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Systemic Pathology > Urinary Pathology > Flashcards

Urinary Pathology Flashcards

1
Q

What are mesangial cells?

A
  • phagocytose macromolecules and immune complexes
  • contract to autoregulate glomerular blood flow
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2
Q

What are examples of non-urinary lesions associated with renal failure?

A
  • gastric ulcers/uremic gastritis
  • ulcerative glossitis/stomatitis
  • mineralization of intercostal pleura - ‘uremic frosting’
  • uremic pneumonitis - pulm edema/mineralization
  • parathyroid hyperplasia
  • anemia
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3
Q

Why does parathyroid hyperplasia occur with renal failure?

A
  • phosphate retention –> decr ionized Ca++ –> PTH release
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4
Q

Describe polycystic kidney disease in cats

A
  • autosomal dominant, defect of PKD1 gene
  • Persians predisposed
  • can dx @ 10 mo via U/S
  • cysts can arise from any segment of nephron
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5
Q

Describe polycystic kideny disease in other species

A
  • congenital PKD w/ an unknown inheritance can occur in all domestic mammals
  • animals are typically stillborn or die of renal failure in first few weeks of life
  • enlarged kidneys w/ numerous 1-5 mm diameter cysts
  • can have concurrent biliary and/or panc cysts
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6
Q

Describe papillary necrosis

A
  • common in horses (esp in dehydrated horses treated w/ bute)
  • NSAIDs inhibit COX–>decr PGE2 production
    • PGE2 maintains vasodilation in arterioles, loss of this –> ischemia and subsequent necrosis
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7
Q

Describe hydronephrosis/hydroureter

A

Hydronephrosis- dilation of renal pelvis/calyces

Hydroureter - dilation of ureters

  • typically occurs secondary to obstruction
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8
Q

What is glomerulonephritis?

A
  • alteration of structure of glomerulus involving one or more of the following: basement membranes, mesangial matrix, mesangial cells, immune complex deposition
  • end result: alter the filtration barrier–> protein loss, decr GFR –> renal failure
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9
Q

Characterization of glomerulonephritis is dependent on what?

A
  • which parts of the glomerulus are affected
  • whether there is immune complex deposition
  • where immune complexes are deposited
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10
Q

What is the pathogenesis of immune complex glomerulonephritis?

A
  • circulating immune complexes deposited in/adjacent to glomerular b.m. or antibodies formed against the glomerular b.m.
    • immune complexes may be deposited subendothelially, in the b.m. or subepithelially
  • complement fixation, leukocytic infiltration and production of inflammatory mediators by mesangial cells may contribute glomerular injury
  • filtration barrier becomes compromised –> protein loss
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11
Q

What are some conditions commonly associated with immune complex glomerulonephritis?

A
  • viral dz
  • chronic bacterial infections
  • parasitic and protozoal dz
  • autoimmune dz
  • neoplasms
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12
Q

What might you see histologically with glomerulonephritis?

A
  • thickened basement membranes
  • increased #s of mesangial cells
  • synechiae - adhesions b/t the glomerular tuft and the capsule
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13
Q

What are the clinical features of acute renal failure?

A
  • good body condition
  • smooth, enlarged kidneys (+/- painful)
  • PCV normal to incr
  • K+ normal to incr
  • more severe metabolic acidosis
  • relatively severe clinical signs relative to bloodwork
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14
Q

What are the clinical features of chronic renal failure?

A
  • poor body condition
  • small irregular kidneys
  • nonregenerative anemia
  • K+ normal to decr
  • less severe metabolic acidosis
  • relatively mild clinical signs relative to bw
  • longstanding PU/PD
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15
Q

What is the clinicopathologic finding the most suggestive of glomerular disease?

A

proteinuria in the absence of hemorrhage or inflammation

*most sensitive way to measure is the urine protein to urine creatinine ratio

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16
Q

Describe glomerular amyloidosis

A
  • often reactive systemic amyloidosis
  • assoc w/ chronic inflammation
  • common in Shar Peis and Abyssinian cats
  • extensive glomerular amyloid deposition leads to compromise of the filtration barrier and proteinuria
    • ​develop progressive renal insufficiency and proteinuria
17
Q

Describe embolic nephritis

A
  • bacteria lodge mainly in glomerular and peritubular capillaries
    • Horses: Actinobacillus equuli
    • Pigs: Erysipelothrix rhusiopathiae
    • Cattle: Trueperella pyogenes
18
Q

What might you see histologically with tubular degeneration?

A

vacuolation of epithelial cells

19
Q

Waht might you see histologically with tubular necrosis?

A
  • loss of cellular detail
  • nuclear karyorrhexis, karyolysis, pyknosis
  • incr cytoplasmic eosinophilia
  • sloughing of epithelial cells
20
Q

What might you see histologically with tubular regeneration?

