W8. glomerulonephritis and interstitial nephritis Flashcards

Question

acute (post strep k, non strep)

Answer 1

-s.pyogenes, impetigo ==>impetigo, pharyngitis -ASLO deposits in glomeruli-->act of acute infla reaction->prolif of cellular elements -a-hemolytic, hypersens 3 micro: -hypercell+enlarged glomerulus - edema -subepi depocite : starry sky grnular apeare BM +mesanigial skin and throath children

Answer 2

-lga AB in glomerulus -henoch schonelin purpura-HSP: skin rash, arthirtis, abd pain, young adults -asym hematuria and proteinura - micro: prolif of mesangium w lga deposits, nephropathy-->is impacted--Zpersistent -->overprod of lga

Answer 3

-cresent shape in Bowmans space - aggressive Type 1: goodpasture sundrome (anti GBM diseasee) -lgG attack BM of glomeruli -lungs maybe involved ->pulmonary hemorrhae -aka goodpasture=glomeruli+gas exchange Type 2: immune complex mediated -SLE, lga nephropathy, post inf gn -compelx stuck in glomeruli-->infka type 3: pauci immune(no complexes visible -ANCA associated vasculitis: - micro: -focal rupture of glomerular capp walls -fubrin exsudate leak into bowman-->endothelial prolif&mononuclear infiltartion-->cresents(prolif +fibrin) - cresent compress glomerular cpp-->dec filtration, increased pressure, kidney failure

Answer 4

-30-50y -idiotpathyc

Answer 5

-immunedeposits in walls of glomerulus ->infla ->structural changes -inlfamed and damaged BM-->^permebility and proteins-->urine-->nephrotic syndrome -nephritic syndrome også micro -increased cellularity->glomerulaus thickened + BM alterations(Also thickened - double contour(tram tarck) -thickened cap loops Type 1: immune complex mediated - in mesangium and subendo -triggere complememnt activation - SLE(lupus), Hepatitis B/C, monoclonal gammopathy type 2:dense deposit disease - abnormal act of alternative complement pathway - dense ribbon like deposits in GBM - c3 glomerulopathy type 3: - subepi and subendo locaiton !MPGN = Proliferative + thick BM + immune complexes Can be both nephritic + nephrotic Seen in infections (HBV, HCV), lupus, and complement disorders!

Answer 6

-nephrotic syndrome -heroin abuse, HIV, unknown -certian foci of glomeruli micro: partial sclerotication of glomeruli in varoius extent -hyalination of feeding arterioles but no ^in nr of cells aka non-prolig

Answer 7

-patho material/chnages in BM -nephritic /nephrotic syndrome -inlfamed and damaged BM-->^permebility and proteins-->urine-->nephrotic syndrome -damaged from immunecomplexes: auto AB attack GBM hvem :30-50y hsito: -Bm thickening -no prolif=no ^in cellularity -IF: diffuse lgG deposits - subepi immunoglobulin containing deposits -spikey/holey apperance primary: idopathic sec: - autoimmune conditions, infections, drugs, inorganic salts, malignant tumors

Answer 8

class 3 <50% of glomeruli

Answer 9

-AD herediatry -thinned glomerular basal memrbane -hematuria and proteinuria

Answer 10

1. ^pressure in blood vessle - constant pressure-->dmaage small vv-->increase permeability-->firbinogen leak-->trigegr infla and scarring 2. endothelial injury -cells damaged-->microthrombi + fibronoid necrosis 3. ischemia -dmaaged veessles-->porr supply-->RAA trigger-->hypertension worse-->kidney failure

Answer 11

lupus nephritis diabetic nephropathy amyloidosis polyarthritis nodosa wegeners granulomatosis

Answer 12

-autoimmuen disease - women, 40y -bytterfly rash -include skin, joints, lungs, cns, indey -interstitial NPHRITIS, nephrotic syndorme and membranous GN

Answer 13

-chronic high blood sugar (hyperglycemia) damage-->progressive protein leakage-->kindey failure -glycemia-->BM thick and dysfunctional-->proteins acc under epi -loss of neg chatrge in bm cant repel the proteins so albumin leak-->microalbunemia and macro - podocyte damage-->BM exposed-->srick to Bowmans-->focal segmental glomeruloscelosis - small vv in kidney damaged-->hyalinosis and arteriosclosis chaaracteristic -kimmel stiel -wilson nodules Mnemonic: "HAG-PK" Hyperglycemia Albuminuria (micro → macro) Glomerulosclerosis Podocyte damage Kimmelstiel-Wilson nodules

