Robbins Ch. 20 - The Kidney III Flashcards
affect on calyces
only chronic PN and analgesic nephropathy
xanthogranulomatous pyelonephritis
accumulation of foamy macrophages
-proteus infection (weil felix)
drug-induced interstitial nephritis
fever, eosinophilia, rash
-PCN, MCN, rifampin, thiazides, NSAIDs
prep for colonoscopy
acute phosphate nephropathy
-precipitate of calcium P
bence jones
myeloma kidney
-pink blue cast
tophus
mononuclear response with giant cells
-chronic urate nephropathy
medial/intimal thickening, hyalinzation of artery walls
nephrosclerosis
granular kidney, shrinkage
elderly, blacks, DM - increased
malignant nephrosclerosis
BP > 200/120
papilledema, retinal hemorrhage, confusion
hyperplastic ateriosclerosis (onion skinning)
elevated renin levels
renal artery stenosis
curable with surgery
-70% caused by atheromatous plaque
- increased renin - leads to ischemic kidney
- causes HTN
-also - fibromuscular dysplasia (string of beads)
string of beads
fibromuscular dysplasia
bruit on kidney, renin, response to ACE (-)
renal artery stenosis
Tx - 70-80% cured with surgery
E. coli 0157/H7
typical HUS
mutation in factor H
atypical HUS
also factor I and CD46
Tx typical HUS
dialysis - recover in weeks
antiphospholipid syndrome
atypical HUS
also pregnancy, systemic sclerosis, chemo, radiation
ADAMTS13
TTP
-inhibitory autoantibodies
Tx for TTP
plasmapharesis
subendo deposits of fibrion and mesangiolysis
TTP
reduced NO and prostaglandins
prothrombotic
-in TTP/HUS
generalized ischemia to kidney
diffuse cortical necrosis
- during obstetric emergency
- coagulative necrosis of glomeruli and tubules
mural thrombi embolizes
renal infarct - 25% CO
-white infarct- wedege shaped
sickle cell nephropathy
hematuria/hyposthenuria (can’t concentrate urine)
if biopsy kidney or do nephrectomy?
check for U/L kidney
hypoplasia
more commonly U/L
ectopic kidney
typically in pelvis