Renal, Genitourinary, and Breast Pathology Flashcards
kidney is _____ of body weight
0.4%
what are kidney functions
- filters 25% of blood through glomeruli
- excretes nitrogenous waste products of metabolism- cleans the blood- turns 1.5L into urine
- regulates body water and electrolytes
- maintains appropriate acid-base balance
- endocrine organ- secretes hormones
what hormones does kidney excrete and what does it control
- renin - blood pressure
- erythropoietin- proliferative effect on bone marrow to make RBCs
what are the morphologic components of the nephron
- glomeruli
- convoluted tubules
- collecting ducts
what does the juxtagomerular complex do
controls BP
where are the juxtaglomerular cells located
in the afferent arteriole
what is in the juxtaglomerular complex
- juxtaglomerular cells
- macula densa
where is the macula densa located and what does it do
- in wall of DCT
- sensor for sodium
describe azotemia
- elevation of blood urea nitrogen and creatinine levels
- usually related to reduced glomerular filtration rate
- associated with many primary renal disorders
- may also be associated with extra renal disroders
what is pre-renal azotemia
hypoperfusion of the kidneys decreases GFR in the absence of parenchymal damage
what is post renal azotemia
urine flow obstructed below the level of the kidney
what is uremia
progression of azotemia to produce clinical manifestations and systemic biochemical abnormalities
- failure of renal excretory function
- metabolic and endocrine alterations
what organs are secondarily involved in uremia
- uremic gastroenteritis
- peripheral neuropathy
- uremic fibrinous pericarditis
- uremic stomatitis
what are the clinical manifestations of renal diseases
- nephrotic syndrome
- nephritic syndrome
- acute renal failure
- chronic renal failure
- urinary tract infections
- nephrolithiasis
- urinary tract obstruction
- renal tumors
describe nephrotic syndrome
- glomerular syndrome
- heavy proteinuria
- hypoalbuminemia
- severe edema
- hyperlipidemia
- lipiduria
describe nephritic syndrome
- glomerular syndrome
- acute onset of grossly- visible hematuria
- mild to moderate proteinuria
- azotemia
- edema
- hypertension
- classic presentation of acute post streptococcal glomerulonephritis
describe acute renal failure and what might it result from
oliguria or anuria with recent onset of azotemia
- may result from glomerular injury or acute tubular necrosis
describe urinary tract infections
- bacteriuria and pyuria - symptomatic or asymptomatic- kidney (pyelonephritis) or bladder (cystits)
what are nephrolithiasis and what are they caused by
- kidney stones
- colic
- hematuria
describe what causes nephrotic syndrome
a non specific disorder in which the kidneys are damaged, causing them to leak large amounts of protein from the blood into the urine
describe what causes nephritis syndrome
a non specific disorder in which the kidneys are damaged causing them to leak protein and red blood cells from the blood into the urine
what is glomerulonephritis and what is it treated with
- an immune mediated disease of the renal glomeruli
- treated with steroids
what is pyelonephritis and what is it treated with
- an infection of the kidney ( not the glomerulus) usually caused by bacteria and of retrograde origin
- treated with antibiotics
describe post streptococcal glomerulonephritis
- acute onset of nephritic syndrome in 9-14 days following streptococcal infection
- type III immune injury ( immune complex mediated inflammation)
what are the pathways of renal infection in pyelonephritis and which is mroe common
- hematogenous dissemination
- ascending infection- more comon
how is pyelonephritis spread and what is the tx
- fecal bacteria from perineal area
- bactrim
pyelonephritis is ____ common than glomerulonephritis
more
what are the symptoms of kidney stones
- may cause obstruction
- pain
- ascending infection
- hematuria
- pyuria
- lithotripsy
- may be associated with hypercalcemia
how are kidney stones treated
extracorporeal shock wave lithotripsy (ESWL)
describe the renin- angiotensin- aldosterone axis
- blood pressure drop detected by JG cells
- secretes renin
- converts to angiotensin I
- ACE converts to ANG II
- ANGII does vasoconstriction and increases aldosterone which increased Na+ retention and increases BP
what are the organs involved in end organ damage in complications of HTN
- cardiovascular system
- peripheral vascular system
- renal system
- central nervous system
- visual system
how is the CVS affected in end organ damage in HTN
- accelerated coronary atherosclerosis
- increased myocardial oxygen demand
- ventricular remodeling
- heart failure
- increased risk for arrythmias
how is the peripheral vascular system affected in end organ damage in HTN
- atherosclerosis
- aortic dissection
-abdominal aortic aneurysm - peripheral vascular disease
how is the renal system affected in end organ damage in HTN
- hypertensive nephrosclerosis
- end stage renal disease
how is the CNS affected in end stage organ disease with HTN
- hemorrhagic CVA
- thromboembolic CVA
how is the visual system affected in end organ damage in HTN
- retinal infarction
- hypertensive retinopathy
- blindness
what is arteriosclerosis
- affects arterioles
- thickened walls reduce lumen diameter causing ischemic injury
what are the types of arteriosclerosis and what diseases are each associated with
- hyaline arteriosclerosis: benign hypertension, diabetes mellitus
- hyperplastic arteriosclerosis: malignant hypertension
what is the inheritance pattern for adult polycystic renal disease
autosomal dominant
what is a cause of renal cell carcinoma
cystic changes associated with renal dialysis
describe renal cell carcinoma
- arises from renal tubular epithelium
- often silent
- may grow into renal vein
is metastasis to kidney a normal site
no