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Urinary Tract Year 3 > Renal Pathology > Flashcards

Renal Pathology Flashcards

1
Q

What causes a release of erythropoietin?

A

Decrease in oxygen tension

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2
Q

What effect does calcitonin have on calcium levels?

A

Causes them to drop

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3
Q

What is pre-renal kidney failure?

A

secondary condition caused by reduction in the perfusion of the kidney

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4
Q

What can caused pre-renal kidney damage?

A

circulatory collapse or physical obstruction to flow

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5
Q

What is intra-renal kidney failure?

A

Kidney failure due to structural damage of the nephrons such as necrosis

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6
Q

What is post renal kidney failure?

A

Obstruction of urine outflow

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7
Q

What is acute renal failure?

A

When more than 75% of the functional renal capacity is impaired

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8
Q

What will you see increase in the blood in the case of severe renal failure?

A

Urea and creatinine (azotaemia) Also retention of K+ and phosphates

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9
Q

What will happen to the Ph of the blood in acute renal failure?

A

It will rapidly drop

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10
Q

In acute renal failure the retention of K+ can have what effect on the heart?

A

Causes cardiac dysarrhythmia

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11
Q

What effect does the retention of phosphates have on calcium levels?

A

Binds ionised calcium causing hypocalcaemia producing muscle tremors and coma

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12
Q

What are the symptoms of chronic renal failure?

A

similar to that of acute but progressive so do not occur rapidly. (azotaemia, retention of water and salt, metabolic acidosis, electrolyte imbalances, hypertension)

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13
Q

What happens to renal tissue in end stage kidney disease?

A

Renal fibrosis. Kidney tissue is completely distorted.

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14
Q

How low does GFR have to drop before azotaemia is detectable?

A

to 25-30% of normal capacity

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15
Q

In renal failure how low does GFR have to drop for uraemia to ensue?

A

20-25%

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16
Q

How much GFR capacity is left in end stage renal disease?

A

5%

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17
Q

What effect does Uraemia have on red blood cells?

A

The kidney damage causes a reduction in the production of erthropoitinm so non regenerative anaemia ensues.

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18
Q

What effect does uraemia have on the parathyroid gland?

A

Causes it to hypertrophy

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19
Q

Why does the parathyroid gland hypertrophy?

A

Because phophate isn’t secreted so it binds to ionised calcium. This leaves very little free calcium so parathyroid gland produces lots of PTH to bring calcium levels up.

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20
Q

What is glomerulosclerosis?

A

scarring of the glomeruli

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21
Q

What clinical signs are seen with hyperparathyroidism as a result of renal failure?

A

Fibrous osteodystrophy and mineralization of soft tissue.

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22
Q

Where can you see the glomeruli?

A

cortex

23
Q

What can you see in the medulla?

A

Tubules and collecting ducts

24
Q

what are the 4 portals of disease entry to the kidney?

A

Haematogenous, Glomerular infiltrate, Ascending from the ureter, Direct penetration

25
Q

How does the basement membrane protect the kidney?

A

It creates a barrier and filters out the toxins so lower down the nephron is unaffected.

26
Q

What 2 mechanisms are associated with non renal lesions of Uraemia?

A

Endothelial degeneration and necrosis. or. Caustic injury to epithilium of the oral cavity and stomac.

27
Q

Why do you get caustic injury of the mouth?

A

Urea is secreted in the saliva and the bacteria in the mouth break it down into ammonia

28
Q

How do you get fibrinous pericarditis?

A

leakage of blood vessels around the heart

29
Q

what is the clinical term for excessive leakage of albumin through into the filtrate?

A

protein losing nephropathy

30
Q

what are the main signs of protein losing nephropathy?

A

generalised oedema, hypercoagubility abd hypercholesterolaemia

31
Q

What are the 2 possible mechanisms for immune mediated glomerulonephritis?

A

Circulating immune complexes being deposited or formation of antibodies against antogens trapped within the GMB

32
Q

How does the kidney look grossly when suffering from immune mediated glomeroulonephritis ?

A

Glomeruli visible as small red pin points

33
Q

What disease is often associated with chronic inflammatory diseases of the kidney ?

A

amyloidosis

34
Q

What are amyloid components made up of?

A

fragments of a serum acute phase reactant protein

35
Q

What is acute suppurative glomerulitis?

A

Formation of microabscesses throughout the cortex due to bacteria getting lodge in the glomerular and interstitial capillaries

36
Q

How can you diagnose acute suppurative glomerulitis?

A

Glomerular capillaries contain numerous bacterial colonies mixed with necrotic tissue and neutrophils

37
Q

When tubules lose function what occurs in the remaining functioning tubules?

A

they hypertrophy in an attempt to maintain renal function.

38
Q

Nephrons cannot regenerate, but if a certain part of the tubule is still there they can .. what group of cells is this?

A

Tubular basement membrane

39
Q

What is primary renal glycosuria?

A

Inherited functional disorder where the capacity of the renal tubules to absorb glucose is reduced

40
Q

What is fanconi syndrome?

A

Inherited dysfunctional disease of the kidney where absorbtion of glucose, proteins, phosphate and aa is reduced

41
Q

How do toxins in the kidney cause necrosis?

A

they damage cells stimulating vasoconstriction which results in prolonged ischemia and necrosis

42
Q

what part of the nephron does lead poisoning cause damge to?

A

PCT

43
Q

What animal is lily plant toxic to the kidneys of?

A

cat

44
Q

How does antifreeze poisoning affect the kidney?

A

Direct toxic effect on the tubules but also calcium oxalate crystals precipitate into renal tubular lumen and cause obstruction

45
Q

How can overdosing on vitamin D damage the kidney?

A

It can cause severe hypercalcaemia and subsequent mineralization of the tubules

46
Q

what is the underlying cause of white spotted kidney disease?

A

E.coli septicaemia

47
Q

What effect does leptospirosis have on the kidney?

A

eventual degeneration and necrosis of tubular epithelial cells

48
Q

What does feline infectious peritonitis do to the kidney?

A

Causes development of interstitial pyogranulomas

49
Q

What other causes except FIP is there for pyogranulomas in the kidney?

A

myocobacteria, fungi and parasites

50
Q

What can cause hemorrhage in the kidneys?

A

Direct trauma, coagulopathies, septicaemia, embolic bacterial diseases, vasculitis, vascular necrosis and DIC

51
Q

What are the 3 major determinants of a thrombosis?

A

endothelial injury, dynamics of blood flow, hypercoagubility of the blood

52
Q

what are the 4 sources of renal emboli?

A

Cardiac thrombosis, endarteritis from parasitic disease, neoplastic cell emboli, bacterial or septic emboli

53
Q

What is the nature of primary renal tumours?

A

highly malignant and metastatic disease is common

Urinary Tract Year 3 (11 decks)

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