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CPR > Test 6 - pathology > Flashcards

Test 6 - pathology Flashcards

1
Q

What is this?

A

Dog Kidney

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2
Q

How can you distinguish the renal cortex from the renal medulla?

A

cortex:

contains glomeruli, PCT, and DCTs

medulla:

only contains tubules

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3
Q

Is this in the cortex or the medulla?

A

Cortex. Notice the glomeruli and the tubules

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4
Q

Is this in the cortex or the medulla?

A

Medula. Notice there are ONLY tubules

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5
Q

What are we looking at? (I know, it’s a bad pic)

A
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6
Q

What are you looking at? Name the arrows? Is this normal or diseased?

A

normal glomerulus

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7
Q

What is the difference between PCT cells and DCT cells?

A

PCT: larger with microvilli

DCT: smaller w/o microvilli

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8
Q

Name it

A
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9
Q

Name it

A

Artery

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10
Q

What are the 3 categories of renal failure? Once has 4 sub-categories, what are they?

A

NOTE: pathologists lump tubular and interstitial diseases into one category

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11
Q

What is tubulointerstitial nephritis?

A

Inflammation of the tubules and interstitium

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12
Q

What is ischemic or toxic tubular injury?

A

it is acute tubular injury

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13
Q

Is this fluoroscopic voiding cystourethrogram (VCUG) image of a 2 year old boy normal?

A

NO! this shows hydronephrosis indicating vesiculouretal reflux

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14
Q

What is acute pyelonephritis? What usually causes it?

A

inflammation of the renal pelvis, calyces, and kidney tissue

bacterial infection

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15
Q

Is pyelonephritis typically an ascending (urethra up) or descending (hematogenous) infection?

A

ascending infection

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16
Q

What is wrong with it? (this is one kidney cut in half and opened like a book, but we are seeing the capsular portion)

A

This is a fixed kidney demonstrating acute pyelonephritis

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17
Q

What in God’s name is going on here?

A

The inside of a kidney demonstrating acute pyelonephritis

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18
Q

What is going on here?

A
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19
Q

What do you see? diagnosis?

A

Bunch of neutrophils hanginging out

pyelonephritis

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20
Q

What is the most common cause of tubulointerstitial nephritis

A

acute pyelonephritis

21
Q

Acute pyeolonephritis can lead to chronic pyelonephritis. What are some of the problems that can occur?

A

scarring and fibrosis

tubular atrophy and “thyroidization”

leads to hypertension (RBF is 20% of CO)

leads to chronic renal failure

22
Q

Normal kidney on the left. What is wrong with the left?

A

Scars. Could be from pyelonephritis, infarct, etc. Need biopsy

23
Q

What is going in these tubules?

A

thyroidization because it looks like thyroid tissue

see picture to see why it is called thryoidization

24
Q

What is interstitial nephritis?

A

inflammation that is not caused by bacteria (otherwise we would call it acute pyelonephritis)

25
Q

Name the major cause of interstitial nephritis

A

drug induced: penicillin, NSAIDS, sulfonamides

26
Q

This a pathological slide of interstitial nephritis. Is this caused by drugs? (look at the slide)

A

NO! If it were drug indiced eosinophils would be present

27
Q

What are some common clinical features of allergic, hypersensitivity interstitial nephritis (caused by drugs), or commonly referred to as acute interstitial nephritis (AIN)?

A

fever, rash, oliguria

eosinophilia

eosinophiluria

28
Q

what do you see? diagnosis?

A
29
Q

What are the most common causes of acute tubular necrosis?

A

ischemia (pre-renal)

toxic: aminoglycosides, radiocontrast dyes, heavy metals

30
Q

What are the pathological findings of ATN (name 6)?

A

Dilation of tubules (reversible)

loss of brush border (reversible)

blebbing of membrane (reversible)

sloughing of cells (irreversible)

accumulation of necrotic debris (irreversible)

inflammation

31
Q

What’s going on with the right? (left is normal)

A

ATN

32
Q

What is going on with the arrow?

A

necrosis of the PCT

33
Q

What is going on?

A
34
Q

What is going on inside this lumen? diagnosis?

A

Necrotic debris (ATN)

35
Q

This is the progression of a disease. Name the disease and what is going on in each slide

A
36
Q

What is going on? (normal on the left)

A

This is arteriolosclerosis (hyaline depositon) causing chronic hypertension

37
Q

What is up with this?

A

arteriolosclerosis (hylane deposition)

Note: the fibrointimal thickening is due to the hyaline

38
Q

Do it

A

arteriolosclerosis (hyaline thickening)

39
Q

What is malignant hypertension?

A

Severe hypertension (>180/>120) with acute impairment of one or more organ systems (especially the CNS, CVS, and renal system) that can result in irreversible organ damage

40
Q

What is thrombotic microangiopathy?

A

Occurs in malignant hypertension –> hyperplasia of smooth muscle in arteries occurs which thickens the media and decreases the diameter of the lumen. Eventually, the lumen becomes so small that RBCs that try to pass through become damage and clog the lumen

41
Q

What is this?

A

Thrombotic microangiography

42
Q

What are the 3 types of cystic kidney diseases (that we need to know)

A

Autosomal Dominant Polycystic Kidney Disease (ADPKD)

Autosomal Recessive Polycystic Kidney Disease (ARPKD)

Acquired Cystic Disease

43
Q

What is the gene(s) in ADPKD? What does is cause? What disease are associated with it? Does is present in adults or infants?

A

PKD1 and PKD2

Result is giant, cystic kidneys

Associated with polycystic liver disease and berry aneurysms

adults

44
Q

What is going on here?

A
45
Q

What gene(s) is mutated in ARPKD? Does is present in adults or infants/neonates? What does it cause? What other diseases is it associated with?

A

Mutations in the fibrocystin PKHD1 gene.

Neonates and infants

Enlarged kidneys, small, radially oriented cysts

Associated with LUNG HYPOPLASIA, death, and CONGENITAL HEPATIC FIBROSIS needing transplant.

46
Q

What is this?

A

ARPKD

47
Q

What is acquired cystic disease? What type of cancer can develop from this?

A

cystic kidney disease that is brought on with end stage renal disease on prolonged dialysis

renal cell carcinoma

48
Q

What is this?

A

Acquired cystic disease

CPR (27 decks)

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