Renal Path Quiz 2- part 1 Flashcards
hypoplastic kidney due to
renal artery occlusion
hypoplastic kidney is more prone to what?
pyelonephritis
horseshoe kidney involves the fusion of kidneys at what pole?
most often the lower pole
horseshoe kidney, (aka fused kidneys) “keep bad company”, what does this mean?
malformations are more likely in other organs due to chromosomal disorders
what’s the most common location for an ectopic kidney?
lower abdomen or pelvis
what coupled with ectopic kidney is likely to produce urinary stasis? what might it result in?
-redundant ureter length -UTI
Simple renal cysts can be numerous but
they are never as numerous as PKD
they also don’t predispose the individual to developing chronic renal failure or to neoplasia
polycystic kidney disease (PKD), both childhood and adult, can result in which condition?
renal insufficiency ultimately leading to renal failure
what does childhood PKD look like microscopically?
large cysts lined by flattened cuboidal epithelium and an intervening parenchyma that is fibrotic with islands of bluish cartilage
the adult form of PKD is often associated with what sequelae?
concurrent liver disease unlike childhood PKD
neither adult nor childhood PKD patients are at an increased risk for…?
renal cell carcinoma
what population IS at an increased risk for renal cell carcinoma?
dialysis patients WITH renal cysts
what do the cysts look like for a dialysis patient?
scattered small cysts, none of which is over 2 cm in size
glomerular disease is characteristic for what?
thickening of the basement membrane (impairs filtration to some degree)
what accounts for the thickening of the basement membrane?
deposition of immune complexes on the epithelial side of the membrane. often these antibody complexes are due to allergic rxns to drugs or autoimmune diseases
what’s happening with nephrotic syndrome?
proteinuria (loss of protein in urine >3 gm)
decr. serum proteins (hypoalbuminemia)
incr. serum lipid levels
pitting edema
____ is the most common cause of nephrotic syndrome in children?
lipoid nephrosis (aka minimal change disease)
what’s lipoid nephrosis (aka minimal change disease)?
it’s the loss of only albumin (selective proteinuria)
microscopically how does minimal change nephrotic syndrome appear?
there is minimal change from a healthy glomerulus, but perhaps with flattening of the foot processes (explains inability to retain albumin) no immune complexes are seen
what’s the most common cause of adult nephrotic syndrome?
membranous glomerulopathy
what will membranous glomerulopathy look like microscopically?
thickened and prominent capillary loops, without increased cellularity
podocytes lose their foot processes
most cases of membranous glomerulopathy are idiopathic, but can be caused by
infections:
Hep B/C
syphilis
malaria
Schistosomiasis
Drug rxn
Tumors
Membranous glomerulopathy is generally an immunologically mediated disease in which deposits of
IgG and/or IgM and complement in the basement membrane
what’s the most common cause of nephrotic syndrome in African-Americans?
Focal segmental glomerulosclerosis (aka focal sclerosis) appears to be idiopathic and immune complexes not always seen
those with focal segmental glomerulosclerosis are prone to have ______ unlike minimal change nephrosis (aka ________)
- non-selective proteinuria
- liphoid nephrosis with selective protein lost (albuminuria)
post infectious glomerulonephritis caused by what?
autoimmune phenomenon following GAS (not a direct cause of strep!)
what does post-infectious glomerulonephritis look like microscopically?
hypercellular
poorly defined capillary loops
Patients who have had a strep infection typically have an elevated
ASO titer
(anti-streptolysin O titer)
characteristic feature of rapidly progressing glomerulonephritis?
proliferation of the epithelial cells and formation of the fluorescent crescent
The first laboratory abnormality in diabetic nephropathy is
microalbuminuria
Nodular glomerulosclerosis related to diabetes is referred to as
Kimmelstiel-Wilson disease (build up of proteinatious material)
______ accumulates within glomerular capillary loops in a patient with Kimmelstiel-Wilson disease of D.M
hyaline material
what’s the most common reason for someone on dialysis?
diabetic kidney dz
electron microscopy of patients with amyloidosis reveals the characteristic presence of
fibrils within the amyloid deposits perpendicular to basement membrane
