Renal Pathology

Question 1

Nephrotic syndrome

Answer 1

Chronic
Massive proteinuria - albumin selective
Oedema

Question 2

Blood changes in Nephrotic syndrome

Answer 2

Hypoalbuminaemia

Hyperlipidaemia

Question 3

Nephritic syndrome

Answer 3

Acute
Variable unselective proteinuria
Haematuria

Question 4

Consequences of Nephritic syndrome

Answer 4

Mild oedema
Oligouria
HTN

Question 5

Blood changes in Nephritic syndrome

Answer 5

Azotaemia - high nitrogen

Question 6

Pathophysiology of Nephrotic syndrome

Answer 6

Damage to glomerular filtration barrier
Loss of foot processes
No inflammation

Question 7

Types of glomerular disease (inc. Nephrotic syndrome)

Answer 7

Minimal change disease
Focal segmental glomerulosclerosis
Membranous glomerulonephritis

Question 8

Pathophysiology of Nephritic syndrome

Answer 8

Inflammation, vascular and epithelial damage

+/- glomerular cell proliferation

Question 9

Types of Nephritic syndrome

Answer 9

1) Proliferative glomerulonephritis

2) Membranoproliferative (mesangiocapillary) glomerulonephritis

Question 10

Proliferative glomerulonephritis

Answer 10

Post infective

Question 11

Membranoproliferative (mesangiocapillary) glomerulonephritis

Answer 11

Diffuse
Crescentic glomerulonephritirs
Lupus nephritis

Question 12

Causes of golmerulonephritis

Answer 12

Primary

Secondary to systemic disease

Question 13

Pathophysiology of glomerulonephritis

Answer 13

Immunological

Deposition of immune complex in glomerular capillary wall

Question 14

Ix for glomerulonephritis

Answer 14

Immunohistochemistry:

• Local deposition of circulating immune complexes
• Anti-glomerular basal membrane antibodies
• Antibodies against glomerular component

Question 15

Causes of Acute tubular necrosis

Answer 15

Ischaemia
Toxic drug injury - statin
DIC
Urinary obstruction

Question 16

Presentation of Acute tubular necrosis

Answer 16

Acute renal failure

Question 17

Causes of Tubulointersitial nephritis

Answer 17

Acute pyelonephritis
Chronic pyelonephritis
Drugs - analgesics

Question 18

Presentation of acute pyelonephritis

Answer 18

Fever

Elevated creatinine

Question 19

Histology of chronic pyelonephritis

Answer 19

Dilated colloid filled tubules

Question 20

Post mortem features of chronic pyelonephrits

Answer 20

Irregularly depressed/scarring of kidneys

Question 21

Hypertensive kidney disease

Answer 21

Benign nephrosclerosis - focal ischaemia

Malignant HTN and accelerated nephroscerlosis

Question 22

Types of Cystic kidney disease

Answer 22

Malformative/congenital
Acquired
Hereditary

Question 23

Malformative cystic kidney disease

Answer 23

Multicystic renal dysplasia

Medullary sponge kidney

Question 24

Acquired cystic kidney disease

Answer 24

Acquired renal cystic disease - often post dialysis

Simple cysts

Question 25

Hereditary cystic kidney disease

Answer 25

Autosomal dominant polycystic kidney disease Nephronophthisis

Question 26

Nephronophthisis

Answer 26

Medullary cystic kidney disease complex

Question 27

Autosomal dominant polycystic kidney disease

Answer 27

Bilateral | Presents in middle age

Question 28

Presentation of Autosomal dominant polycystic kidney disease

Answer 28

``` Haematuria UTI Abdo mass HTN Cysts in liver, pancreas, lung Cerebral aneurysms ```

Question 29

Complication of Autosomal dominant polycystic kidney disease

Answer 29

Ruptured berry aneurysm

Question 30

Mx of Autosomal dominant polycystic kidney disease

Answer 30

Supportive Treat HTN Renal replacement therapy

Question 31

Causes of CKD

Answer 31

DM | HTN

Question 32

Stages of CKD and eGFR

Answer 32

1) > 90 2) 60-90 3A) 45-60 3B) 30-45 4) 15-30 5) < 15

Question 33

Nephrolithiasis

Answer 33

Stone formation | In kidney or renal tract

Question 34

Types of kidney stone

Answer 34

Calcium oxalate Triple phosphate Urate Cystine

Question 35

Renal tumours

Answer 35

Wilm's tumour - childhood Benign - papiliary adenomas Malignant - RCC, TCC

Question 36

Renal cell carcinomas (RCC) RFs

Answer 36

Smoking HTN Heavy metals Von Hippel Lindau syndrome

Question 37

Histotypes of RCC

Answer 37

Clear cell Papiliary Chromophobe

Question 38

Sx of RCC

Answer 38

``` Polycythaemia Hypercalcaemia Cushing's Haematuria Back pain ```

Question 39

Benign Bladder tumours

Answer 39

Papilloma

Question 40

Low malignant potential Bladder tumours

Answer 40

Papillary urothelial neoplasm

Question 41

Malignant Bladder tumours

Answer 41

Low grade papillary urothelial carcinoma | High grade urothelial carcinoma

Question 42

Bladder tumour RFs

Answer 42

``` Smoking Dye industry Long term analgesic use Schistosomiasis - SCC Cyclophosphamide ```