Renal Pathology 1: Anatomy (Dobson)

Question 1

What structures in the female are the embryologic equivalent of the prostate?

Answer 1

Skene’s glands

Question 2

Retroperitoneal structures?

Answer 2

SAD PUCKER
Suprarenal (adrenal) glands
Aorta and IVC
Duodenum (2nd and 4th)
Pancreas (except tail)
Ureters
Colon (descending and ascending)
Kidneys
Esophagus (thoracic portion)
Rectum

Question 3

3 Narrowing locations of the ureters?

Answer 3

1. Ureteropelvic Junction (UPJ)
2. Mid urethra (urethral stricture)
3. Ureterovesical Junction (entering bladder)

Question 4

What are two disorders that can heavily affect renal vasculature?

Answer 4

Diabetes and HTN

Question 5

What makes up the juxtaglomerular apparatus?

Answer 5

macula densa region of the thick ascending limb, extraglomerular mesangial cells, and renin and angiotensin II-producing granular cells of the afferent arterioles.

Question 6

The filtration barrier is made up of what 3 layers?

Answer 6

1. endothelium of capillaries (prevents cells)
2. basement membrane (collagen type IV)
3. Podocytes foot processes

Question 7

The filtration barrier is affected by what?

Answer 7

Size and charge; freely permeable to water, small solutes and proteins

Question 8

Answer 8

kidney biopsy displaying the renal cortex (less vasculature)

Question 9

Answer 9

kidney biopsy displaying the renal medulla (more vasculature)

Question 10

Warning signs of kidney disease (6)

Answer 10

1. Cr and BUN blood test outside normal range
2. GFR less than 60
3. Blood and/or protein in urine
4. High BP
5. Increased frequency, particularly at night, dysuria
6. Puffiness around eye, swelling around hands and feet

Question 11

Azotemia

Answer 11

biochemical abnormality; elevated Cr and BUN and decreased GFR w/o symptoms

Question 12

Uremia

Answer 12

biochemical abnormality with clinical signs and symptoms (cognitive dysfxn, fatigue, SOB, loss of appetite, muscle cramps, n/v, metallic taste)

Question 13

Uremic frost

Answer 13

striking cutaneous finding seen in patients w severe kidney disease; initiate urgent dialysis

Question 14

The ideal ratio of BUN and Cr

Answer 14

10:1 or 20:1

Question 15

What factors go into eGFR?

Answer 15

gender, age, weight and RACE

Question 16

normal GFR

Answer 16

90 mL/min/1.73 m2 or higher

Question 17

Red urine

Answer 17

most likely blood; will need UA and confirm with microscopy

Question 18

Brown urine

Answer 18

could be an infection; UA and urine culture

Question 19

Acute kidney injury (AKI)

Answer 19

rapid decline in GFR with concurrent dysregulation of fluid and electrolyte balance. Can manifest with oliguria/anuria.

Question 20

Chronic Kidney Disease (CKD)

Answer 20

presence of diminished GFR that is persistently less than 60 mL/min/1.73 m2 for at least 3 months and/or persistent albuminuria