A
  • increased cytoplasmic basophilia
  • piling/crowding of epithelial cells
  • nuclei with an open chromatin pattern and prominent nucleoli
  • mitotic figures
21
Q

Describe acute tubular (ischemic) injury

A

Due to hypotension; mild - degeneration/necrosis of primarily tubules; prolonged ischemia- renal cortical necrosis, affects all cortical structures; disruption of b.m can occur —> no scaffolding for tubular epithelial regeneration

22
Q

Describe acute tubular toxic injury

A

Histologic lesions: extensive necrosis of predominantly proximal tubules, distal tubules sometimes; b.m may be preserved (scaffolding)

23
Q

List some examples of nephrotoxic substances

A

Animal venom, antimicrobials, chemo, cantharadin, contrast media, ethylene glycol, heavy metals, plants, mycotoxins

24
Q

Describe oxalate necrosis

A

Can be d/t ethylene glycol or oxalate containing plants (ie halogeton, greasewood, rhubarb, sorrel)

25
Q

Describe ethylene glycol toxicosis

A

Major component of antifreeze; fluorescein dye added to it to help detect a radiator leak - urine of animals with acute toxicosis might fluoresce w/ black light; calcium oxalate crystals precipitate in renal tubules and cause tubular necrosis

26
Q

What is pigment nephrosis?

A

Myoglobin and hemoglobin can cause tubular injury - myoglobin from mm damage and hemoglobin from hemolytic anemias; cannot distinguish Hb and Mb casts in kidney on light microscopy

27
Q

Describe interstitial (tubulointerstitial) nephritis

A

acute cases - edema, leukocyte infiltration, focal tubular necrosis; chronic cases - leukocytic (usually lymphoplasmacytic) infiltrate, interstitial fibrosis, tubular atrophy

28
Q

What causes “white-spotted kidney” disease in calves?

A

Thought to be due to a prior bacteremia, usually E. Coli; nonsuppurative interstitial nephritis w/ fibrosis

29
Q

Describe the pathogenesis of leptospirosis

A

Caused by serovars of L. Interrogans, contact w/ infected fluid (often urine), bacteria can enter via mucous membranes or wet skin —> abortion, stillbirth, hepatitis, nephritis, meningitis, septicemia; renal failure most common in dogs, pigs - extensive interstitial nephritis (not renal failure); histo: tubular degeneration/necrosis, interstitial/tubulointerstitial nephritis

30
Q

Describe canid herpesvirus 1

A
  • often fatal for newborn puppies, can also cause abortion and stillbirth
  • puppies generally need to be exposed before 2 wks of age - die within 2d of showing signs
  • C/S: anorexia, vomiting, abd pain
  • Gross lesions: foci of hemorrhage and necrosis in mult. organs, esp kidney
31
Q

Describe pyelonephritis

A
  • inflammation of the renal pelvis and parenchyma
  • usually results from ascending infection from lower urinary tract, so patients typically have concurrent ureteritis and cystitis
  • vesiculouerteral reflux - retrograde flow up ureters during micrturition
32
Q

What are two parasites involved in renal disease?

A
  • Stephanurus dentatus - kidney worm in swine that encyst in perirenal tissue
    • these cysts communicate w/ the renal pelvis to allow for passage of eggs
  • Dioctophyma renale - giant kidney worm, usually in piscovorous mammals (mink, dogs, cats); adults live in renal pelvis and are very destructive
    • cause progressive destruction of renal parenchyma
33
Q

What are examples of renal neoplasms?

A
  • Adenomas: benign tumors of tubular epithelium
  • Adenocarcinomas: most common primary renal tumors in horses, cattle and dogs; usually well-demarcated, compress remaining renal parenchyma, located at one pole
  • Nephroblastomas: most common primary renal tumor of pigs and chickens, usually occurs in young animals
    • Histo: primitive glomeruli, tubules and mesenchyme, may contain cartilage, bone or fat
  • Metastatic lymphoma very common
34
Q

What are a few examples of congenital urinary tract abnormalities?

A
  • Ectopic ureters - ureters can empty into bladder neck, urethra, vagina, vas deferens or seminal vesicles; may be uni- or bilateral; certain predisposed breed
  • Patent urachus - failure of closure of the urachal lumen results in dribbling of urine from the urachus; most common in foals
35
Q

Describe urolithiasis

A
  • calculi in urinary passages, may be located from renal pelvis to urethra
  • calculogenic substances must be present in sufficient concentration
  • predisposing factors:
    • urine pH (precipitation)
    • water intake
    • hereditary factors (dalmatians)
    • dietary factors
    • UTIs
    • male sex
36
Q

Describe bacterial cystitis

A
  • bacteria from ascending infection from urethra, almost always rectal flora
  • predisposing factors:
    • female
    • loss of normal voiding mechanisms
    • loss of acidic urine pH (carnivores)
    • glucosuria
    • proteinuria
    • mucosal trauma
37
Q

What is emphysematous cystitis?

A
  • seen rarely in diabetic animals d/t bacterial fermentation of urinary glucose into carbon dioxide; E. coli most common
38
Q

What are some neoplasms of the lower urinary tract?

A

Papilloma - covered by well-differentiated transitional epithelium, May undergo malignant transformation to TCC in dogs; transitional (urothelial) cell carcinoma - most often in bladder neck or trigone, 50% met.; botyroid rhabdomyocsarcoma - young (usually <18 mo) large or giant breed dogs

Systemic Pathology (8 decks)

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