Renal Path 3 Flashcards
blood flow in kidney
renal cortex recieves 90% of the blood supply
renal medulla is relative ischemic
Renal artery stenosis- gender, what happens
Young women
-Fibromuscular dysplasia of the renal artery
What is atheroembolic renal disease
pieces of atherosclerotic plaques from one loc may travel all the way down to the kidney causing a blockage in arteries of the kidney
Pathogenic causes of atheroembolic renal disease
Build up of plaque in central renal artery can occur due to:
- Atheroclerosis- Creation of atehrosclerotic plaque in arterial wall
- Atheroembolic- a plaque that originated from a major artery elsewhere in the body and becomes dislodged and travels to kidney
- both mech reduce blood flow to kidney
- low blood flow to glomerular apparatus activates renin angiotensin system yielding an increase in aldosterone
predisposing factors for atheroembolic renal disease
- systemic atherosclerosis and hypertension
- smoking
- hypercholesterimia
- diabetes
- > 55
- trauma to plaque
What is benign nephroclerosis
an increase in wall thicknes of smaller caliber artery leads to constantly reduced lumen over time
-results in focal ischemia of perenchyma
What is malignant hypertension
-A hypertensive emergency is a condition in which elevated BP results in target organ damage (180-200sBP)
What does malignant hypertension lead to
Acute and severe elevation of BP, usually as a result of primary mech (initially related to vascular damage)
What does malignant hypertension lead to
Results in an increase in permeability of the vessel to
- Fibrinogen and plasma proteins
- Platelet deposition
Together resulting in hyperplastic arteriosclerosis (luminal obliteration + reduction in Blood flow)
What is a renal infarction (+ symptoms)
-Sudden, abrupt blockage of renal artery or smaller renal artery (EMERGENCY)
cause- thrombi, atherosclerotic embolus
Symptoms- flank pain/hematuria
What is sickle cell nephropathy and what is it due to
- secondary to sickle cell disease
- increased blood viscosity (due to crisis) contributes to ischemia and eventual infarction that involves the renal microcirculation
- the ischemia and infarction cause papillary necrosis
what is diffuse cortical necrosis due to
- acute condition involbing patchy necrotic changes to the cortex of the kidney
- caused by local or generalized compromised blood supply
Complications of diffuse cortical necrosis
Acute renal failure
chronic renal failure
Renal cell carcinoma- age, gender, risks, tissue targeted
6-7th decae
Male: Female 2:1
Smoking, cadmium,chronic dialysis
Targets proximal renal tubular epithelium
(hereditary caused by alteration of the short arm of chromosome 3)
What is von hippie landau syndrome
autosomal dominant syndrome that confers predisposition to a variety of neoplasms including:
-renal cell carcinoma (40% of causes)
microscopy of clear cell renal cell carcinoma
-consists of clear cytoplasm cells
What is a papillary renal cell carcinoma
- very invasive tumor- often invades renal vein and sometimes inf vena cava
- has potential to produce erythropoietin (tumor marker)
What is the primary site of metastasis in RCC (3)
lungs
bones
liver
What is the mc primary renal tumor in children
Wilms tumor
Clinical findings of Wims tumor
- Unilateral palpable mass in a child
- Hypertension due to renin secretion
- metastisis into the lungs (MC)
What is WAGR syndrome
Wilms tumor
Aniridia (lack of iris)
Genetal Abnormalities
Retardation
What is beck Weidmann syndrome and what causes it
congenital disorder (CH 11 distal region)
- Syndrome involves:
- Wilms tumor
- enlarged body organs
- Hemihypertrophy of extremities
etiology of cystitis
- fecal flora
- radiation cystitis (inflammation of mucosa of urinary bladder due to radiation)
- chemotherapeutic cystitis
Female>male
clinical manifistations of cystitis
Frequency, urgency, dysuria, suprapubic pain, systemic signs
