Renal Pathology Flashcards
What defines Azotemia?
Elevated blood-urea-nitrogen (BUN) and creatinine, due to decreased glomerualer filtration rate (GFR)
What defines Uremia?
Azotemia plus other symptoms
What are the three major clinical renal syndromes and their most prevalent symptom?
- Acute nephrotic syndrome: hematuria
- Nephrotic syndrome: severe proteinuria
- Acute renal failure: oliguria/anuria
What is hematuria?
Blood in urine
In nephrotic syndrome, roughly how much protein will be seen in the urine?
> 3.5 grams per day
What gene and protein are affected by Autosomal Dominant (Adult) Polycystic Kidney Disease?
PKD1 gene; polysystin-1
What is a major complication of Adult Polycystic Kidney Disease?
Aneurysms affecting circle of Willis
T/F: Adult Polycystic Kidney Disease leads to very large kidneys.
True
T/F: Childhood Polycystic Kidney Disease is much more common than Adult Polycystic Kidney Disease.
FALSE
Adult more common
T/F: Adult polycystic Kidney Disease is one of the major contributors to renal failure.
True
What are three mechanisms for Glomerular Disease?
- Immune complex deposits in GBM or mesangium
- Anti-GBM antibody
- Epithelial and endothelial injury
T/F: Glomerular diseases will lead to nephritic syndrome.
FALSE
Nephrotic - heavy proteinuria
What is the most obvious clinical sign of Nephrotic Syndrome?
Severe edema
What is the most common cause of nephrotic syndrome in children?
Minimal change disease
What diagnostic tactic is the only one that can help diagnose minimal change disease?
Electron Microscopy
What is a common cause of adult nephrotic syndrome?
Focal segmental glomerulosclerosis
What can be seen via light microscopy in a patient with focal segmental glomerulosclerosis?
Focal (some glomeruli) and segmental (part of the involved glomerulus) sclerosis with obliteration of capillary loops
T/F: ____________ normally involves children and responds well to corticosteroid treatment. ___________ normally involves adults and does not respond well to corticosteroid treatment.
Minimal change disease; focal segmental glomerulosclerosis
What is evident in light microscopy of a patient with Diabetes Mellitus?
Nodular glomerulosclerosis
What is 2nd to MI as cause of death in patients with diabetes?
Renal failure
T/F: Membranous nephropathy is a renal disease that will lead to nephrotic syndrome.
True
Nephritic syndrome is characterized by __________.
Hematuria
Nephritic syndrome is mostly mediated by _____________ problems. Nephrotic syndrome is normally mediated by _____________ problems.
Inflammation; immune
What disease often occurs several weeks after streptococcal pharyngitis infection and can cause nephritic syndrome?
Acute postinfectious glomerulonephritis
T/F: IgA Nephropathy is a cause of Nephritic syndrome that most often affects older adults.
FALSE
Children and young adults
IgA Nephropathy often occurs after __________ infection.
Respiratory
IgA is characterized by by hematuria accompanied with ______________ purpura.
Henoch-Schonlein purpura
What disease is characterized by severe oligouria and can lead to acute renal failure within a few weeks?
Rapidly progressive glomerulonephritis
What will untreated glomerular disease eventually lead to?
Loss of glomeruli and tubules with fibrosis
A patient is diagnosed with chromic glomerulonephritis, what is the likely cause of this?
Hard to tell. Often once diagnosed as chronic, cannot tell what the original renal disease is.
What are the three types of biopsy evaluation techniques and where would they be useful?
- Light microscopy: trachoma (collagen), Jones stains (basement membrane)
- Immunofluorescence: immunoglobulins and compliment
- Electron microscopy
If you wanted to evaluate the basement membrane of a biopsy what technique would be used?
Jones stains
If you wanted to evaluate collagen in a biopsy what technique would you use?
Trichrome stain
If you were interested in evaluating immune factors in a biopsy what technique would you use?
Immunofluorescence
