Renal Pathology

Question 1

Acute Renal Failure

Answer 1

There is an acute reduction in glomerular filtration rate, that is measured in creatinine clearance, thus raised serum creatinine

Question 2

Acute Tubular Necrosis Features?

Answer 2

Causes by: tubular ischaemia or nephrotoxins
There is interstitial oedema
Tubular casts
Reversible in 2-4 weeks

Question 3

Post infectious Glomerulonephritis?

Answer 3

Presents with nephritic syndrome
You get a starry sky appearance, with IgG and C3
You get subepithelial humps on EM

Question 4

What constitutes a rapidly progressive GN

Answer 4

ANCA vasculitis - Pauci Immune GN
Anti GBM nephritis
Immune complex mediated: SLE, Cryoglobulinaemia

AntiGBM and SLE are positive for IgG antibodies on immunofluoresence

Question 5

What are the most common causes of chronic renal failure

Answer 5

The most common causes in order:
Diabetic nephropathy
Glomeurlonephritis
Hypertension
PCKD
Analgesic nephropathy
Reflux
Other

Question 6

Macroscopically what do the kidneys look like in chronic kidney disease?

Answer 6

In chronic renal failure, macroscopically the kidneys are shrunken

Question 7

What is acute pyelonephritis? What is its definition How does it present?

Answer 7

Pyelonephritis is the infection of the renal parenchyma?
Presents with lower urinary tract symptoms: Frequency, urgency, haematuria ( no dysuria unless there is concurrent cystitis). There is also fevers, chills, nausea, vomiting, myalgia, CVA tenderness or exquisite flank pain.

Question 8

What is the triad of symptoms which commonly presents in pyelonephritis

Answer 8

The triad:

• Fever
• Flank Pain
• Nausea and vomitting