Answer 14

-abnormal deposits of protiens -feet, ankles, calves swell -kidney smalla nd hard -cholestrol elevation and proteiunuria congored, thioflavin, schema

Answer 15

-40-50 -men - hepatitis b , unkoen renal a vasculitis-->proteinuria, imparied kidney function and hypertension - polymorphonuclear leukocytes

Answer 16

-nose, lungs, kidneys, and others -micro hematuria and proteiuria -kindey failure if not trated

Answer 17

whole kidney oarenchyme

Answer 18

part pf parenchyme but involve all structural components

Answer 19

-tubule and surroindign interstitial tissue become inflamed or damaged from toxins or low BF cause 1.ischemia(low BF) -hypovolemia -low perfusion-->tubules dont get enough oxy-->cell death -get shock kidney: aka enlarged, odematous kidney, pale corte and dark medulla, focal tubuular necoriss, 2. toxic damage -antibiotis, antiviral, NSAIDS, chemo drugs, heavy metals, endogenous substnced - get toxic kidney: tubular vacuolization and dilation mciro: -abnormal tubule strucyrie->flattened, ruptures, missing nuclei -necrosis -

Answer 20

interstitial edema, neutrophils, focal tubular necorsis, hyepremaia, leukocyte

Answer 21

mononuclear infla, interstitial fibrosis, tubualr atrophy

Answer 22

-most common -bacteria, viruses, parasites ASCENDING ROUTE: common -vesicouretral reflux, obstructive nephropathy HEMATOGENOUS: - bacteria to kidney-sepsis

Answer 23

suppurative/pus formin infection f kidney in collecting system and interstitium - ascending UTI, catetrization, hydronephrosis, pregnancy, hematogenous -e.coli - nephritis, necrosis, absess -recurrent attacks of acute IN-->chornic signs and symptoms -costovertebral angle pain and fever -symptoms of systemic infection or UTI -pyuria, WBC in urine

Answer 24

-enlargment fo kidney - focal abscessin og bilat kidney and renal cortex -wedge shaped area of suppuration, radial yellow stripes complications -mucosa inflamed and edomatous -abscesses overlalt micro: -pathy, diffuse suppurativ einfka -intersitital ededma -neutrophils -tubular necrosis -abscess -normal glomeruli and vv -paipllary coagulative necorsis

Answer 25

-infka w renal scarring -calyces and pelvis-deformation , scarrring an datrophy -recurrent attack of IN cause: 1. refluc: childhood, uni/bilat, infection: calcyecael dilation (functional changes-->urine flow stopped+^pressure-->dilation of calcyeal and pelvis 2. obstruction: hydronephrosis signs: -in apparent -advace

Answer 26

-destroyed parenchyme w fibrosis -tubular dialtion and atrophy - tubular thyroidization -interstitial inflamamation -obliterative endarteritis -later glomeruli hyalinization(aka thickened capsul and periglomerular fibrosis)

Answer 27

normal chronic tin w ^macrophages macro - multiple yellow nodules around calyces-->tumorus mass and maybe infiltartice micro: - foamy macrophages-hsitiocytes -multinuclear giant cells -lymphoplasmatic infilatraiton -some neutro

Answer 28

primary and secondary macro: -multiple yellow nodues - isolaated noduel-aka granuloma: casefication, colliquation micro: -caseous necrosis + giant langerhans cells

Answer 29

durgs, poisons, heavy metals

Answer 30

-80% women -kidney dont concenrate urine, renal stones -anaemia UTI, HT -necrosis of papils -chronic TIN

Answer 31

hypersens 4 RASH, FEVER, ESOSINOPHULIA, HEMATURIA, MILD PROTEINUNARIA, RISING CREATINE

Answer 32

-procimal concoluted tubule morphology: -enlarged and edomatous kidney -extensive necrosis of tubular cells -fatty chnage, balloning, hydropic chnages, calcium oxolate cyrstals

Answer 33

urate nephropathy hyeprcalcemia nephropathy plasmatic myeloma

Answer 34

stones prostatic hypertrophy tumors infla normal pregnancy uterine prolapse pain due to distention of collecting system or renal capsuel

