Renal Pathology (6) Flashcards
What causes ADH secretion
high blood pressure sensed by the carotid barorecptors
What does ADH cause
it inserts aquaporins into the wall of the collecting duct, making it possible for water to leave the collecting duct, leading to less urine that is more concentrated.
What causes the kidneys to release renin, and the liver to release angiotensinogen
low blood pressure and low sodium
What do renin and angiotensinogen do
angiotensinogen is turned into angiotensin I by renin, then angiotenisin I is turned into Angiotensin II by ACE from the lungs, it then causes the adrenal gland to secrete aldosterone. this causes reabsorption of Na, and secretion of K+
What is Azotemia
increased in blood urea nitrogen and creatinine
What is uremia
azotemia and more problems (Gastroenteritis, bleeding, peripheral neuropathy, fibrinous pericaditis)
What are glomerulopathies
disorders that directly affect the glomerulus, they are the most common cause of kidney failure. They cause decreased GFR, less urine, elevated plasma creatinine and urea
What are the two primary types of glomerulopathies
nephrotic syndrome (nephrosis) Nephritic syndrome (nephritis)
What are the secondary types of glomerulopathies
lupus nephritis
diabetic nephropathy
DIC with thrombotic microangiopathy
What is nephrotic syndrome (nephrosis)
damage to the glomerular membrane resulting in elargement of the fenestrations. causes secretion of proteins in the urine. but there are less overall fenestrations
what can cause nephrosis
hypertension
diabetes mellitus destroying capillary beds
Type 3 immune disorders (lupus and RA)
What happens to fluid balance in nephrosis
more water leaves the blood due to less osmotic pressure becuase of the proteins lost. this leads to edema and hypotension
how is nephrosis treated
Anti-inflammatory steroids
anti-immune drugs (if related)
insulin for diabetics
high protein diet
What are the three types of nephrosis
minimal change disease
focal segmental
membranous
What is minimal change disease nephrosis
common in children, few discernable changes, good prognosis
what is focal segmentation glomerulosclerosis
scarring of the glomerulus with a poor prognosis. can be primary, or caused by HIV, heroin, or hypertension
What is membranous glomerulonephritis
autoimmune activation of immune complex, causing deposition of antibodies in the basement membrane leading to increased permeability
What is nephritic syndrome (nephritis)
inflammation of the glumerulus
what causes nephritis
immunologic abnormailities drugs or toxins vascular disorders systemic diseases viral cases
What are the symptoms of nephritis
slight proteinuria
hematuria
azotemia
hypertension
What are the types of nephritis
acute postinfectious glomerulonephritis
IgA nephropathy
RPGN
chronic glomerulonephritis
what is acute postinfecious glomerulonephritis
happens 2-3 weeks after strep infection, antigen-antibody complexes precipitate on glomerular membrane, leads to inflammation and thickening
how is acute postinfectious glomerulonephritis treated
antibiotics, anti-inflammatory steroids, Dialysis
what is IgA neuropathy (Berger disease)
2-3 days after URT or GI viral infection, the IgA binds to mesangial cells causing them to proliferate
how is IgA neuopathy treated
antibiotics, anti-inflammatory steroids, Dialysis
What is RPGN (goodpasture syndrome)
rapidly progressing glomerulonephritis, antibodies form against the basement membrane
how is RPGN treated
anti-inflammatory steroids, anti-immune drugs, kidney transplant
what is chronic glomerulonephritis
slow progressive loss of renal function, caused by diabetes, hypertension, autoimmunity
What are the symptoms of chronic glomerulonephritis
tubular atrophy, slight proteinuria, Waxy and RBC casts in urine
how is chronic glomerulonephritis treated
autoimmune medication
What are the types of inflammatory lesions of the nephron
polynephritis - invasive kidney infection (from UTI)
Drug induced intersitial nephritis
What is acute Tubular Necrosis
ischemia or toxicity induced tubular injury. most common cause of acute renal failure, but it is reversible
What is fanconi syndrome
a genetic, or aquirable disease of the PCT associated with decreased reabsorption. more stuff in the urine, less stuff in the blood
What is benign nephrosclerosis
hyaline thickening of arterial walls caused by benign hypertension, that can lead to mild functional impairment
What is malignant nephrosclerosis
hyperplastic vessels that leads to renal ischemia. it is found in patients with malignant hypertension and is an emergency
What is adult polycystic kidney disease
autosomal dominant disorder that leads to many cysts in the kidneys. it is usually associated with brain aneurysms
what is childhood polycystic kidney disease
autosomal recessive disorder with numerous small cysts that are also in the liver. often lethal
What is urolithiasis
kidney stones (calculus in the urinary collection syndrome) more commonly found in males, with calcium oxalate as the main component.
what is the process of urolithiasis formation
supersaturation of one or more salts
precipitation of a salt from liquid to solid (temp and ph influence it alkaline = Ca and phosphate stone, acid = uric acid stones)
grow into a stone
What is hydronephrosis
blockage leading to fluid accumulation and dilation of renal pelvices and calyces
what causes hydronephrosis
congenitral atresa of ureter
calculi
tumors
inflammation
From where is a renal cell carcinoma derived
tubular epithelium
What causes renal cell carcinoma
smoking and hypertension
how is renal cell carcinoma manifested
hematuria, flank pain
from where is bladder carcinoma derived
transitional epithelium
how is bladder carcinoma manifested
painless hematuria
What is micturition syncope
fainting while and after urination
