renal tubular injury

Question 1

histologically what does the PCT look like ?

Answer 1

cells are larger than in the DCT
ample cytoplasm
less number of lining cells so less number of visible nuclei

Question 2

histologically what does the DCT look like ?

Answer 2

less cells in number 
cells are smaller 
however the lumen is wider 
pale cytoplasm 
many nuclei

Question 3

what are the causes of tubular injury ?

Answer 3

hypotension/ischaemia
obstruction
toxicity
inflammation

Question 4

what type of drugs could cause tubular injury?

Answer 4

gentamicin
anti-retrovirals
contrast agents

Question 5

what is acute tubular necrosis a result of ?

Answer 5

prolonged untreated acute kidney injury

Question 6

what are the causes of acute tubular necrosis?

Answer 6

1.marked trauma
septicemia
acute pancreatitis
2.poisons, drugs and organic solvents

Question 7

what is the nature of the clinical course of acute tubular necrosis ?

Answer 7

initial phase
maintenance phase
recovery phase

Question 8

what are the features of the initial phase of ATN ?

Answer 8

lasts 36b hours
slight reduction in urine
rise in BUN

Question 9

what are the features of the maintenance phase of ATN ?

Answer 9

lasts from a few days to three weeks
marked oliguria
uremia
fatal if not treated

Question 10

what are the features of the recovery phase ?

Answer 10

a remarkable increase in the volume of urine takes place yet with severe electrolyte imbalance

Question 11

what is the gross picture of the kidneys during ATN ?

Answer 11

kidneys are enlarged

pale , necrotic cortex and a congested medulla

Question 12

what is the microscopy like in Ischemic ATN ?

Answer 12

short segments of distal and proximal convoluted tubules with foci of ruptured basement membrane

Question 13

what is the microscopy in nephrotoxic ATN ?

Answer 13

the whole length of the proximal convoluted tubule is damaged but with preservation of tubular basement membrane

Question 14

what are the expected investigation results inn nATN ?

Answer 14

glycosuria with normal blood glucose
alkali urine
low serum bicarb and phosphate

Question 15

what is the cause of atherosclerosis (senile) kidney ?

Answer 15

atheroma of the renal artery

Question 16

what is the gross picture of the senile kidney ?

Answer 16

kidney is contracted with an irregular outer surface

Question 17

what are the renal lesions associated with hypertension ?

Answer 17

nephrosclerosis

Question 18

what does nephrosclerosis eventually lead to ?

Answer 18

interstitial fibrosis
tubular atrophy
focal global glomerulosclerosis

Question 19

what is the gross picture of nephrosclerosis ?

Answer 19

bilateral symmetrical atrophy of the kidneys

Question 20

what does the microscopy look like in advanced cases of nephrosclerosis ?

Answer 20

fibroelastic hyperplasia

Question 21

what is the value for malignant hypertension ?

Answer 21

200/120 mm hg

Question 22

what is a flea bitten appearance associated with ?

Answer 22

pin point petechial hemorrhages are associated with malignant hypertension affecting the kidneys at a gross level

Question 23

what does onion skin appearance on microscopy indicate?

Answer 23

hyperplastic arteriolosclerosis

Question 24

what is the early clinical presentation of malignant hypertension ?

Answer 24

early symptoms are related to increased intracranial pressure

Question 25

what is the full-blown syndrome of malignant hypertension ?

Answer 25

characterized by 
papiloedema 
encephalopathy 
cardiovascular abn
renal failure

Question 26

what is the triad for hemolytic uremic syndrome ?

Answer 26

microangiopathy hemolytic anemia
thrombocytopenia
acute renal damage