Renal pathology

Question 1

How does adult polycystic kidney disease present?

Answer 1

hypertension
flank pain
haematuria

Question 2

Which other group of patients do cysts develop in the kidney?

Answer 2

patients with end stage renal disease who are on dialysis

Question 3

Which type of malignancy is more likely to develop in patients with renal cysts

Answer 3

papillary renal cell carcinoma

Question 4

What is the most common cause of AKI

Answer 4

acute tubular injury

Question 5

How does NSAID predispose to AKI

Answer 5

inhibit vasodilatory prostaglandin

Question 6

How do tubular epithelial cells get damaged?

Answer 6

ischaemia
toxins - contrast, haemoglobin, myoglobin, ethylene glycol, drugs

Question 7

What are the consequences of acute tubular injury

Answer 7

Failure of glomerular filtration
Blockage of tubules by casts
leakage of tubules to interstitial space
secondary haemodynamic changes

Question 8

Define acute tubulo-interstitial nephritis

Answer 8

immune injury to tubules and interstitium

Question 9

Describe the histopathology of acute tubulo-interstitial nephritis

Answer 9

immune injury to tubules and interstitium

Question 10

Define acute glomerulonephritis

Answer 10

acute inflammation of glomeruli

Question 11

How does acute glomerulonephritis present

Answer 11

presents with oligouria with urine casts containing erythrocytes and leucocytes

Question 12

What do the cresents represent in acute glomerulonephritis

Answer 12

proliferation of cells within Bowmans space

Question 13

What are the three types of acute crescentic glomerulonephritis

Answer 13

immune complex
anti GBM disease
Pauci-immune (ANCA)

Question 14

What comprises a nephron

Answer 14

Glomerulus
Arterioles
Tubules

Question 15

What can be used to highlight immune complexes in the kidney?

Answer 15

immunofluorenscence

Question 16

What genetic mutations are associated with PKD?

Answer 16

PKD1, PKD2

Question 17

What are the four main categories of medical renal disease syndromes?

Answer 17

AKI
Nephrotic syndrome
CKD
isolated urinary abnormalities

Question 18

Define acute renal failure

Answer 18

rapid deterioration in renal function (hours,days)

Question 19

Pre-renal cause of AKI

Answer 19

failure of prefusion

Question 20

Post-renal causes of AKI

Answer 20

obstruction

Question 21

Name three drugs that cause acute-tubulo-interstitial nephritis

Answer 21

NSAIDS
antibiotics
diuretics

Question 22

Causes of immune complex associated cresentic glomerulonephritis?

Answer 22

SLE
IgA nephropathy
Post-infectious streptococcal

Question 23

What do the antibodies in Anti-GBM disease target

Answer 23

C-terminal domain of type IV collagen

Question 24

What cross linking may happen in anti-GBM disease

Answer 24

anti-GBM antibodies may cross react with alveolar basement membrane leading to pulmonary haemorrhage

Question 25

Define thrombotic microangiopathy

Answer 25

damage to endothelium in glomeruli, arterioles, arteries leading to thrombosis

Question 26

What are the 2 types of thrombotic microangiopathy

Answer 26

diarrhoea associated non-diarrhoea associated

Question 27

Two most common causes of nephrotic syndrome

Answer 27

1. minimal change disease - children 2. focal segmental glomerulosclerosis (FSGS)

Question 28

What is FSGS

Answer 28

some glomeruli are partially scarred less likely to respond to immunosuppression

Question 29

Pathophysiology of membranous glomerulonephritis?

Answer 29

subepithelial immune complex deposits along entire GBM

Question 30

What stain is used to diagnose amyloidosis

Answer 30

congo red

Question 31

What colour is seen when the stain is viewed under polarised light

Answer 31

apple green birifringence

Question 32

What do Kimmelstiel- Wilson nodules indicate

Answer 32

Stage three nodular glomerlosclerosis in diabetic nephropathy