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Year 2 Renal > Renal pathology I > Flashcards

Renal pathology I Flashcards

1
Q

what are the congenital renal pathologies?

A
  • agenesis
  • hypoplasia
  • ectopic
  • horseshoe
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2
Q

is renal agenesis usually unilateral or bilateral?

A

bilateral

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3
Q

is renal hypoplasia usually unilateral or bilateral?

A

unilateral

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4
Q

horseshoe kidney carries an increased risk of ____________

A

infection

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5
Q

autosomal dominant polycystic kidney disease is due to mutation in what genes?

A

PKD1 or PKD2

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6
Q

1/3 of patients with AD polycystic kidney disease also present with cysts in what other organ?

A

liver

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7
Q

berry aneurysms are associated with what renal disease?

A

AD polycystic kidney disease (10% of patients)

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8
Q

PKD1 or PKD2 mutations cause what renal pathology?

A

AD polycystic kidney disease

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9
Q

how much of the kidney must be displaced with cysts before a precipitous drop in renal function?

A

2/3

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10
Q

further workup in ADPKD includes looking at what organs?

A

liver and brain (berry aneurysms)

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11
Q

what is the gross appearance of the kidney in ADPKD?

A
  • no recognizable normal kidney tissue

- cysts containing hemorrhage causing a darkening appearance

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12
Q

does autosomal recessive polycystic kidney disease (ARPKD) present in childhood or adulthood?

A

childhood

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13
Q

ARPKD is due to a mutation in what gene?

A

PKHD 1

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14
Q

in ARPKD cysts develop from what renal structure?

A

collecting ducts

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15
Q

congenital hepatic fibrosis is associated with what renal pathology?

A

ARPKD

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16
Q

what is the gross appearance of the kidney at birth in ARPKD?

A

huge, white, SMOOTH surfaced kidneys

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17
Q

does ARPKD take on a more cystic or fibrotic morphology?

A

fibrotic

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18
Q

what are the other terms for simple cysts?

A
  • “retention”

- “acquired”

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19
Q

renal biopsies are routinely stained for what factors?

A
  • IgG
  • IgA
  • IgM
  • C3
  • C1q
  • kappa light chains
  • lambda light chains
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20
Q

anti-GBM disease has what type of immunofluorescence staining pattern?

A

linear capillary loop

21
Q
  • membranous nephropathy
  • lupus nephritis

these have what type of immunofluorescence staining pattern?

A

granular capillary loop

22
Q
  • IgA nephropathy
  • lupus nephritis

these have what type of immunofluorescence staining pattern?

A

mesangial

23
Q

lupus nephritis can show what type of immunofluorescence staining patterns?

A
  • granular capillary loop

- mesangial

24
Q

what is the other name for the glomerular epithelial cell?

A

podocyte

25
Q

in the pathogenesis of glomerular disease, antibodies are formed against what structures?

A
  • native GBM
  • “planted” antigens
  • glomerular cells (mesangial cells, podocytes, etc)
26
Q

what arm of immunity is associated with glomerular disease?

A

cell mediated

27
Q

what cell types are associated with glomerular disease?

A
  • neutrophils
  • monocytes
  • macrophages
  • T cells
  • NK cells
  • platelets
  • mesangial
28
Q

what soluble mediators are associated with glomerular disease?

A
  • cytokines
  • chemokines
  • coagulation factors
29
Q

what are the three main clinical renal syndromes?

A
  • nephritic
  • nephrotic
  • acute renal failure
30
Q

what is the general cause of nephritic syndrome? what is the result?

A
  • GLOMERULAR injury: breaks in glomerular capillary loops

- hematuria

31
Q

what is the general cause of nephrotic syndrome? what is the result?

A
  • GLOMERULAR injury: glomerular capillary filtration defects
  • severe proteinuria
32
Q

what is the general cause of acute renal failure? what is the result?

A
  • tubular injury in most cases

- oliguria + rapid rise in serum creatinine

33
Q

what is the first approach to diagnosis in a patient with renal disease?

A

classify the patient’s symptoms using clinical and laboratory parameters into one of the clinical renal syndromes

34
Q

what are the symptoms of nephritic syndrome?

A
  • HTN
  • oliguria
  • proteinuria
  • azotemia
  • hematuria
  • RBC casts
35
Q

what type of casts are seen in nephritic syndrome?

A

RBC casts

36
Q

what are the symptoms of nephrotic syndromes?

A
  • proteinuria (over 3.5 g / 24 h)
  • pitting edema
  • hypoalbuminemia
  • hypercoagulable state
  • hypercholesterolemia
  • hypogammaglobinemia
  • fatty casts
37
Q

what type of casts are seen in nephrotic syndrome?

A

fatty casts

38
Q

is azotemia seen in nephritic or nephrotic syndrome?

A

nephritic

39
Q

what is the cause of hematuria in nephritic syndrome?

A

breaks in the glomerular capillaries that results in leakage of RBCs into urinary space

40
Q

what is the cause of proteinuria in nephrotic syndrome?

A

glomerular capillary filtration defects (podocyte effacement) that results in leakage of protein into urinary space

41
Q

what is the gross appearance of the kidneys in chronic renal failure?

A
  • small kidneys
  • thinning cortex
  • increase in pelvic fat
42
Q

what is the microscopic appearance of the kidneys in chronic renal failure?

A
  • glomerular sclerosis
  • interestitial fibrosis
  • tubular atrophy
43
Q

what are the three primary causes of nephrotic syndrome?

A
  • minimal change disease
  • focal segmental glomerulosclerosis
  • membranous nephropathy
44
Q

what is the main secondary cause of nephrotic syndrome?

A

diabetic nephropathy

45
Q
  • minimal change disease
  • focal segmental glomerulosclerosis
  • membranous nephropathy

these can cause what type of renal syndrome?

A

nephrotic syndrome

46
Q

what is the most common cause of nephrotic syndrome in children (2-6 y)?

A

minimal change nephropathy (minimal change disease, lipoid nephrosis)

47
Q

what is the histological appearance of minimal change nephropathy?

A
  • diffuse epithelial foot process effacement

- lipid in tubular cells

48
Q

minimal change nephropathy responds to what treatment?

A

steroids

49
Q

“diffuse epithelial foot process effacement” describes the histological appearance of what disease?

A

minimal change nephropathy

Year 2 Renal (38 decks)

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