Answer 35

-males, 20-49y -^conc of metabolitc substarte, decreses urine volume or deficit of crystal inhibitors in urine -80% uni -pain and hematuria -mocturia, polyuria->after relief -hydronephrosis=cystic dialtion f renal pelvis and calyces associated with progressive atrophy of kidney bc of obstructive uropathy

Answer 36

flank pain palpable mas nause and vomiting UTI fever painful urination ^urinary frequency and urgency

Answer 37

early -dilated tubules -atrophy and firbous replacement of epi later: -atrophy an disappering of glomeruli -thin , fibrous shell remains of parenchyme

Answer 38

-obst below ureter -complete obs: anuria, bladde robstruciton -incompleted: fysfunctionaø tubular -no treat: uremia and renal failure

Answer 39

obstru above bladder - incomplete: enlargement, atrophy and compression of parenchyme. papilla diminshes and flattened pyramids -complete: glomerular filtartion and decreased renal function. hydroureter complication: coagulative necosis of papillae and pyelonephritis

Answer 40

-red GFR or proteinuria macro: -little shrunken kindyes -grnaular cortical surface +smal cysts micro: - ats plaques -initmal and medial dystrophic hcnages -intimal prolif w fibroplasia, irr thickening of intima -chirnic infla reactions

Answer 41

-nrphroblastoma-wilsm tumors 99% -congenitalmesoblastic nephroma -neuroblastoma -metnephric stromal tumors -clear cell sarcoma -ossifying renalt umor of infancy -renal cell carcinoma -rhabdoid tumor

Answer 42

-young people-malignant hypertension -^permeability of vascular wall for fibrinogen -damage of endo micro: fibrinoid necrosis -hemorrhages

Answer 43

-most common in children -on of most common tumor in infancy -90% bfore 6y -large abd mass, -MTS to lung or traumatic ruoture -spred into perrenal soft tissue -from nephrogenic blastoam cells-small blue cell triphasic tumor: 1-undiff blastema 2. fibroblast like stroma 3. eoi

Answer 44

rare 1. papillary cortical adneoma 2. oncocytoma-peculiar

Answer 45

1.clear cell carcinoma-renal cell carcinoma . MOST common and malingnant 2.papillary carincoma -intermediate malingnacy 3. chromophobe carcinoma- highest risk of recurrency 4. sacromatoid carcinoma

Answer 46

1. angiomyolipoma-most common, mixed 2.leiomyoma 3.lipoma 4. mixed epi and stromal 4. primitive neuroepi tumors (PNET)|

Answer 47

nephroblastoma-wilsms clear cells sarcoma anaplsatic sarcoma

Answer 48

mts of lungs, thyroid, breast carcinoma, CRC

Answer 49

who: adult over 50y, males more dangerous - detected incidentally(bc it doesnt innercate kidney parenchyme -shen it invade UT: hematuria -when renal capsule: discomfort clincial -costrovertebral oain -palpamble mass hematuria mTS: lungs, bones, LN, adrenals , liver, bra

Answer 50

1% of renal tumors in adults -act of MET gene -age 60y -MTS ti lungs -poor prognosis -spindle girantl cells, resemble sarcoma

Answer 51

-peculiar macro: -red, gray-white, yellow -may inavede LN and renal vain -capsular invasion 25% micro -triphasic tumors

Answer 52

risk: smokin, obesity, hypertension -others: APKD, renla cystic dissde WHY called: -high glycogen and lipid content-->yellowish-orange appearnce mcrio: -weel circusided, yellow -show hemmprhage, necrosis, calcification, cystic degeneration, renal vein thrombosis mts: lung, LN, liver, bone, adrenal gland, colat kidney, brian, heart, spleen , intesitne , skin symptoms -hematuria -flank pain -night swats -weight loss

Answer 53

macro: -red brown color-hemoorahe -multifocal -well circumscribed micro: -papillary/tubulopapillary pattern - foamy macrophage -psammoma bodies -adneomatous chnges in adjacent kindey mts: regional LN

Answer 54

-cells of this cancer are afriad to be stained by histological staining -good prognnosnis -but high recurrency macro: -weel circumscribed -tan brown -necrosis -small cyst mciro: -nests/broaf alveoli and trabeculae -large polygonal cells with cytopllams and siticnt cell borders -perinuclaer halo -calcification