Renal Pathology

Question 1

Renal normal function?

Answer 1

1- Excretion of nitrogenous base
2- Erythropoietin secretion
3- Formation of active form of VIT-D(Calcitriol)
4- Acid base balance

Question 2

Erythropoietin secreted by?

Answer 2

Peritubular capillary cell.

Question 3

Renin secreted by?

Answer 3

JG cell

Question 4

What is normal GFR?

Answer 4

125ml/m

Question 5

Any type of renal disease lead to?

Answer 5

Increased BLOOD UREA NITROGEN and SERUM CREATININE

Question 6

What Is Azotemia?

Answer 6

Increase Nitrogen in body, Creatinine, and related to decrease GFR.

Question 7

Uraemia?

Answer 7

Azotemia with clinical symptoms

Question 8

Which of portion of kidney is at high risk of ischemic damage?

Answer 8

Medulla because it receives less blood supply then cortex

Question 9

Renal demographic from anterior to posterior

Answer 9

Anterior- Renal vein
Middle- Renal artery
Posterior- Pelvis

Question 10

Types of Azotemia?

Answer 10

1- Pre Renal Azotemia: When hypo-perfusion of the kidney like in hypotension or excessive fluid loss , shock, CHF

2- Post Renal Azotemia: Urine flow obstructed to distal of kidney

Question 11

Nephritic Syndrome?

Answer 11

Grossly visible hematuria or microscopic hematuria with dysmorphic RED Cell and red cell cast, decrease GFR, mild to moderate proteinuria and hypertension

Glomerular disorders characterized by glomerular inflammation and bleeding

1. Limited proteinuria (< 3.5 g/day)
2. Oliguria and azotemia
3. Salt retention with periorbital edema and hypertension
4. RBC casts and dysmorphic RBCs in urine

Question 12

Nephrotic syndrome?

Answer 12

Heavy proteinuria[>3.5gm/d], hypoalbuminemia, severe edema, hyperlipidemia and lipiduria.

Question 13

Types of nephritic syndromes?

Answer 13

1- Acute proliferative(poststreptococca) glomenulonephritis
2- post streptococcal GN
3- Non streptococcal Acute GN(Postinfectious)
4- Rapidly progressive GN( Crescentric)

Question 14

What is Acute Proliferative (Poststreptococcal, Postinfectious) Glomerulonephritis?

Answer 14

Cluster of diseases which is diffuse proliferation of glomerular cell + Leukocytes influx(exudation)
CAUSED BY IMMUNE COMPLEXES

Question 15

What is post streptococcal GN?

Etiology?

Answer 15

Glomerular disease which caused by immune complex deposition.

Poststreptococcal GN is caused by immune complexes containing streptococcal(A beta streptococcus) antigens and specific antibodies, which are formed in situ.

Question 16

When does post streptococcal gn appear?

Answer 16

usually appears1 to 4 weeks after a streptococcal infection of the pharynx or skin (impetigo).

Skin infection associated with poor hygiene

Question 17

Post streptococcal GN mostly occur in?

Answer 17

B/W 6-10 yr mostly or may occur at any age

Question 18

Biopsy of nephritic syndrome?

Answer 18

Hypercellular and inflamed glomeruli

Question 19

Etiology of nephritic syndrome?

Answer 19

Immune-complex deposition activates complement—>C5a attracts neutrophils—>which mediate damage.

Question 20

Which protein contains by PSGN?

Answer 20

M-Protein which is its virulence factor

Question 21

C/F of PSGN?

Answer 21

Presents 2-3 weeks after infection as hematuria (cola-colored urine), oliguria, hypertension, and periorbital edema

Question 22

PSGN biopsy?

Answer 22

Hypercellular, inflamed glomeruli on H&E
Mediated by immune complex deposition (granular immunofluroscence);
subepithelial ‘humps’ on electron microscope