Renal Path Quiz 2- part 1

Question 1

hypoplastic kidney due to

Answer 1

renal artery occlusion

Question 2

hypoplastic kidney is more prone to what?

Answer 2

pyelonephritis

Question 3

horseshoe kidney involves the fusion of kidneys at what pole?

Answer 3

most often the lower pole

Question 4

horseshoe kidney, (aka fused kidneys) “keep bad company”, what does this mean?

Answer 4

malformations are more likely in other organs due to chromosomal disorders

Question 5

what’s the most common location for an ectopic kidney?

Answer 5

lower abdomen or pelvis

Question 6

what coupled with ectopic kidney is likely to produce urinary stasis? what might it result in?

Answer 6

-redundant ureter length -UTI

Question 7

Simple renal cysts can be numerous but

Answer 7

they are never as numerous as PKD

they also don’t predispose the individual to developing chronic renal failure or to neoplasia

Question 8

polycystic kidney disease (PKD), both childhood and adult, can result in which condition?

Answer 8

renal insufficiency ultimately leading to renal failure

Question 9

what does childhood PKD look like microscopically?

Answer 9

large cysts lined by flattened cuboidal epithelium and an intervening parenchyma that is fibrotic with islands of bluish cartilage

Question 10

the adult form of PKD is often associated with what sequelae?

Answer 10

concurrent liver disease unlike childhood PKD

Question 11

neither adult nor childhood PKD patients are at an increased risk for…?

Answer 11

renal cell carcinoma

Question 12

what population IS at an increased risk for renal cell carcinoma?

Answer 12

dialysis patients WITH renal cysts

Question 13

what do the cysts look like for a dialysis patient?

Answer 13

scattered small cysts, none of which is over 2 cm in size

Question 14

glomerular disease is characteristic for what?

Answer 14

thickening of the basement membrane (impairs filtration to some degree)

Question 15

what accounts for the thickening of the basement membrane?

Answer 15

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

Question 16

what’s happening with nephrotic syndrome?

Answer 16

proteinuria (loss of protein in urine >3 gm)

decr. serum proteins (hypoalbuminemia)
incr. serum lipid levels

pitting edema

Question 17

____ is the most common cause of nephrotic syndrome in children?

Answer 17

lipoid nephrosis (aka minimal change disease)

Question 18

what’s lipoid nephrosis (aka minimal change disease)?

Answer 18

it’s the loss of only albumin (selective proteinuria)

Question 19

microscopically how does minimal change nephrotic syndrome appear?

Answer 19

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

Question 20

what’s the most common cause of adult nephrotic syndrome?

Answer 20

membranous glomerulopathy

Question 21

what will membranous glomerulopathy look like microscopically?

Answer 21

thickened and prominent capillary loops, without increased cellularity

podocytes lose their foot processes

Question 22

most cases of membranous glomerulopathy are idiopathic, but can be caused by

Answer 22

infections:

Hep B/C

syphilis

malaria

Schistosomiasis

Drug rxn

Tumors

Question 23

Membranous glomerulopathy is generally an immunologically mediated disease in which deposits of

Answer 23

IgG and/or IgM and complement in the basement membrane

Question 24

what’s the most common cause of nephrotic syndrome in African-Americans?

Answer 24

Focal segmental glomerulosclerosis (aka focal sclerosis) appears to be idiopathic and immune complexes not always seen

Question 25

those with focal segmental glomerulosclerosis are prone to have ______ unlike minimal change nephrosis (aka ________)

Answer 25

• non-selective proteinuria
• liphoid nephrosis with selective protein lost (albuminuria)

Question 26

post infectious glomerulonephritis caused by what?

Answer 26

autoimmune phenomenon following GAS (not a direct cause of strep!)

Question 27

what does post-infectious glomerulonephritis look like microscopically?

Answer 27

hypercellular

poorly defined capillary loops

Question 28

Patients who have had a strep infection typically have an elevated

Answer 28

ASO titer

(anti-streptolysin O titer)

Question 29

characteristic feature of rapidly progressing glomerulonephritis?

Answer 29

proliferation of the epithelial cells and formation of the fluorescent crescent

Question 30

The first laboratory abnormality in diabetic nephropathy is

Answer 30

microalbuminuria

Question 31

Nodular glomerulosclerosis related to diabetes is referred to as

Answer 31

Kimmelstiel-Wilson disease (build up of proteinatious material)

Question 32

______ accumulates within glomerular capillary loops in a patient with Kimmelstiel-Wilson disease of D.M

Answer 32

hyaline material

Question 33

what’s the most common reason for someone on dialysis?

Answer 33

diabetic kidney dz

Question 34

electron microscopy of patients with amyloidosis reveals the characteristic presence of

Answer 34

fibrils within the amyloid deposits perpendicular to basement membrane