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Pathology > Urinary 1-3 Review, Start of Dz of Kidney > Flashcards

Urinary 1-3 Review, Start of Dz of Kidney Flashcards

1
Q

What are the 2/5 developmental anomalies he mentioned that he stressed about?

A

Renal dysplasia and Polycystic Kidney

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2
Q

Basenji Dog Fanconi Syndrome

Whats happening here?

A

Abnormal brush border membrane structure of the Proximal tubular epithelium

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3
Q

What does Fanconi Syndrome cause clinically?

A

Glucosuria
proteinuria
metabolic acidosis
endocrine disorder

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4
Q

Most important cause of acute renal failure?

A

acute tubular necrosis

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5
Q

CS of Acute Tubule Necrosis?

A

Oliguria/anuria with

severe azotemia

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6
Q

Causes of acute tubule necrosis-main one

A

Ischemic or nephrotoxic injury

also heavy metal, drugs, toxins, etc

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7
Q

Causes of death from Renal Failure

A

Metabolic acidosis
Pulmonary edema
hypERkalemia

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8
Q

Clinical indicators of renal failure

A 
Urine quantity-poly
urine quality-isos
Proteinuria
azotemia
uremic syndrome
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9
Q

Why do you have polyuria in renal failure?

A

failure of resorption of Na and water by the tubules

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10
Q

When does isosthenuria occur in renal failure?

A

Loss of renal fxn, failure to concentrate

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11
Q

Uremia can cause systemic lesions, by what 2 mechanisms?

A

Endothelial injury: vasculitis, thrombosis, infarction

Caustic injury to epithelium of mucosal surfaces due to production of large amounts of NH3 by urea-splitting bacteria

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12
Q

Bacteria which might cause tubular necrosis?

A 
LESS-P
Lepto
E. Coli
Staph
Strep
Proteus
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13
Q

Tubular necrosis results in further renal injury by what 2 mechanisms?

A

Leakage of tubular filtrate into renal interstitium

Intratubular obstruction-resulting from sloughed necrotic epithelium (casts)

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14
Q

3 major causes for intrarenal falure

A

Acute tubular necrosis

Acute
Glomerulonephritis

Acute Pyelonephritis

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15
Q

What is acute pyelonephritis caused by?

A

Ascending bacterial infxn from teh urethra, ureters, and renal pelvis

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16
Q

What are the 3 main reasons of postrenal failure

A

Urolithiasis
Tumors
Iatrogenic

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17
Q

Post renal obstructions can lead to what 2 conditions?

A

Hydroureter

Hydronephrosis

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18
Q

What is a hematological result of CRF

A

Non-regenerative anemia

reduced EPO production

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19
Q

What is a biochemical result of CRF?

A

Altered Ca-P metabolism.
↓ GFR → ~HypERphosphatemia~ → Ca precipitation → ~Hypocalcemia~ → ~stim of Parathyroid Hormone secretion~ → ~Ca mobilization by osteoclastic bone resorption~ → reduced bone mineral density ~(Osteopenia)~ known as ~Renal 2° Hyperparathyroidism~ & Chronic Hyperparathyroidism → ~Fibrous Osteodystrophy~

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20
Q

Renal 2ndary hyperparathyroidism:
Which ions does it affect

Hows is the gland affected?

A

Hyperphosphatemia
Hypocalcemia

Bilateral hyperplasia

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21
Q

4 portals of entry into the kidney?

A

Ascending from ureter
Hematogenous
Glomerular filtrate
Direct penetration

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22
Q

In an ascending entry from ureter, what usually gets into the kidney via this route?

A

Infections.

Suppurative pyelonephritis

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23
Q

In hematogenous route, what gets into the kidney via this route?

A

Bacteremia–embolization and nephritis.

Metastesis

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24
Q

Glomerular filtrate-what stuff gets into the kidney via this route?

A

Substances secreted into the filtrate can be bad-toxins, drug metabolits (NSAIDs, chemo, aminos)

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25
Q

What is the most important barrier in defense mechanisms of the kidney?

A

GBM

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26
Q

How does the GMB protect the nephron?

A

Filters out most circulating bacteria and inflammatory cells

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27
Q

How does the mesangium protect glomerulus?

A

They are a component of the monocyte-macrophage system, which can remove macromolecules from teh ciruclation by phagocytosis

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28
Q

What is those most harmful thing to the tubular basement membrane?

A

Ischemia-it usually destroys the TBM.

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29
Q

What are the 2 defense mechanisms of the renal interstitium?

A

Humoral Ab

Macrophages, lymphocytes, and plasma cells

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30
Q

What are the 2 ways the vasculature can act as a defense mechanism for the kidney?

A

Intact endothelial lining is a defensive barrier against blood borne paths

Also prevents activation of clotting cascade which reduces thrombus formation

31
Q

2 examples glom injury due to hyperfiltration

A

Prolonged systemic hypertension

increase in dietary protein

32
Q

Chronic proteinuria can lead to what?

A

Glom Injury

33
Q

Glom injury also causes damage in what ways?

A

Interferes with the peritubular blood supply resulting in hypoxia with tubular atrophy and loss of fxn

34
Q

What is nephrotic syndrome?

