Minimal ∆

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20
Q

Congo Red stain with Apple Green Birefringence

Underlying Chronic Condition

Nephrotic Syndrome

A

Amyloidosis

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21
Q

Amyloidosis associated with

A

Multiple Myeloma (1º)

TB, RA (2º)

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22
Q

Normal glomeruli on LM
EM shows effacement of foot processes
Kid
Nephrotic Syndrome

A

Minimal ∆

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23
Q

minimal ∆ Tx

A

Coritcosteroids

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24
Q

Nephrotic Syndromes associated with HBV/HCV

A

Focal Segmental

Type I Membranoproliferative

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25
Q 
Subendothelial IC deposition
Granular IF
Tram Track appearance 
GBM splitting due to mesangial ingrowth
HBV/HCV
A

Type I membranoproliferative

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26
Q

INTRAmembranous immune complex deposition
Dense deposits
C3 nephrotic Factor

A

Type II membranoproliferative

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27
Q

Nonenzymatic glycosylation of GBM

Deposition of hyaline in efferent arterioles of kidney

Kimmelstiel Wilson lesion

A

Diabetic GN

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28
Q

Kimmelstiel Wilson Lesion

A

eosinophilic nodular glomerulosclerosis seen in diabetic GN

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29
Q 
Subepithelial Humps seen on EM
hypercellular neutorphils with lumpy bumpy appearance
Child with recent pharyngitis
Granular IF
Nephritic Syndrome
A

Acute Poststreptococcal GN

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30
Q

Immune complexes deposited in PSGN

A

IgM
IgG
C3

Along GBM and Mesangium

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31
Q

Nephritic Syndrome
Crescent moon shaped lesion on LM and IF
deteriorating condition in days to weeks

A

Rapidly Progressive GN (RPGN)

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32
Q

RPGN deposition

A

Fibrin and plasma proteins

Macrophages, parietal cells, monocytes

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33
Q

Syndromes that cause RPGN

A

Goodpasture’s (hematuria and hemoptysis)
Wegener’s (c-ANCA)
Microscopic Polyangiitis (p-ANCA)

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34
Q 
Wire looping of capillaries
Subendothelial/intramembranous IgG immune complexes
C3 deposition
Nephritic Factor
SLE
Granular IF
A

Diffuse Proliferative

Can be nephritic and nephrotic concurrently

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35
Q

Mesangial Proliferation
Mesangial IC deposits
IgA deposits in mesangium
URI or GI infection

A

Berger’s Disease

IgA nephropathy

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36
Q 
Mutation of Type IV collagen
split basement membrane
X-linked
Hearing deficits
Visual disturbances
Nephritic syndrome
A

Alport Syndrome

37
Q

Most common Kidney Stone

A

Calcium

Phosphate–high pH
***Oxalate–low pH

38
Q

Tx for Ca stones

A

Thiazides and citrate

39
Q

Most common presentation of Ca stone pt.

A

hypercalciuria
Normal serum Ca
Calcium oxalate stone

40
Q

Causes of Ca stones

A

Crohn’s
Vit. C abuse
Ethylene Glycol

41
Q

Staghorn stone in adults

A

Ammonium Mg Phosphate

Struvite stones

42
Q

Cause of Struvite stones

A

Proteus
Klebsiealla
Staph

Urease+ bugs alkalinize the urine

43
Q

Radiolucent Kidney Stone

A

Uric acid stone

visible on CT and US but not Xray

44
Q

Tx Uric Acid Stones

A

Alkalization of urine

45
Q

Tx Staghorn stones

A

Surgery

Clear infxn

46
Q

Staghorn stone in children

A

Cystine Stone

Forms at Low pH

47
Q

Tx cystine stones

A

Alk. urine

48
Q

Cause of Cystine stones

A

2º to cystinuria

low pH urine

49
Q

Hydronephrosis

A

Back up of urine into kidney–dilation of renal pelvis and calyces proximal to obstruction

vesicoureteral reflux can cause too

50
Q

50-70 year old fat smoker
Renal Mass filled with clear cells and lipids/carbohydrates
Paraneoplastic Syndrome

A

Renal cell CA

51
Q

RCC gene association

A

VHL gene on Chromosome 3 (von Hippel-Lindau) for inherited

52
Q

Paraneoplastic syndromes associated with RCC

A

EPO
ACTH
PTHrH

53
Q

RCC Tx

A

Surgery

Resists chemo and radiation

54
Q

Child (2-4) with huge unilateral mass on flank

Hematuria

A

Wilm’s Tumor

55
Q

Wilm’s Tumor composed of

A

Blastema–embryonic glomerular stxrs

56
Q

Gene associated with Wilm’s Tumor

A

WT1 on Chromosome 11

57
Q

WAGR complex

A

Wilm’s Tumor
Aniridia
Genitourinary Malformations
Retardation (motor/mental)

