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Pathology 2 > Urinary System > Flashcards

Urinary System Flashcards

0
Q

What normally surrounds a bovine kidney?

A

Peri-renal fat

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1
Q

What is a distinction of the feline kidney?

A

Distinct vascular pattern on the cortical surface just under the capsule.

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2
Q

What are 4 structures to examine histologically in the kidney?

A
  • Glomerulus
  • Proximal tubules
  • Distal tubules
  • Interstitium
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3
Q

The absence of development of a kidney is known as what?

A

Renal aplasia

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4
Q

What is the difference in the significance of unilateral and bilateral renal aplasia?

A

Unilateral is incidental and bilateral is fatal.

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5
Q

Is renal aplasia a rare or common developmental abnormality?

A

Rare

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6
Q

In what 3 species can you see renal aplasia?

What are 2 specific breeds?

A
  • Swine, dogs, cattle

- Doberman pinscher and Beagle

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7
Q

A quantitative defect caused by reduced mass of metanephric blastema is known as what?

A

Renal hypoplasia

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8
Q

With what condition is the affected kidney reduced in size with otherwise normal architecture?

A

Renal hypoplasia

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9
Q

A rare condition affecting the kidneys that is very difficult to diagnose grossly is what?

A

Renal dysplasia

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10
Q

An abnormal and asynchronous differentiation of renal tissue is what?

A

Renal dysplasia

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11
Q

What might severe bilateral dysplasia lead to?

A

Renal failure

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12
Q

What are 3 examples of congenital infections that can cause renal dysplasia?

A
  • Feline panleukopenia
  • ## Canine herpesvirus
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13
Q

A common congenital renal malformation found in pigs, calves and to a lesser extent other species is what?

A

Renal cysts

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14
Q

What is the significance of finding renal cysts?

A

Usually incidental

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15
Q

Grossly, kidneys containing numerous variably-sized cysts in both the cortex and the medulla are known as what?

A

Polycystic kidneys

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16
Q

Normal kidneys in an abnormal location are known as what?

Is this more often unilateral or bilateral?

A
  • Ectopic kidneys

- Unilateral

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17
Q

What are 2 species where you can see ectopic kidneys?

A
  • Dogs

- Pigs

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18
Q

Ectopic kidneys are predisposing factors for what 2 conditions?

A
  • Ureter obstruction

- Development of hydronephrosis

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19
Q

A congenital malformation that results from a fusion of the cranial or caudal poles of the kidneys is know as what?

A

Horseshoe kidney

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20
Q

Is a horseshoe kidney in a cat a significant or incidental finding?

A

Incidental

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21
Q

What is a common post-mortem finding that causes the kidneys to become soft and friable?

A

Autolysis

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22
Q

What is a pigment that stains the surface of the kidney black?

A

Pseudomelanosis

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23
Q

What are 4 examples of pigmentary disturbances?

A
  • Hemoglobinuria
  • Myoglobinuria
  • Lipofuscin
  • Bile
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24
Q

What are the gross features of hemoglobin in the kidneys?

A

Dark red to black kidneys

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25
Q

Severe intravascular hemolysis and hemoglobinuria can cause what type of pigmentation to occur in the kidneys?

A

Hemoglobin

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26
Q

What are 4 possible causes of hemoglobin in the kidneys?

A
  • Leptospirosis
  • Bacillary hemoglobinuria
  • Babesiosis
  • Chronic copper poisoning
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27
Q

Hemoglobinuria in sheep can be seen secondary to what?

A

Copper poisoning

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28
Q

Dark red to black kidneys and dark red urine are gross findings with what type of pigmentation?

A

Myoglobin

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29
Q

When does myoglobin pigmentation occur?

A

Occurs when high levels of myoglobin are filtered into tubules (myoglobinuria).

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30
Q

What are 2 examples of conditions where myoglobin pigmentation can be seen?

A
  • Rhabdomyolysis in capture myopathy in wild animals

- Equine paralytic myoglobinuria

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31
Q

What type of pigmentation is an incidental finding in old cattle?

A

Lipofucsinosis

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32
Q

How do the kidneys appear grossly with lipofucsinosis?

A

Dark brown to black

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33
Q

T/F: A bovine kidney with lipofucsinosis is enlarged.

A

False - The size is normal.

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34
Q

How does lipofucsinosis appear in the bovine heart?

A

The cardiac parenchyma is uniformly dark brown.

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35
Q

In obstructive jaundice or severe liver disease, the kidneys excrete conjugated bilirubin resulting in what?

A

Choluria

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36
Q

How do the kidneys appear grossly with bile pigmentation?

