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SYSTEMIC PATHOLOGY 3 > Urinary System III > Flashcards

Urinary System III Flashcards

1
Q

What are the anomalies of development with the kidney?

A
  • Renal aplasia
  • Renal hypoplasia
  • Ectopic kidney
  • Renal fusion
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2
Q

Renal aplasia

A
  • Unilateral or bilateral
    • you can live with half a kidney
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3
Q

Renal hypoplasia

A
  • Decreased renal mass
    o Stimulates the other kidney to undergo compensatory hypertrophy
  • Should NOT have evidence of scarring
    o Often pitted kidneys in young animals is misdiagnosed as hypoplastic, even though it probably represented progressive juvenile nephropathy or dysplasia
  • If both hypoplastic=can have renal failure
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4
Q

Ectopic kidney

A
  • Kidney within subcutaneous tissue
  • *between the stomach and liver
  • Rare in domestic animals
  • Usually renal function is normal
    o But at higher risk for renal failure
  • *if ureter gets kinked can lead to HYDRONEPHROSIS
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5
Q

Renal fusion

A
  • Happens embryologically
  • Renal function is normal
  • “horseshoe kidney”
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6
Q

Renal dysplasia

A
  • Disorganized development of renal parenchyma due to anomalous differentiation
  • Congenital
  • YOUNG ANIMALS present with renal failure
  • Unknown cause (viral, random hereditary abnormality
  • *made histologically NOT grossly
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7
Q

3 causes of dysplasia in/of any organ?

A
  • Hereditary
  • Viral infections
  • Idiopathic
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8
Q

What does renal dysplasia look like grossly?

A
  • Small
  • Misshapen
  • *can look exactly the same as end stage kidney
    o Important DDx in a YOUNG dog with renal failure
  • **diagnosis it histologically
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9
Q

Progressive juvenile nephropathy

A
  • YOUNG DOG DISEASE (as young as 4 months)
  • Runs in families of dogs and in specific dog breeds
  • Hereditary
  • *chronic progressive renal disease leading to severe bilateral renal fibrosis
  • Grossly looks the same as renal dysplasia
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10
Q

What are the specific breeds of dogs have progressive juvenile nephropathy?

A
  • Samoyeds
  • Shih Tzu
  • Bull terriers
  • Minatare schnauzer
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11
Q

Renal cysts

A
  • Dilated nephron structure filled with water fluid
    1. Acquired: secondary to fibrosis
    1. Congenital: a few is ‘normal’
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12
Q

Renal cysts secondary to fibrosis

A
  • Fibrosis squeeze renal tubules=leads to obstruction and causing a backflow of urine causing cysts
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13
Q

Polycystic kidney disease

A
  • Many cysts in a kidney with young animals (in liver and pancreas as well)
  • Inherited as an autosomal dominant trait in:
    o Families of Persia cats
    o Bull terrier
  • Happens in many species
  • *can lead to renal failure
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14
Q

Renal congestion

A
  • Difficult to recognize grossly b/c of colour of kidney
  • Ex. R. sided heart failure
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15
Q

What are some examples of what causes renal hemorrhage?

A
  • DIC
  • Bacterial septicemia
    o Receives lots of blood=excellent place to culture (spleen and liver as well)
  • Viral disease
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16
Q

What is a young puppy that died acutely with ecchymotic renal hemorrhages characteristic of?

A
  • Canine herpesvirus-1 infection
    o In utero or after birth
  • *multisystemic=other organs as well
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17
Q

Renal infarction: cause and appearance

A
  • Obstruction of renal vasculature
  • *appearance depends on TYPE of obstructing material and size of affected vessel and duration
  • *often wedge shaped=arcuate OR interlobular
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18
Q

What will septic infarcts become?

A
  • Abscess
  • *AV valve endocarditis
  • Cattle: A. pyogenes
  • Pigs: Erysipelothrix rhusiopathiae
  • Small animals: Staph
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19
Q

What will thrombosis of a trunk of a renal artery produce?

A
  • Total OR subtotal necrosis of the kidney
20
Q

Vessel size: arcuate artery infarction

A
  • Wedge of BOTH cortex and medulla
21
Q

Vessel size: interlobular artery infarction

A
  • Wedged LIMITED to cortex
22
Q

Renal infarct: acute appearance

A
  • Red and bulging
  • *significant for the case NOT the kidney
    o Look at heart (left AV valve)
23
Q

Renal infarct: acute to subacute appearance

A
  • Pale and bulging
24
Q

Renal infarct: subacute appearance

A
  • Pale & bulging with a rim of hyperemia
25
Q

Renal infarct: chronic appearance

A
  • Pale depressed with loss of tissue
    o Necrosis
  • *INCIDENTAL FINDINGS=NOT SIGNIFICANT
    o Unless they are a chronic abscess
26
Q

What are the causes of renal papillary/medullary crest necrosis?

