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Pathology > Renal Pathology > Flashcards

Renal Pathology Flashcards

1
Q

Renal hypoplasia is …….

A

failure of the kidney to reach the normal weight

  • Usually unilateral
  • There is decreases number of calyces and lobules
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2
Q

Define Horseshoe kidney

A

The fusion of the two kidneys at the lower pole

* Normal function, but may cause calculi

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3
Q

Define childhood polycystic disease

A
  • Autosomal recessive
  • Progressive renal failure, with subsequent liver cirrhosis and portal hypertension
  • Multiple cysts in the cortex and medulla
  • There is dilatation of the tubules
  • Liver cysts may also present
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4
Q

Define Adult polycystic disease

A
  • Autosomal dominant
  • Renal insufficiency in middle age, hematuria, hypertension
  • Also, Berry aneurysm & liver cysts, colonic diverticula, mitral valve disease
  • Cysts involve less than 10% of nephrons, but they expand later to interfere with function
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5
Q

What is the effect of T4, T3 and cortisol on blood pressure?

A

Increase BP

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6
Q

What is the effect of high BP on the kidney?

A

Atrophy and scarring of the glomeruli

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7
Q

In renal failure, ….. & …… can not be synthesized properly

A

Prostoglandins & Kinins

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8
Q

Malignant hypertension is …..

A

BP above 200/140 mm Hg, leads to acute end organ damage

* Usually in poorly controlled patient

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9
Q

What are the clinical features of malignant hypertension??

A
  1. Increased intracranial pressure: will cause, papilledema, headache, vomiting, scotoma (vision change), subarachnoid & intracerebral bleeding
  2. Left heart failure.
  3. Malignant nephrosclerosis: proteinuria, hematuria, acute renal failure
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10
Q

What are the forms of glomerular responses to injury?

A
  1. Cellular proliferation: of mesangial, endothelial & epithelial cells
    2 Thickening of basement membrane
  2. Leukocytic infilteration: of monocytes & neutrophils
  3. Sclerosis and hyalinization
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11
Q

Glomerulonephritis may result from anti bodies against :

A
  1. Basement membrane: example is Goodpasture syndrome
  2. Antibodies against any other glomerular antigen
  3. Ag-Ab complex may get trapped withing the glomeruli resulting in injury. The antigen could be exogenous (eg. serum sickness) or endogenous (eg. SLE with DNA-anti-DNA complex)
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12
Q

Nephrotic syndrome is a tetrad of …….

A

Proteinuria, edema, hypoalbuminemia, hyperlipidemia

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13
Q

What is the most common cause of nephrotic syndrome children & adults?

A
  1. Children: Lipoid nephrosis (minimal change disease)

2. Adults: Membranous glomerulonephritis (idiopathic)

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14
Q

Rapidly progressing glomerulonephritis is …..

A

rapidly deteriorating renal function accompanying glomerular injury
* Also called crescentic GN

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15
Q

Acute poststreptococcal GN is ……

A

immune related GN due to “skin” or throat infection. More in children

  • Lab work show elevated antistreptolysin O (ASLO) titers and low complement
  • The disease is probably related to immune complex deposition
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16
Q

Lipoid nephorsis is ……..

A

Nephrotic syndrome due to allergy, medications or hematologic malignancy

  • Loss of visceral epithelial cells (podocyte) foot processes
  • More in children, 2-3 years of age
  • Complete recovery is expected
  • Called minimal change disease
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17
Q

Membranoproliferative GN is ……

A

a mixed nephritic/nephrotic syndrome.

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18
Q

Antibodies against the glomerular basement membrane will cause ……..

A

rapidly progressing GN.

* Add pulmonary involvement and you get Goodpasture

19
Q

The final stage of glomerular disease is ……..

A

chronic glomerulonephritis

* There is anemia, anorexia, hypertension, azotemia, nausea & vomiting, proteinuria

20
Q

The most common cause for acute renal failure is ……

A

acute tubular necrosis

21
Q

What are the types of acute tubular necrosis?

And what is the pathogenesis?