A

Yellow-green

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37
Q

What are 2 examples of other tissues where evidence of jaundice/icterus can be seen with bile pigmentation?

A
  • Mucous membranes

- Connective tissue

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38
Q

What are 3 examples of circulatory disturbances that can be seen with the kidneys?

A
  • Hyperemia and congestion
  • Hemorrhage
  • Ischemia
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39
Q

How do the kidneys appear grossly with hyperemia and congestion?

A

Bright or dark red

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40
Q

T/F: Hyperemia can be physiologic.

A

True

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41
Q

What is common as a result of prolonged prostration and circulatory failure?

A

Hypostatic congestion

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42
Q

What are commonly seen in kidneys as a result of vasculitis or vascular necrosis?

A

Hemorrhages

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43
Q

Renal hemorrhages can come in what 2 forms?

A
  • Petechial

- Ecchymotic

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44
Q

What has to usually be removed in order to see renal hemorrhages?

A

The renal capsule.

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45
Q

What are preferentially affected with renal hemorrhage?

A

Glomeruli

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46
Q

How do cortical hemorrhages appear grossly?

A

Speckled appearance

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47
Q

What are 4 examples of causes of renal hemorrhage?

A
  • Coagulopathies
  • Viral infections
  • Septicemia
  • Toxins
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48
Q

Extensive vascular injury or platelet consumption leading to disseminated intravascular coagulation (DIC) can cause what in the kidneys?

A

Renal petechia

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49
Q

What are 3 examples of acquired or congenital clotting defects that can cause renal petechia?

A
  • Sweet clover- coumarin poisoning
  • Vitamin K deficiency
  • Hemophilia A and B
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50
Q

What are 3 examples of viremia sources that can cause renal petechia and ecchymosis?

A
  • Hog cholera leading to endothelial damage.
  • African Swine Fever leading to platelet destruction.
  • Canine herpes virus in neonatal puppies.
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51
Q

What are 3 examples of bacteremias that can cause renal petechia?

A
  • Erysipelas
  • Streptococcal infections
  • Salmonellosis in pigs
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52
Q

If septicemia is suspected, tissues from what 3 organs should be sent for bacteriological examination?

A
  • Lung
  • Kidney
  • Liver
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53
Q

What are 3 examples of toxins that can cause renal petechia?

A
  • Oak toxicity
  • Endotoxins
  • Enterotoxins
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54
Q

What are 2 possible causes of renal ischemia?

A
  • Renal torsion

- Renal infarcts

55
Q

What are typically triangular in shape with the apex pointing towards the medulla?

A

Renal infarcts

56
Q

What are renal infarcts associated with?

A

Thrombosis of renal vessels (usually the interlobular artery).

57
Q

What does the size of a renal infarct depend on?

A

The size of the affected vessels.

58
Q

What color are renal infarcts in acute cases?

Why?

A
  • Red

- Hemorrhage

59
Q

What is a common cause of renal infarcts?

A

Valvular endocarditis

60
Q

What can prolonged ischemia lead to in the kidneys?

A

Infarction/coagulative necrosis

61
Q

How will the area affected by chronic renal infarcts heal?

A

By fibrosis.

62
Q

What causes retraction of the parenchyma and characteristic depression on the renal cortex of kidneys with healed renal infarcts?

A

Fibrosis

63
Q

Renal infarcts are most commonly seen with what condition in cattle and pigs?

A

Vegetative valvular endocarditis of the left heart.

64
Q

Renal infarcts are most commonly seen with what condition in cats?

A

Left atrial thrombosis associated with cardiomyopathy.

65
Q

Renal infarcts are most commonly seen with what condition in dogs?

A

Renal amyloidosis due to loss (through the urine) of plasma anticoagulants such as antithrombin III.

66
Q

Renal infarcts from endotoxin-mediated thrombosis can be due to what?
What is an example?

A
  • Gram-negative sepsis or endotoxic shock.

- Dogs with suppurative prostatitis.

67
Q

Heterogenous group of diseases due to deposition of amyloid in tissues is known as what?

A

Amyloidosis

68
Q

What is one of the most important targets of amyloidosis?

A

Kidneys

69
Q

What type of nephropathy is glomerular amyloidosis?

A

A protein-losing nephropathy.

70
Q

What are 2 types of amyloidosis?

A
  • Primary amyloidosis

- Secondary (reactive) amyloidosis

71
Q

Which type of amyloidosis is rare in domestic animals?

A

Primary amyloidosis

72
Q

Primary amyloidosis is due to the deposition of what?

What is this derived from?

A
  • Deposition of amyloid AL.

- Derived from Ig light chains produced by abnormal plasma cells.

