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Y3 Urinary pathology > Urinary system pathology 2 > Flashcards

Urinary system pathology 2 Flashcards

1
Q

Give 3 examples of inflammatory kidney conditions

A
  • Glomerulonephritis
  • Tubulointerstitial nephritis
  • Pyelonephritis
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2
Q

What is glomerulonephritis?

A

Inflammation of glomeruli with secondary damage to other parts of the nephron

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3
Q

Glomerular damage produces…?

A
  • increased permeability

- reduced perfusion of the downstream parts of the tubule

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4
Q

Can glomeruli compensate for damage?

A

They are incapable of regeneration but can hypertrophy to a limited extent

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5
Q

Describe the pathogenesis of glomerulonephritis

A
  • Immune mediated
  • Immune complexes deposited in glomeruli
  • These cause obstruction to filtration slits
  • Type III hypersensitivity reaction which damages the glomerulus
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6
Q

Describe the type III hypersensitivity reaction that occurs in glomerulonephritis - explain the damage caused by this reaction

A
  • Antigen-antibody complex blocks filtration pores within the glomerulus
  • They then fix complement which is attracted to the immune complex
  • Neutrophils latch on and degranulate: lysosomal enzymes released from the neutrophils damage the vessel wall causing exposure of the underlying basement membrane
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7
Q

Following damage to the basement membrane from the type III hypersensitivity reaction, what happens to the damaged site?

A

Fibrin is deposited in the attempt to form a clot and stabilise the site

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8
Q

What are some causes of glomerulonephritis is the following species:

  1. dog
  2. cat
  3. pig
  4. cow
A
  1. infectious canine hepatitis, pyometra, neoplasia
  2. FeLV, FIP, neoplasia
  3. Classical swine fever, porcine reproductive and respiratory syndrome
  4. Bovine viral diarrhoea
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9
Q

How do the kidneys appear grossly in acute glomerulonephritis?

A
  • swollen and reddened

- diffusely scattered over the renal cortical surface there are fine red dots of less than 1mm in diameter

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10
Q

How do the kidneys appear grossly in chronic glomerulonephritis?

A
  • fibrosis and scarring

- the collagen lay down by fibroblasts contracts which leads of a pitted surface

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11
Q

What are 3 consequences of glomerular damage?

A
  • increased permeability
  • reduced perfusion of downstream tubules
  • proteinuria
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12
Q

Describe post-weaning multisystemic wasting syndrome

A
  • occurs in growing/fattening pigs
  • caused by porcine circovirus 2
  • necrogranulomatous hepatitis, interstitial pneumonia
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13
Q

Describe Porcine Dermatitis + Nephropathy Syndrome

A
  • Caused by porcine circovirus 2

- Occurs following Post-weaning Multi-systemic Wasting Syndrome outbreaks in pig herds

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14
Q

How do kidneys appear in Porcine Dermatitis + Nephropathy Syndrome

A

Kidneys are enlarged, pale brown with petechial haemorrhages.
- systemic necrotising vasculitis of skin (over the whole body) + kidneys.
‘Multifocal to coalescing erythematous skin lesions, some progressing to dermal necrosis. Bilateral renal enlargement with multifocal cortical petechiae’

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15
Q

How does glomerulonephritis (e.g. Porcine Dermatitis + Nephropathy Syndrome) appear histologically?

A
  • Intense pink staining means it is highly proteinaceous = fibrin deposited within the glomerulus
  • RBCs visible in the glomerulus
  • Fibroblasts within the parenchyma and inflammatory cells.
  • Bowman’s space dilated by RBCs (shouldn’t be there), distorted by pink amorphous material (fibrin)
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16
Q

Describe the pathogenesis of tubulointerstitial nephritis

A

Interstitial inflammation and fibrosis results in tubular atrophy and degeneration with secondary damage to glomeruli and vessels
- Tubular damage stimulates inflammation which goes into the interstitium
=> chronic renal disease

17
Q

What is the main cause of acute tubulointerstitial nephritis in dogs?

A

Canine leptospirosis

18
Q

What is the source of infection of canine leptospirosis?

A

Rats

19
Q

Describe how canine leptospirosis is transmitted directly and indirectly

A

Direct - via infected urine, bites or ingestion of infected tissues
Indirect - via exposure to contaminated water, soil, food or bedding

20
Q

How do kidneys with acute tubulointerstitial nephritis appear grossly?

A

Swollen and reddened

21
Q

How do kidneys with acute tubulointerstitial nephritis (canine leptospirosis) appear histologically?

A

Leptospira associate with microvilli of P/DCT => ep necrosis
Secondary interstitial inflammation with lymphocytes, plasma cells + macrophages

22
Q

How does leptospirosis cause chronic tubulointerstitial nephritis?

A
  • Leptospiras can persist in renal tubules without causing disease + excreted in urine for long periods
23
Q

What is the importance of leptospirosis in cattle?

A

Zoonotic

24
Q

What are the possible causes of suppurative interstitial nephritis?

A

Pyogenic organisms either haematogenously or ascending up pelvis:
- E.coli (white spot kidney in cattle)

25
Q

What are the 2 causes of granulomatous interstitial nephritis?

A
  • FIP in cats

- Mycobacteria bovis

26
Q

How does FIP appear grossly and histologically?

A

Gross - pale yellow/tan cortex, multifocal creamy nodules in cortex and medulla, pus, increased firmness
Histological - neutrophil dominated response, macrophages, large amounts of purple stippling

27
Q

What is a pyelonephritis?

A

Ascending LUT infection - bladder, urethra and ureters

28
Q

What makes females predisposed to pyleonephritis?

A

Shirt, wide urethra which is more likely to get infected

29
Q

What are some causes of pyelonephritis?

A
  • Urine stasis, not passing frequently enough, retention
  • Retrograde flow from the bladder back up the ureters
  • Local trauma e.g. calculi
30
Q

Give examples of bacterial species that can cause pyelonephritis

A
  • E.coli
  • Staphylococcus
  • Streptococcus
31
Q

Describe the gross appearance of a kidney with pyelonephritis

A
  • Multifocal to coalescing areas of red/black colouration extending from the renal pelvis to the cotex
  • Necrosis
32
Q

Describe the histological appearance of a kidney with pyelonephritis

A
  • purple stippling
  • lots of inflammatory cells
  • fibrosis
  • glomerular sclerosis
33
Q

Give an example of parasitic renal disease

A

Toxocara canis

  • roundworm of dogs
  • neglect
34
Q

How does Toxocara canis cause renal disease?

A

Migration of ascarid larvae producing granulomatous nephritis – stimulate a macrophage dominated response in the kidney

Y3 Urinary pathology (5 decks)

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