A
  1. Ischemic: most common, due to hypotension, renal vasoconstriction, shock
  2. Nephrotoxic: due to drugs (polymyxin, methicillin, sulfonamide), metals (mercury, lead, gold) etc…
    * These lead to: vasoconstriction & decrease GFR, tubular obstruction, back leakage of fluid (into the interstitium), decrease glomerular permeability
    * Prognosis is excellent
22
Q

Tubulointerstitial disease is ………., it is cause by …….

A

Infection of everything but the glomerulus. Caused by G-ve bacilli (E. Coli, proteus, klebsiella, enterobacter) or Strep faecalis

  • More common in females, since the urethra is shorter
  • Infection ascends from urethra to the kidney
23
Q

Chronic pyelonephritis may cause ……

A

renal failure due to parenchymal scarring

24
Q

Toxic nephritis is ……

A

hypersensitivity reaction to infections or drugs (analgesics or antibiotics)
* Results in interstitial edema, mononuclear infiltrate, and renal necrosis

25
Q

What are the clinical features for renal infarcts?

A

Asymptomatic, or may cause pain, hematuira, hypertension

26
Q

What are the clinical features of diffuse cortical necrosis?

A

acute anuria and uremia

27
Q

Renal vein thrombosis is associated with ……. . The clinical features are …….
The kidney looks ……

A

membranous glomerulonephritis (nephrotic syndrome)

  • Flank pain, hematuria & renal failure
  • The kidney looks enlarged
28
Q

Urolithiasis formation has a family predisposition. T/F?

A

True

* Depends on the type of stone

29
Q

What are the types of renal stones?

A
  1. Ca stones (80%): there is hypercalciuria without hypercalcemia. Also, there could be hyperuricosuria
  2. Magnesium ammonium (struvite) 15%: occur after infection with protease (splits urea)
  3. Uric acid (5%): seen in gout, leukemia, acidic urine
  4. Cystine (1%): due to cystinuria
    * Ca stones are radio-opaque (the only that can be seen on xray)
30
Q

Renal cell carcinoma is ……

A

adenocarcinoma arising from the PCT.

  • They form 90% of all renal cancers in adults
  • Associated with smoking & family history
  • Prone to metastasis if larger than 3cm
31
Q

What are the clinical features of renal cell carcinoma??

A

Hematuria, palpable mass, costovertebral pain

  • May be asymptomatic until advanced
  • May cause amyloidosis, leukemoid reaction, eosinophilia
32
Q

What are the sites for metastasis of renal cancer?

A

opposite kidney, liver, lung, bone, adrenals, brain, lymph nodes

33
Q

Hydroureter and hydronephrosis are caused by …….

A

ureter obstruction

  • Obstruction could be due to:
    1. Hematoma in the kidney
    2. Renal caliculi
    3. Stricture (post surgical/inflammatory)
    4. Tumors
34
Q

Bladder diverticula may cause …….

A

urinary stasis, and infection

35
Q

Define bladder exstrophy

A

The presence of part of the bladder outside the body due to failure of downgrowth of mesoderm over the anterior bladder wall

36
Q

Cystitis is caused by ……..

A 
fecal flora (E. coli, Proteus, Klebsiella, Enterobacter, S. faecalis or Staphylococci)
* Systemic signs are uncommon with lower UTI
37
Q

Cystocele is ……

A

herniation of the fibrous barrier between the bladder and anterior vaginal wall during childbirth
* This may cause urine leakage or bladder obstruction

38
Q

Most of the bladder tumors are …….

A

derived from the transitional epithelium, called “urothelium”

  1. Papilloma are uncommon, present with hematuria
  2. Carcinomas: due to Schistosoma haematobium, or smoking
39
Q

What are the clinical features of bladder cancer?

A

Painless hematuria, dysuria, frequency, hydronephrosis, pyelonephritis
* High recurrence

40
Q

Bladder sarcomas are ……..

A

large polypoid masses, usually leiomyosarcomas

41
Q

Urithritis is two types, …… & ……

A

gonococcal & non gonococcal

* Non gonococcal are caused by Chlamydia, Mycoplasma & enteric bacteria

42
Q

Urethral caruncle is …..

A

small red painful benign mass in the external urethral opening in the female

43
Q

Urethral carcinoma are ……..

A

papillary growths composed of malignant squamous cells

* Rare. Cause by papillomavirus

Pathology (18 decks)

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