73
Q

What is the most common form of amyloidosis seen in domestic animals?

A

Secondary (reactive) amyloidosis

74
Q

Secondary (reactive) amyloidosis is due to the deposition of what?
Where does it originate?

A
  • Deposition of amyloid AA

- Originates from serum alpha-globulin

75
Q

Secondary (reactive) amyloidosis is associated with what?

What are 3 examples?

A
  • Chronic antigenic stimulation

- Chronic inflammation, infection, neoplasia

76
Q

What is the gross appearance of kidneys with amyloidosis?

A

Enlarged, pale and have a finely granular surface.

77
Q

What would you stain fresh kidneys with to reveal many solid black dots which correspond to glomeruli filled with amyloid protein?

A

Iodine solution

78
Q

Do kidneys with amyloidosis have rough edges or rounded edges?

A

Rounded edges

79
Q

What are 2 ways the cortical surface of a kidney with amyloidosis may appear?

A
  • Smooth and pale

- Slightly granular

80
Q

How does the cut surface of a kidney with amyloidosis appear grossly?

A

Pale and waxy

81
Q

Deposition of pink amorphous material in glomeruli (most species) or in medullary interstitium (cats and cattle) are seen microscopically in what condition?

A

Renal amyloidosis

82
Q

Signs of renal amyloidosis can be seen in the medullary interstitium in what 2 species?

A
  • Cats

- Cattle

83
Q

What are 2 specific locations the pink homogenous relative acellular material known as amyloid is deposited?

A
  • Mesangial matrix

- Along the adjacent basement membrane

84
Q

What are 2 stains that can be used to microscopically confirm amyloidosis?

A
  • Congo red (polarized light)

- Thyoflavine-T (fluorescence)

85
Q

What are 2 species in which familial renal amyloidosis can occur?

A
  • Abyssinian cats

- Chinese Shar Pei dogs

86
Q

What type of amyloidosis is characterized by medullary deposits of amyloid, with fibrosis and papillary necrosis?

A

Familial renal amyloidosis

87
Q

Amyloidosis can lead to thrombosis of pulmonary arteries or renal veins due to hypercoagulable state caused by what 2 things?

A
  • Stimulation of production of acute-phase proteins such as fibrinogen.
  • Simultaneously losing (due to increased glomerular permeability) low-molecular weight anticoagulants, such as antithrombin III.
88
Q

An acute and severe ischemia of the renal cortex due to vasospasm of cortical vessels is known as what?

A

Bilateral renal cortical necrosis

89
Q

Bilateral renal cortical necrosis has been traditionally associated with what?

A

Endotoxemia

90
Q

What parts of the cortex may be involved with renal cortical necrosis?

A

All or part of the cortex.

91
Q

The renal cortex has a mosaic (patchy) appearance with intermixed areas of red and yellow discoloration can be seen with what condition?

A

Renal cortical necrosis

92
Q

What condition is caused by a localized ischemia of the renal medulla?

A

Renal medullary (papillary) necrosis

93
Q

What is a cause of medullary necrosis in cats?

A

Amyloidosis

94
Q

What are 4 possible causes of medullary necrosis?

A
  • Pyelonephritis
  • Diabetes mellitus
  • Urinary obstruction
  • Use of anti-inflammatory and analgesic drugs
95
Q

What are 3 examples of anti-inflammatory and analgesic drugs that may cause medullary necrosis?

A
  • Phenylbutazone
  • Phenacetin
  • Aspirin
96
Q

Acute necrosis of tubular cells is the primary process of what?

A

Nephrosis

97
Q

What type of renal tissue is highly susceptible to ischemia or to toxic damage?
Why?

A
  • Renal tubular epithelium (especially proximal tubules).

- It is metabolically very active.

98
Q

T/F: Grossly, acute tubular nephrosis is easy to diagnose.

A

False - It is difficult to diagnose.

99
Q

What is the gross appearance of kidneys with acute tubular nephrosis?

A

Kidneys are swollen, capsular surface is pale and moist and bulges on the cut surface.

100
Q

What are 4 differential diagnoses for diffusely pale kidneys?

A
  • Amyloidosis
  • Acute nephrosis
  • Glomerulonephritis
  • Lymphosarcoma
101
Q

Histologically, most cases of nephrosis are what with minimal to absent what?

A
  • Acute to per-acute

- Inflammatory cell infiltration

102
Q

Cases of what type of necrosis are characterized by fibrosis, tubular loss, architectural disorganization, regeneration and limited inflammatory response?

A

Chronic nephrosis

103
Q

Are most cases of nephrosis acute to per-acute or chronic?