A
  1. NSAIDs by inhibiting PGE-2 which is a vasodilator
    a. Often dehydrated animal
  2. Space occupying mass
    a. Renal medullary vessels are very THIN WALLED
27
Q

What is the sequelae to renal papillary/medullary crest necrosis based on?

A
  • Severity
    o If small=resolution
    o If severe=acute renal failure
  • *chronic renal failure can occur if lesion heals by fibrosis and is severe enough to result in decreased ability to concentrate urine
28
Q

What is hydronephrosis?

A
  • Dilation of renal pelvis and calyces associated with progressive atrophy and cystic enlargement of kidney
29
Q

What is the cause of hydronephrosis?

A
  • Urinary obstruction
    o Acquired: urinary caliculi, enlarged prostate, cysitis
    o Anomalous
  • *depends on location of obstruction
  • *unilateral or bilateral
30
Q

Hydronephrosis ‘outcome’ depends on location of obstruction

A
  • Ureteral obstruction: severe unilateral hydronephrosis
    o Severe as lesion, but incidental finding
  • Lower obstruction: bilateral hydronephrosis with less severe kidney lesions
    o *early death from uremia
31
Q

**What is the importance of glomerular disease?

A
  1. Interference with glomerular blood flow and decreasing formation of ultrafiltrate IMPARIS PERITUBULAR PERFUSION
    a. May cause loss of entire nephron
  2. Glomerular permeability may be altered=leading to proteinuria
    a. With NO inflammation
32
Q

What is glomerular disease an important cause of in dogs and cats?

A
  • Chronic kidney disease in dogs, occasionally cats
  • Acute kidney injury
  • *can lead to nephrotic syndrome
33
Q

What in particularly indicative of glomerular damage?

A
  • Proteinuria, occurring in absence of UT inflammation
34
Q

If high proteinuria, what are the 2 things that cause cause it?

A
  • Glomerular disease
  • Amyloidosis
    o Which can lead to glomerular disease later on
35
Q

What are the 3 hallmarks of nephrotic syndrome?

A
  1. Hypoalbuminemia
  2. Generalized edema
  3. Hypercholesteremia (not totally sure why)
36
Q

Why can animals with glomerular disease be hypercoagulable?

A
  • Have loss of antithrombin III
    o Often results in systemic thrombosis, most commonly respiratory thrombosis
37
Q

Glomerulonephritis

A
  • Subtype of glomerular disease
  • Important cause of renal failure in dogs and cats
  • *disease within glomerulus with extension to tubules and interstitium
  • *NOT a final diagnosis=tells you that there are Abs attacking the glomerulus due to something outside the glomeruli (inciting cause may NOT be found)
38
Q

What is the pathogenesis of glomerulonephritis?

A
  1. Deposition in glomeruli of circulating immune complexes UNRELATED to glomerular components (aka IMMUNE COMPLEX glomerulonephritis)
  2. From formation in situ of Abs against glomerular BM (rare in domestic animals)
    a. Abs are produced against the BM of glomeruli
39
Q

What can cause immune-complex glomerulonephritis in cats?

A
  • FeLV
  • FIP
  • FIV
  • Neoplasia
40
Q

What can cause immune-complex glomerulonephritis in dogs?

A
  • Chronic bacterial diseases
  • Endometritis (pyometra)
  • Immune-mediate polyarthritis
  • -neoplasia
41
Q

What are the 3 types of glomerulonephotis? (histology reports)

A
  1. Membranous
  2. Proliferative
  3. Membranoproliferative (most common)
42
Q

Proliferative GN

A
  • Increased cellularity of glomerular tufts
  • *blue dots in glomerulus
  • **most common variant in HORSES
43
Q

Membranous GN

A
  • Diffuse glomerular capillary basement membrane thickening
  • *most common type in CATS
44
Q

Membranoproliferative GN

A
  • Hypercellularity and thickening of capillary BM
  • *most common type in DOGS
45
Q

What can be done to highlight the deposits within glomeruli?

A
  • Immunofluorescence
  • PAS stains
46
Q

What is the gross appearance of acute GN?

A
  • Can give cortex a lumpy appearance
  • But can’t tell fully by GROSS appearance
  • *white nodules on surface of cortex (=affected glomeruli)

SYSTEMIC PATHOLOGY 3 (6 decks)

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