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Systems 1 Part 2 > Renal Pathology II > Flashcards

Renal Pathology II Flashcards

1
Q

vascular resistance controlled in –

A

arterioles

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2
Q

factors that influence bp

A

blood volume, vascular resistant e, cardiac output, sodium content

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3
Q

T/F: renal disease can cause HTN and may be a cause of HTN

A

true

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4
Q

95% of HTN is –

A

primary, essential, idiopathic, benign

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5
Q

5% of HTN has - cause

A

renal or adrenal

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6
Q

mechanism of secondary HTN

A

renal artery stenosis

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7
Q

renal artery stenosis: – blood flow

A

decreased

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8
Q

renal artery stenosis has decreased blood flow –> pressure in afferent arteriole

A

decreased

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9
Q

renal artery stenosis induces

A

renin secretion

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10
Q

renal artery stenosis increases –

A

sodium reabsorption

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11
Q

HTN accelerates – in large and medium vessels

A

atherogenesis

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12
Q

HTN causes degenerative changes in –

A

medium vessels

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13
Q

How is small vessel HTN disease distinct from large vessel disease

A

arteriolar nephrosclerosis (expanded intima)

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14
Q

feature of arteriolar nephrosclerosis (in small vessel disease)

A

intimal hyalinosis (hyaline accumulates in tissues)

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15
Q

arteriolar nephrosclerosis causes –

A

loss of glomeruli through ischemia

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16
Q

ischemia activates –

A

renin secretion

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17
Q

T/F: glomerular loss results in loss of entire nephron

A

true

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18
Q

how are nephrons replaced?

A

by small areas of scarring

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19
Q

gross presentation of the result of small foci of scarring in benign nephrosclerosis

A

granular cortical surface

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20
Q

advanced renal disease is associated with people with chronic –

A

diabetes

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21
Q

clinical syndromes of diabetes

A

non-nephrotic proteinuria (not as high as nephrotic 3.5 g), nephrotic syndrome, chronic renal failure

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22
Q

HTN in diabetics increase the chance of –

A

diabetic nephropathy

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23
Q

what reduces diabetics’ risk for developing advanced renal disease?

A

better glycemic control

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24
Q

features of diabetic nephropathy

A

glomerular lesions
tubular lesions
vascular lesions
pyelonephritis

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25
glomerular lesions in diabetics: thickened --
capillary loop BM
26
glomerular lesions in diabetics: diffuse --
mesangial sclerosis/expansion
27
glomerular lesions in diabetics: -- glomerular sclerosis
nodular
28
nodular glomerular sclerosis aka
Kimmelstiel-Wilson lesion
29
what can reverse some changes of diabetic nephropathy?
pancreatic transplant
30
T/F: diabetes can affect all areas of kidney
true
31
what is the classic glomerular lesion?
nodular glomerular sclerosis
32
types of tubulointerstitial disease
acute tubular necrosis tubulointerstitial nephrisits obstruction (hydronephrosis)
33
Acute tubular necrosis (ATN) clinicopathologic entity is characterized by --
tubular cell injury and | acute loss of renal function
34
Is acute tubular necrosis reversible?
yes
35
causes of acute tubular necrosis
ischemia, toxic injury, obstruction
36
T/F: ATN histology ranges from mild and subtle cellular alterations to extensive necrosis with tubular rupture
true
37
ATN histology
``` skip areas sloughing of necrotic cells mitoses loss of brush border vacuolization thin/dilated epithelial cells ```
38
what causes interstitial nephritis?
drugs and toxins
39
most interstitial nephritis result from an interstitial --
immunologic hypersensitivity reaction
40
interstitial nephritis may result from a --
subtle cumulative injury
41
most common association with interstitial nephritis
drug induced (synthetic penicillins, sulfonamides, rifampin, thiazide diuretics, NSAIDs, herbs)
42
what causes acute pyelonephritis?
bacterial infection
43
what is acute pyelonephritis?
purulent inflammation in kidney
44
what are most acute pyelonephritis associated with?
UTI (ascending pyelonephritis)
45
acute pyelonephritis prevalence
women
46
how does acute pyelonephritis spread?
in blood
47
-- % of UTI are complicated boy pyelonephritis
small
48
risk for ascending pyelonephritis from UTI is associated with --
repeat UTIs, instrumentation, anatomic anomalies
49
most common organism that causes ascending pyelonephritis
E. coli
50
other organisms other than E. coli that cause ascending pyelonephritis
Proteus, Pseudomonas, Enterobacter, Klebsiella
51
histologic feature of acute pyelonephritis
neutrophils in tubular lumens
52
obstruction increases susceptibility to --
infection
53
if obstruction is unrelieved -->
hydronephrosis (obstructive uropathy)
54
how does glomerular loss cause scarring of tubules
tubular ischemia, inflammation, severe proteinuria
55
-- supplies blood to tubules therefore glomerular scarring results in tubular ischemia
efferent arteriole
56
many glomerular disease are accompanied by acute and chronic -- which promotes scarring
interstitial inflammation
57
severe proteinuria derived from glomerular injury causes damage to --
tubular epithelial cells
58
bladder is lined by --
urothelium with muscular wall
59
most common diseases of bladder
cystitis, stones, tumors
60
triad for cystitis (bladder disease)
frequency, lower abdominal pain and dysuria
61
dysuria
pain or burning during urination
62
prevalence of cystitis (bladder disease)
young women of reproductive age and older people
63
what causes cystitis (bladder disease)
obstruction or instrumentation
64
cystitis (bladder disease) may lead to --
pyelonephritis
65
bacteria that cause cystitis (bladder disease)
E. coli, Proteus, Enterobacter, Klebsiella
66
bacteria that cause cystitis (bladder disease) in immunocompromised patients
Candida or Cryptococcus
67
noninfectious causes of cystitis (bladder disease)
chemotherapy, radiation therapy, trauma
68
histologi feature of cystitis (bladder disease)
WBC in bladder wall
69
most common bladder tumor
urothelial carcinoma
70
prevalence of urothelial carcinoma
men 3x
71
risk factors of urothelial carcinoma
cigarette smokings chemicals: occupational disease Arylamines Schistomsoma drugs
72
drugs that are risk factors for urothelial carcinoma
cyclophosphamide and phenacetin
73
urothelial carcinoma: tumor --
occludes bladder lumen
74
urothelial carcinoma: tumor is composed of --
irregular papillary structures
75
initial symptoms of urothelial carcinoma
painless hematuria, infection, obstruction near ureteral orifices
76
70% of urothelial carcinoma tumors are localized to --
bladder
77
urothelial carcinoma: tumors tend to recur at--
higher grade and different side
78
prognosis of urothelial carcinoma
good for low grade lesions
79
protective for urothelial carcinoma
drink lots of water
80
tubulointersitial injury may be secondary to --
ischemia, immunologic mech, infectious agents
81
anatomic abnormaliteit can results in -- which lead to renal scarring
urinary outflow obstruction or reflux of urine back to kidney

Systems 1 Part 2 (27 decks)

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