A

Acute to per-acute

104
Q

Is there inflammatory cell infiltration seen with nephrosis?

A

Minimal to absent

105
Q

Cases of chronic nephrosis are characterized by what 5 factors?

A
  • Fibrosis
  • Tubular loss
  • Architectural disorganization
  • Regeneration
  • Limited inflammatory response
106
Q

Histologically, acute tubular nephrosis is characterized by what?

A

Swelling of the tubular epithelium

107
Q

How does the cytoplasm appear with acute tubular nephrosis?

The nucleus?

A
  • Vacuolated

- Pyknotic, karyolytic or karyorrhetic

108
Q

What are 3 features of the tubules in acute tubular nephrosis?

A
  • Hypocellular
  • Often dilated
  • Contain necrotic cellular debris and hyalinized casts
109
Q

If the basement membrane is intact with tubular necrosis, regeneration of the proximal convoluted tubules can be seen as early as when?

A

3 days after the toxic insult is removed.

110
Q

Nephrosis can be caused by the ingestion of what?

Some substances precipitate as what?

A
  • Exogenous substances

- Crystals in tubules

111
Q

What are 6 examples of heavy metals that can cause toxic nephrosis?

A
  • Mercury
  • Lead
  • Cadmium
  • Chromium
  • Copper
  • Phosphorus
112
Q

What are 2 examples of insecticides that can cause toxic nephrosis?

A
  • Carbon tetrachloride

- Chlorinated-hydrocarbon

113
Q

What are 2 examples of nephrotoxic plants?

A
  • Pigweed

- Oaks

114
Q

What can pigweed cause in pigs and cattle?

A

Tubular degeneration and peri-renal edema

115
Q

Oak poisoning can occur in what 2 species?

A
  • Cattle

- Horses

116
Q

Oak toxicity can cause what?

A

Acute tubular necrosis

117
Q

The proposed pathogenesis of what type of poisoning involves the binding of tannic acid to endothelial cells causing necrosis of the epithelium?

A

Oak poisoning

118
Q

What is embolic nephritis caused by?

A

Bacteremia

119
Q

What pattern is seen with embolic nephritis?

A

Multifocal suppurative glomerulitis

120
Q

With embolic nephritis, bacterial colonies are seen where?

A

In glomerular and interstitial capillaries.

121
Q

What may develop as a result of embolic nephritis?

A

Chronic renal micro-abscesses

122
Q

What are 2 heterogenous groups of diseases in which the main morphologic change takes place in the glomeruli?

A
  • Glomerulonephritis

- Glomerulopathies

123
Q

Glomerulonephritis is largely, but not exclusively, associated with what?

A

Immune-mediated injury

124
Q

What are the 2 main mechanisms of glomerulitis and glomerulonephritis related to immune-mediated processes?

A
  • Deposition of antigen-antibody (Ag/Ab) complexes

- Auto-antibodies directed against the GBM (anti-basement membrane disease)

125
Q

Persistent antigens in the blood result in deposition of antigen-antibody complexes where?
What are 3 examples of persistent antigens sources?

A
  • Glomerular basement membranes

- Viral, bacterial, parasitic

126
Q

Is anti-basement membrane disease common or rare in domestic animals?

A

Rare

127
Q

Are the gross lesions seen with acute glomerulonephritis subtle or obvious?
What are 2 examples of these changes?

A
  • Subtle

- Swollen and pale

128
Q

What is the gross appearance of chronic glomerulonephritis?

A

Kidneys are shrunken and granular.

129
Q

What are 3 morphologic types of glomerulonephritis?

A
  • Membranous glomerulonephritis
  • Proliferative glomerulonephritis
  • Membrano-proliferative glomerulonephritis
130
Q

Membranous glomerulonephritis is characterized by what?

A

Thickening of the basement membrane.

131
Q

Proliferative glomerulonephritis is characterized by what?

A

Increased cellularity

132
Q

Membrano-proliferative glomerulonephritis often lead to what?

A

Glomerular sclerosis

133
Q

Inflammatory infiltration in the interstitium affecting tubular functions such as impaired reabsorption, concentration and/or excretion can be seen with what?

A

Interstitial (tubulo-interstitial) nephritis

134
Q

What 2 types of distribution can be seen with interstitial nephritis?

A
  • Multifocal

- Diffuse

135
Q

How do kidneys appear grossly with the acute form of diffuse interstitial nephritis?

A

Kidneys swollen with a mottled appearance.

136
Q

Is multifocal interstitial nephritis considered a common or rare condition?
Is it an incidental or significant finding?

A
  • Common

- Incidental

Pathology 2 (10 decks)

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