Renal Pathology ONLY THINGS NOT IN THE CARDS BELOW

Question 1

Acute Interstitial Nephritis (AIN)?

Answer 1

Acute Interstitial Nephritis (AIN) is a renal lesion that causes a decline in renal clearance and is characterized by an inflammatory infiltrate in the renal interstitium (as the name suggests)

Question 2

Most common cause of death in SLE

Answer 2

Diffuse proliferative glomerulonephritis

Question 3

Systolic pressure greater than 140 mmHg

2nd most common cause of end stage renal disease (ESRD)

Answer 3

benign arteriosclerosis - small, atrophic kidneys with fine granular surfaces

Question 4

Morphology of benign arteriosclerosis

Answer 4

Atherosclerosis and intimal hyperplasia of endothelial cells

Concentric hyaline thickening of arterioles

Renal vascular and glomerular sclerosis with mild to moderate HTN

Question 5

Fibrinoid necrosis of small arterioles and concentric smooth muscle cell proliferation

Answer 5

malignant arteriosclerosis

Question 6

“Onion-skin” appearance

Answer 6

malignant arteriosclerosis

Question 7

Systemic issues related to malignant arteriolosclerosis

Answer 7

CNS, retinal and cardiac changes. Renal failure

Question 8

Discuss arteriolar nephrosclerosis

Answer 8

benign nephrosclerosis - small, atrophic kidneys with fine granular surfaces

malignant nephrosclerosis - hemorrhage seen in this form (“flea-bitten kidney”)

Question 9

For review of arterial pathologies, what affects small, medium, and large vessels?

Answer 9

Medium = Polyarteritis nodosa

Small = Churg Strauss

Large = Giant Cell, Takayasu

Question 10

Wilm Tumor is associated with problems in your:

Answer 10

Pee SAC: Phenacetin, Smoking, Aniline dyes, and Cyclophosphamide

Question 11

Denys-Drash syndrome and what mutation it is associated with

Answer 11

Denys-Drash syndrome: Wilms tumor, progressive renal (glomerular) disease, and male pseudohermaphroditism; associated with mutations of WT1

Question 12

Renal oncocytoma

What is this and what is the histology?

Answer 12

Benign epithelial cell tumor. Large eosinophilic cells with abundant mitochondria without perinuclear clearing. Presents with painless hematuria, flank pain, and abdominal mass. Grossly, it appears as a well circumscribed mass with a central scar

Question 13

Hydronephrosis

What is it and what causes it?

Answer 13

Distention/ dilation of the renal pelvis and calyces. Usually caused by urinary tract obstruction (e.g. renal stones, BPH, cervical cancer, injury to ureter); other causes include retroperitoneal fibrosis and vesicoureteral reflux.

Question 14

What is the track that hydronephrosis follows and who does it affect the most? What does it lead to?

Answer 14

Dilation occurs proximal to site of pathology. Only impairs renal function if bilateral or patient only has one kidney. Leads to compression atrophy of renal cortex and medulla.

Question 15

Diffuse cortical necrosis and likely cause

Answer 15

Acute generalized cortical infarction of both kidneys. Likely due to a combination of vasospasm and DIC.

Question 16

Associated with obstetric catastrophes (e.g. abruptio placentae) and septic shock.

Answer 16

Diffuse cortical necrosis

Question 17

Consequences of Renal Failure (this is long simply because most of these have been covered. Think about what pneumonic FA provides that helpsyou ith this)

Answer 17

Consequences: MAD HUNGER

Metabolic Acidosis

Dyslipidemia (especially increasing triglycerides)

Hyperkalemia

Uremia: clinical syndrome marked by increasing BUN and creatinine. We see nausea and anorexia, pericarditis, asterixis
encephalopathy, platelet dysfunction

Na and water retention (CHF, pulmonary edema, hypertension)

Growth retardation and developmental delay in children

Erythropoietin failure (anemia)

Renal osteodystrophy