RENAL PATHOLOGY 4 Flashcards
This strong negative charge prevents negatively charged proteins like (1) from being filtered into the urinary space
- albumin
Immunological damage to the glomeruli can either produce predominantly (1) (nephrotic symptoms and signs) or predominantly (2) (nephritic symptoms and signs).
- mainly protein loss
2. bleeding and more severe injury
Clinically, patients with heavy proteinuria have the (1) syndrome which consists of proteinuria (usually 3.5 grams of protein in a 24 hour urine collection), (2)
- nephrotic
2. hypoalbuminemia, edema, hyperliipidemia, and lipiduria
The proteinuria leads directly to the (1) because the kidney is excreting the protein from blood into urine.
- hypoalbuminemia or low serum albumin
The hypoalbuminemia causes (2) because of the decreased plasma oncotic pressure from decreased serum proteins.
- edema (fluid within tissues)
The hyperlipidemia occurs because the (1) produces more (2) in the generalized response to produce more (3).
- liver
- lipoproteins
- albumin
(1) happens because of the increased lipoproteins carrying lipid and because of loss of the filtration barrier.
- Lipiduria (lipid in urine)
There can be extensive (1) in patients without any histopathological changes that can be seen by light microscopy (MCD/lipoid nephrosis)
- selective proteinuria
However, ultra-structural changes can be seen by electron microscopy generally show (1) in nephrotic syndrome in Minimal Change disease (MCD).
- loss of the epithelial podocyte foot processes
Minimal change disease (biopsy (1) is the most common cause of nephrotic syndrome in children. Children who do not develop any complications have a completely normal life span without any later renal disease.
- H&E stains- no change in glomeruli; hyaline (protein and lipid) droplets in tubular cells
Although the cause of minimal change disease is unknown, it is thought to be the result of (1) occurring in glomeruli
lymphokines of the T cells
Membranous nephropathy can be either primary (Anti-phospholipase A2 receptor antibody) or secondary from a disease which is producing (2) within the kidney
- antigens or immune complexes
Some of the secondary causes of secondary membranous nephropathy include inflammation disorders like (1)
- SLE, infections (IE), drugs (gold, penicillamine), and adenocarcinomas, DM
An experimental animal model called Heymann nephritis suggest that (1) are more often present first in the (2) or surrounding cells before the (3) arrive to form immune complexes.
- antigens
- basement membrane
- antibodies
Light microscopy can show (1) in membranous nephropathy (silver stains show (2) material so they can show immune complexes as areas where the silver stain is lost)
- thickened basement membranes
2. basement membrane