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Pathology > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

Most commonrenal developmental disorder

A

Renal cystic dysplasia

-abnormal differention of renal structures during embryonic period, with cyst formation

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2
Q

Are adult polycystic kidney disease unilateral or bilateral?

A

bilateral

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3
Q
  • Serous or purulent-filled cysts that destroy parenchyma
  • Cysts form from obstructed tubules
  • Dull, aching pain in abdomen or back
  • Hematuria
  • Liver cysts (also common)
A

Adult polycystic kidney disease

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4
Q
  • non-functional kidney, bilaterally at birth
  • sponge-like
  • cysts from collecting ducts
  • Autosomal recessive
A

Childhood polycystic kidney disease

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5
Q

Most common infective agents of acute pyelonephritis

A

gram negative - E.coli**, (also Klebsiella, Enterobacter, pseudomonas, serritia, proteus)

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6
Q

Fever, chills, malaise, sudden sharp costovertebral pain

A

Acute pyelonephritis

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7
Q

Complication of acute pyelonephritis seen with diabetics.

-Ischemia + necrosis at renal pyramid tip

A

Renal papillary necrosis

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8
Q
  • Scarring involving pelvis and/or calyces leading to papillary blunting and calyceal deformities
  • Dialated tubules contain pink, glassy colloid casts (thyroidization)
A

Chronic pyelonephritis

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9
Q

Proteinaceous casts in distal tubules and collecting ducts–> Tamm-Horsfall protein

A

Acute tubular necrosis

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10
Q

Most common cause of acute renal failure

A

Acute tubular necrosis

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11
Q

Causes of Acute Tubular necrosis

A

-reduction in blood flow that affects the cortex of the kidney

When?: after MI, cardiac arrect, hypotensive shock

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12
Q

Is Acute tubular necrosis reversible?

A

yes

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13
Q

Diabetic nephropathy (2 microscopic findings/urinalysis finding)

A
  1. basement membrane thickens and becomes more permeable
  2. Nodules in the glomerular tuft (Kimmelsteil-Wilson dx)
  3. Proteinuria (massive if >3 gms a day)
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14
Q

Vascular changes (2) in diabetic nephropathy

A
  1. Narrowing of lumen (thickening of vessel walls)

2. Ischemia–>papilary necrosis of pyramids, detach and cause ureter obstruction

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15
Q

Location of urinary stones (2)

A
  1. renal pelvis

2. Urinary bladder

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16
Q

Hematuria, urinary colic, renal colic, flank pain radiating to the groin

A

urolithiasis

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17
Q

Most common urinary stone

A

Calcium stone (calcium oxalate or calcium phosphate)

causes: hyperparathyroidism, diffuse bone disease

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18
Q

Urea splitting bacteria: Proteus causes this type of stone

A

Struvite

ex. Staghorn calculi (largest type of stones)

19
Q
  • Radiolucent stones

- complication of gout or leukemia (hyperuricemia)

A

Uric Acid stone

20
Q

Stone from inborn error of amino acid metabolism

A

Cysteine stone

21
Q

Causes of urinary tract obstruction

A
  1. Developmental defect
  2. Urinary calculi
  3. Pregnancy
  4. BPH
  5. Prostate cancer
  6. Infection/inflammation
  7. Uterine prolapse
22
Q
  • Dilation of renal pelvis and calyces with progressive atrophy of the kidney due to obstruction to the outflow of urine
  • Compress blood supply of kidney (lowers GFR)
A

Hydronephrosis

23
Q

Hydronephrosis (gross kidney appearance)

A

enlarged, dilation of pelvis and calyces with interstitial inflammation (latter leads to fibrosis)

24
Q

Which type of bilateral hydronephrosis has inability to concentrate urine (polyuria and nocturia)?

A

partial hydronephrosis

25
Q

Which type of hydronephrosis does not produce urine (oliguria or anuria?

A

complete hydronephrosis

-irreversible damage

26
Q

Renal cell carcinoma risk factors

A

-Older men who smoke

27
Q

Which renal cancer arises from either the lower or upper pole?

A

Renal cell carcinoma

28
Q

Gross appearance of renal cell carcinoma

A
  • nodules, sharply demarcated
  • upper or lower pole
  • yellow, bosselated
  • encapsulated
29
Q

Where does RCC like to metastasize to?

A
  1. lung

2. bone (hypercalcemia, polycythemia)

30
Q

Classic triad of Renal cell carcinoma

A
  1. Hematuria
  2. Dull flank pain
  3. Palpable abdominal mass
31
Q

Cuboidal cells with clear or granular cytoplasm, filled with glycogen and lipids are histological features of what?

A

Renal cell carcinoma

32
Q

Treatment for RCC?

A

surgery

33
Q

Papillary neoplasms of the renal pelvis that resemble carcinomas of the urinary bladder

A

Transitional Cell Carcinoma

34
Q

Most common solid kidney tumor in infants/children

A

Wilms tumor

35
Q

Kidney tumor of childhood that is highly malignant and comprised of blastic or immature cells

  • palpable
  • manifests around age 2-4
A

Wilms tumor

36
Q

Most common type of urinary bladder cancer?

A

Transitional cell carcinoma

37
Q

Risk factors of urinary bladder cancer

A
  1. Cigarette smoking
  2. Azo dyes
  3. Rubber industry chemicals
  4. Schistosoma haematobium infection (Egypt) [very rare squamous cell CA)
38
Q

Sudden onset _____ may cause fibrinoid necrosis of glomerular capillaries

A

Hypertension

39
Q

Rapid, reversible deterioration in renal function. Sudden onset, loss of excretory function (oliguria or anuria)

A

Acute Renal Failure

40
Q

Most common nephrotic syndrome in children

A

Minimal change disease (Nils Disease)

41
Q

Acute Post-streptococcal glomerulonephritis

A
  • nephritic
  • hypocomplementemia (gets stuck in the kidney)
  • immune complexes in basement membrane (humps)
  • marked hypercellularity of the glomerulus
  • smoky colored urine, oliguria
  • Red cells casts in urine
  • periorbital edema (recurring each morning)
42
Q
  • Autoimmune, abo to bm collagen type 4
  • injury to lungs
  • linear deposits in glomerulus
  • Kidneys don’t survive this, will need dialysis/transplant
A

Good Pasture’s Syndrome

43
Q

Fusion of visceral epithelial foot processes
complete remission
Treatment: steroids

A

Minimal Change Disease (Nils) Disease

44
Q

Membranous glomerulonephritis

A

-nephrotic
-adults
-bm thickening due to immune complexes
-granularity of deposits
TX: steroids

Pathology (15 decks)

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