A

Glom damage can cause severe proteinuria leading to hypOproteinemia w/reduced plasma oncotic pressure resulting in ascites, plural effusion and generalized edema

35
Q

Nephrotic syndrom is a result of___?

36
Q

What is a clinical sign of prolonged proteinuria?

A

weight loss

37
Q

What are some acute responses to injury of the glom? 4

A

Mesangial hypertrophy and hyperplasia

Increased vascular permeability

Infiltration of leukocytes

necrosis

38
Q

What are some chronic responses to injury of the glom? 3

A

Atrophy
Fibrosis (glomsclerosis)
Renal tubules will become secondarily atrophic due to loss of blood supply from efferent glom arteriole

39
Q

Glomerulosclerosis is what? Resulting from what?

A

Fibrosis which results from Chronic Glom Dmg

40
Q

What are some abnormal glom filtrates that can cause tubular dmg? 2

A

Inc protein

Inc crystalline salts/organic acids

41
Q

4 ways tubular responds to damage

A

Atrophy
Degeneration
regeneration
necrosis

42
Q

What is nephrotoxin associate ischemia?

A

Nephrotoxins indirectly stimulate vasoconstriction of the intertubular capillaries causing ischemia

43
Q

Nephrotoxins cause dmg by what 3 mechanisms?

A
  1. Direct damage to epithelium
    2 produce reactive metabolites that dmg the epithelium via oxidative injury
  2. indirectly stimulate vasoconstriction of the intertubular capillaries causing ischemia
44
Q

What is nephrosis?

A

A form of acute tubular necrosis that is NOOOOTTT caused by inflammation

45
Q

What causes nephrosis?

A

Hypoxic injury combined with nephrotoxic injury

46
Q

What can exacerbate the hypoxic injury in nephrosis?

A

Hemoglobinuria during a hemolytic crisis

47
Q

What part of the nephron is more sensitive to hypoxia due to higher metabolism demands?

48
Q

What part of the nephron is resistant to ischemia and often remains morphologically normal in necrosis?

49
Q

Multinodular lymphocytic rx to chronic or recurrent inflammation is called?

What is this a common rxn to?

A

Lymphofollicular inflammation

Lepto

50
Q

What are some infectious causes in interstitial nephritis?

A

Ehrlichiosis

Lepto

EIA

51
Q

How does hypercoag happen w/dz of the urinary tract?

A

Glom damage–PLN—loss of antithrombin III–hypercoag

52
Q

What is the specific form or renal dysplasia called? It occurs with variable severity and degrees of renal failure.

A

Juvenile Progressive Nephropathy

53
Q

What dog breeds is Juvenile Progressive Nephropathy common in?

A

Lhasa Apsos, Shih tzu, and Golden Retriever

54
Q

What species is an ectopic kidney common in?

A

Pigs and Dogs

55
Q

Fused kidney is also called? is it functional?

A

Horseshoe Kidney

Yes, 1 large kidney and 2 ureters

56
Q

How does a renal cyst look?

A

Spherical, thin-walled, distended tubules filled with clear watery fluid

57
Q

How do renal cysts occur?

A

Result from tubular obstruction or dysplasia

58
Q

Renal cysts are common in what spp?

A

Pigs and Cattle

59
Q

Define Polycysitc kidneys

A

many renal cysts affecting NUMEROUS nephrons

60
Q

Who is prone to polycystic kidney Dz?

How do they get it

A

Persian cats

Bull Terriers

Autosomal dominant trait

61
Q

Pathogenesis of polycystic kidney dz, is it dangerous?

A

Mutations in 1 or more genes, resulting in abnormal tubulogenesis.

Can be dangerous depending on the severity

62
Q

How is Proliferative Glomerulonephritis characterized?

A

Increased cellularity of the glom tufts caused by proliferation of glom endothelial, epithelial, and mesangial cells and an influx of leukocytes.

63
Q

What spp is Proliferative Glomnephritis common in?

64
Q

What is glomerulosclerosis associated with?

A

High blood pressure

Unrestricted protein in diet

65
Q

How does the glom look in result of glomerulosclerosis?

A

Shrunken, hyalinized and sclerotic with fibrous CT. This reduces tubular blood flow causing secondary tubular degeneration and atrophy

66
Q

What are the most common site of renal deposition of amyloid? I

A

Glom

Abyssinians predominantly have medullary interstitial deposition

67
Q

What breeds are predisposed to reactive amyloidosis

A

Abyssinian cats

Chinese shar-pei

68
Q

What is a common cause of PLN

A

amyloidosis

69
Q

What does glom amyloidosis look like grossly?

A

Kidneys are enlarged, pale and have a WAXY smooth to fine granular capsular surface

70
Q

What does glom amyloidosis look like microscopically?

A

Deposition of amyloid protein w/in the glom tufts

71
Q

What stain do you use to see amyloidosis microscopically?

A

Congo Red Stain

72
Q

What dz causes multiple, RANDOMLY DISTRIBUTED FOCI of suppurtative inflammation

A

Acute Suppurative Glonerulitis

73
Q

Whats another name for acute suppurative glomerulitis?

A

Bacterial embolic nephritis

Pathology (20 decks)

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