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D&T 3 Test 3 > Renal Vascular Disease > Flashcards

Renal Vascular Disease Flashcards

1
Q

What is the parthenogenesis for Benign Nephrosclerosis

A
  • Medial and intimal thickening

- Hyaline deposition in arterioles

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2
Q

what can cause medial and intimal thickening in Benign Nephrosclerosis

A

Hemodynamic changes
aging
genetics

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3
Q

What is the gross morphology of nephrosclerosis

A
  • kidney size is normal to reduced

- surface is granular

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4
Q

What are microscopic morphology changes in nephrosclerosis

A
  • narrowed lumens of arterioles and small arteries
  • scarring, glomerular sclerosis
  • tubular atrophy
  • Fibroelastic hyperplasia
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5
Q

what is fibroelastic hyperplasia

A

medial hypertrophy, reduplication of elastic lamina, myofibroblastic tissue in intima

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6
Q

what are clinical features of Nephrosclerosis

A
  • mild proteinuria
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7
Q

Rarely nephrosclerosis does not cause renal insufficiency except in what?

A
  • african descent
  • severe hypertension
  • underlying disease (diabetes)
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8
Q

What is the gross appearance of Malignant hypertension

A

“fea-bitten” apperance of kidney from petechial hemorrhages on cortical surface

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9
Q

What is the histology for malignant nephrosclerosis

A

Fibrinoid necrosis of arterioles

Hyperplastic ateriolitis “onion-skinning”

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10
Q

What does fibrinoid necrosis look like

A

vessel walls appear eosinophilic, granular

- stain positive for fibrin

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11
Q

What happens to the glomeruli in malignant nephrosclerosis

A

glomerulitis with neutrophils and necrosis

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12
Q

What is renal artery stenosis

A
  • unilateral constriction decreases circulation/blood pressure
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13
Q

What is triggered by renal artery stenosis

A

RAAS system

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14
Q

What are 3 different ways renal artery stenosis can present itself

A
  1. atherosclerosis plaque occlusion
  2. Fibromuscular dysplasia of renal artery
  3. Ischemic kidney
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15
Q

Who is likely to get fibromusclar dysplasia of renal artery

A

women

3rd and 4th decades

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16
Q

Name 2 thrombotic microangiopathies

A
  1. hemolytic uremic syndrome (HUS)

2. Thrombotic thrombocytopenic purpura (TTP)

17
Q

What goes wrong in thrombotic microangiopathies

A
  • tissue dysfunction resulting from formation of microthrombi
  • then vascular obstruction
  • then tissue ischemia
18
Q

HUS hemolytic uremic syndrome, injury occurs where

A

endothelial injury

- then platelet activation and thrombosis

19
Q

What triggers the endothelial injury in typical HUS

A

shiga-like toxin

20
Q

What goes wrong in atypical HUS

A

excessive activation of complement

21
Q

TTP thrombotic thrombocytopenic purpura what goes wrong

A

platelet aggregation from very large multimers of vWF

  • autoAbs to ADAMTS13
22
Q

What causes typical HUS

A

intestinal infection with E. Coli strain 0157-H7

23
Q

How do you distinguish HUP from TTP

A

HUS has normal ADAMTS13 plasma levels

24
Q

symptoms for typical HUS

A
  • flu like or diarrhea
  • severe oliguria and hematuria
  • microangiopathic hemolytic anemia
  • thrombocytopenia
25
Q

how is typical HUS managed and prognosis

A
  • manage with dialysis

- renal function recovers in weeks

26
Q

atypical HUS most common thing among everyone

A

Factor H

27
Q

Atypical HUS is associated with what conditions

A
  1. anti-phospholipid Ab syndrome
  2. pregnancy
  3. vascular renal disease
28
Q

What are symposiums for TTP

A

petad of fever

CNS Involvement

29
Q

What perseves atherosclerotic ischemic renal disease

A
  • surgery

- bilateral

30
Q

Atheroembolic renal disease?

A

embolization of atherosclerotic plaque fragments

- usually cholesterol

31
Q

3 clinical symptoms of sickle-cell disease

A
  1. hematuria
  2. proteinura
  3. diminished concentration
32
Q

What is diffuse cortical necrosis

A

massive ischemic (coagulative) necrosis

33
Q

prognosis for diffuse cortical necrosis

A

rapidly fatal without supportive treatment

34
Q

What usually occurs from obstetric emergency

A

diffuse cortical necrosis

35
Q

renal infarcts are usually do to what? source?

A

emboli from left heart

D&T 3 Test 3 (7 decks)

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