58
Q

Wilm’s tumor syndromes

A

WAGR

Beckwith-Wiedemann Syndrome

59
Q

Most common tumor of lower urinary tract

A

Urothelial (transitional cell) CA

60
Q

Presentation of Urothelial CA

A

Painless hematuria

No casts

61
Q

Urothelial CA risk factors

A

Smoking
Phenacetin
Aniline Dyes (hair dresser)
Cyclophasphamide

62
Q 
Fever
Costovertebral Angle tenderness
Cx effected but glomeruli spared
N/V
White casts in urine
A

Acute Pyelonephritis

63
Q

Cause of chronic pyelonephritis

A

Recurrent episodes of acute PN

Vesicouretal reflux

Chronic Obstruction

64
Q

Chronic Pyelonephritis findings of kidney

A

Coarse, asymmetric corticomedullary scarring

Blunted Calyx

Eosinophilc Casts in tubules

Thyoroidization of kidney

65
Q 
Acute interstitial renal inflammation
Pyuria
azotemia 
Recent Rx started
fever, rash, hematuria
CVA tenderness
A

Rx Induced Interstitial Nephritis

Tubulointerstitial nephritis

66
Q

Rx Induced Interstitial Nephritis causes

A 
Diuretics
Penicillin
NSAIDS
sulfonamides
rifampin
67
Q

Diffuse Cortical Necrosis

A

Cortical infaction due to:

Vasospasm
DIC
OB catastrophe
Septic Shock

68
Q

Most common cause of intrinsic renal failure

A

Acute Tubular Necrosis

69
Q

Stages of Acute tubular necrosis

A
  1. Inciting event
  2. Maintenance phase–oliguria for 1-3 weeks, hyperkalemia risk
  3. Recovery phase–polyuric, BUN/Creatinine fall, hypokalemia risk
70
Q

Causes of Acute Tubular necrosis

A

renal ischemia
crush injury (myoglobinuria)
Rx
Toxins

71
Q

most common COD in SLE

A

Diffuse Proliferative GN

72
Q

Gross Hematuria and proteinuria

recent infection or immune stim.

A

Renal Papillary Necrosis

73
Q

Renal Papillary Necrosis associations

A

DN
Acute Pyelonephritis
Chronic Phenacetin (acetaminophen is a derivative)
Sickle Cell anemia/trait

74
Q

abrupt decline in renal fxn

increased Creatinine and BUN

A

Acute Renal Failure

75
Q

Urine Osmolality > 500
Urine Na < 20
FeNA < 1%
Serum BUN:Cr > 20

A

Prerenal Azotemia

76
Q

Urine Osmolality 40
FeNA > 2%
Serum BUN:Cr < 15

A

Intrinsic Renal Azotemia

77
Q

Urine Osmolality 40
FeNA > 2%
Serum BUN:Cr > 15

A

Post renal Azotemia

78
Q

Prerenal Azotemia causes

A

decreased RBF–heart, hemorrhage, etc.

Anything before the kidney blood flow

79
Q

Postrenal Azotemia

A

Urine flow obstruction

Stones, BPH, neoplasia, congenital anomalies

BILATERAL

80
Q

Intrarenal azotemia mechanism

A

patchy necrosis –> debris obstructs tubule

backflow across necrotic tubule –> dec. GFR

Urine has epithelial granular casts

81
Q

Uremia

A

Increased Nitrogen waste products in blood

Nausea/anorexia
percarditis
Asterixis
encephalopathy
Plt. Dysfxn
82
Q

Renal osteodystrophy

A

Failure of Vit. D hydroxylation –> decresed Ca abs. in gut

Hypo-Ca, Hyper-Pi 2º to hyperparathyroidism

Hyper-Pi precipitates Ca and deposits in tissues

83
Q

ADPKD

A

Presents in young adult
Multiple large cysts on both kidneys that destroy parenchyma

Flank pain, hematuria, progressive renal failure, urinary infxn, HTN–high renin

84
Q

ARPKD associated with

A

Hepatic Cysts and fibrosis

85
Q

ADPKD mutation

A

Autosomal Dominant

PKD1 or PKD2

86
Q

ADPKD complicaitons

A

Berry aneurysm
MVP
Benign Hepatic Cysts

87
Q

ARPKD Presentation

A 
Infant
Significant renal failure
HTN
Portal HTN
progressive renal insufficiency
Enlarged kidney
88
Q

Medullary Cystic Disease

A

Tubulointerstitial fibrosis and progressive renal insufficienc with inability to concentrate urine

Medullay cysts

SHRUNKEN kidney

Poor prognosis

Pathology 1st aid (11 decks)

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