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Nephrology > Renal Vascular Diseases > Flashcards

Renal Vascular Diseases Flashcards

1
Q

Nephrosclerosis is assoc. w/ what existing medical conditions?

A

HTN, DM

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2
Q

describe the gross pathologic characteristics of nephrosclerosis.

A

cortical surface w/ fine, even granularity

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3
Q

Describe the pathogenesis of nephrosclerosis.

A

focal ischemia induced by medial & intimal thickening and deposition of hyaline: narrows blood vessels and causes sclerosis

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4
Q

describe the renal pathogenesis of malignant HTN?

A

increased permeability of small vessels to fibrinogen and plasma proteins causes damage to vascular endothelium, platelet deposition, & focal necrosis of vascular wall tissue

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5
Q

Describe the histologic characteristics of malignant HTN.

A

hyperplastic arteriosclerosis: onion skin-like laminations of hypertrophied smooth muscle; fibrinoid necrosis

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6
Q

describe the pathogenesis of Hemolytic uremic syndrome.

A

Typical:
E. coli O157:H7: produces a shiga-like toxin causes endothelial injury and hemolytic anemia

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7
Q

What is the model 1 theory for the pathogenesis of HUS?

A

shiga-like toxin activates endothelial cells to increase expression of leukocyte adhesion molecules and decrease production of NO

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8
Q

what is the model 2 theory for the pathogenesis of HUS?

A

Shiga-like toxin binds directly to platelets or inhibition of complement protein Factor H causing hyperactivity of complement

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9
Q

Describe the pathogenesis of atypical HUS.

A

mutations of complement proteins or abs against complement proteins which leads to hyperactivity of complement; half of pts. have an H factor deficient; complement 1 & CD46 mutations

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10
Q

What role does factor H play in complement regulation?

A

breaks down alternative pathway C3 convertase to protect cells from complement damage

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11
Q

Describe the pathogenesis of thrombotic ,thrombocytopenic purpura/

A

Inactivating Abs against ADAMTS13 – plasma metalloprotease which regulates function of von Willebrand factor
More common in women, esp. < 40 yrs

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12
Q

describe the histologic and gross characteristics of thrombic microangiopathy.

A

Diffuse cortical necrosis:
Pale ischemic necrotic areas confined to cortex and columns of Bertini (conical projections of renal pelvis into renal medulla between the renal pyramids)

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13
Q

describe the pathogenesis of renal stenosis.

A

caused by increased renin production due to renal ischemia; common causes include atheromatous plaques, fibromuscular dysplasia (more common in young women, atrophied kidney

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14
Q

What is the main contributor of renal infarcts?

A

mural thrombosis of LA & LV

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15
Q

describe the gross characteristics of renal infarct.

A

pale, yellow, white areas containsing small foci of hemrrotic discoloration

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16
Q

what is atherosclerotic ischemic renal disease?

A

bilateral renal artery disease of chronic ischemia & renal insufficiently

17
Q

what is atheroembolic renal disease?

A

typically secondary embolic disease to atherosclerosis in older individuals; assoc. w/ post-surgery complications

18
Q

describe sickle cell nephropathy.

A

hematuria due to decreased concentrating ability: hypertonic hypoxic renal medulla and papillary necrosis

19
Q

granulomatosis w/ polyangiitis induced vasculitis presents in which regions of the body?

A

renal vessels, URI, lungs; granulomas and necrosis also present

20
Q

List the clinical presentations of GPA?

A

Perforation of nasal septum/ulcer
Recurrent sinusitis
Hemoptysis
Pulmonary infarction
Pneumonia
Pauci-immune crescentic GN
Saddle nose deformity

21
Q

what Ab test would you order for suspected GPA?

A

c-ANCA/PR3-ANCA (GPA), MPO-ANCA/p-ANCA (microscopic polyangitis)

22
Q

List the clinical presentations of Chronic Renal Failure.

A

Nonspecific complains:
Anemia
Loss of appetite/Anorexia
Vomiting
Malaise
Proteinuira
HTN
Azotemia
Edema

23
Q

describe the gross characteristics of chronic renal failure.

A

Symmetrically SHRUNKEN kidneys
Diffusely granular, cortical surfaces
Cortex is thinned

24
Q

describe the histologic characteristics of chronic renal failure.

A

Diffusely and globally sclerosed glomeruli
Tubular atrophy
Interstitial fibrosis
Lymphocytic infiltrate
Arterial and arteriolar sclerosis

25
Q
A

Nephrology (11 decks)

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