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Pathology > Renal Pathology > Flashcards

Renal Pathology Flashcards

1
Q

What does pre-renal functional problems cause?

A

Compromised renal perfusion - Reduced RBF leading to Renal Ischemia

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2
Q

What does functional problems intrarenally cause?

A

Compromised kidney function

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3
Q

What does post-renal functional problems cause?

A

Obstruction of urine outflow

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4
Q

When does acute renal failure occur?

A

When over 75% of renal function is abruptly impared

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5
Q

What are the main signs of acute renal failure?

A

Azotaemia - Cardiac dysrrythmia (due to to K retention) - Muscle tremors and coma (due to phosphate retention) - Metabolic acidosis (due to failure of pH control) - Hypertension - Oliguria

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6
Q

What is chronic renal failure characterised by?

A

Prolonged signs of uraemia

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7
Q

Define azotemia. How is it caused?

A

Retention of nitrogenous metabolites - Insufficient glomerular filtration

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8
Q

What are the clinical signs of chronic renal disease?

A

Polyuria - Isosthenuria - Polydipsia - Halitosis - Dribbling - Lank coat - Weight loss

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9
Q

Define uraemia

A

Urea in the blood

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10
Q

Give the progression of normal renal function to uraemia

A

1- Diminished renal reserve, GFR 50% of normal 2- Renal reserve, GFR 20-50%, azotaemic and polyuric 3- Renal failure, 20-25%, kidneys can’t maintain homeostasis = uraemia 4- End-stage renal disease, 5%, terminal stages of uraemia

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11
Q

What are the systemic effects of uraemia?

A

Causes retention of electrolytes (esp Ca) - Plasma protein loss - Hyperphosphataemia - Secondary renal hyperparathyroidism - Reduced erythropoietin - Hypertension

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12
Q

How does uraemia cause Secondary renal hyperparathyroidism?

A

Reduced GFR - inadequate secretion of phosphate - Precipitation of ionised calcium concentration - Reduced activation of Vit D - Reduced Ca absorption - PTH stimulated - Osteoclastic bone resorption

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13
Q

How does uraemia cause non-renal lesions?

A

Endothelial degeneration and necrosis = vasculitis and secondary thrombosis Large amounts of ammonia/bacteria in saliva

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14
Q

What are the portals of entry for infection into the kidney?

A

Haematogenous - Glomerular infiltrate - Ascending ureter - Direct penetration

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15
Q

What are the defence mechanisms within the kidney?

A

Urine flow flushes out bacteria - pH of urine - basement membrane

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16
Q

What are the categories of renal disorders?

A

Glomerular - Tubular - Interstitial - Vascular system

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17
Q

What condition is affecting these kidneys?

A

Hydronephrosis

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18
Q

What is the pathogenesis of hydronephrosis?

A

Obstruction of outflow tract - Increased pressure in renal pelvis - Tubules undergo necrosis and atrophy - Interstitial fibrosis - Pale radiatiing rays

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19
Q

What is the condition of this cows kidney? What are the gross problems?

A

Pyelonephritis - Renal calyces contain supprative exudate bordered by red rim of haemorrhage

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20
Q

What infectious agents are involved in pyelonephrotitis in cows?

A

E. coli - Arcanobacterium pyogens - Cornyebacterium renale

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21
Q

When are cows most likely to get pyelonephrititis? What other species is susceptible?

A

Post-partum period - Sows

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22
Q

What is this condition called? What are the microscopic features of this disease?

A

Acute tubular necrosis - Diffuse degeneration and necrosis of epithelial cells of convoluted tubules

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23
Q

What can cause acute tubular necrosis?

A

Ischaemia - Nephrotoxins - Inflammation - Certain infectious agents

24
Q

What causes chronic renal failure?

A

Uraemia

25
Q

This is a histological section of a cat’s pancreas - What has happened and what could cause it?

A

Vacuolated beta cell islets consistent with hydropic degeneration - Type 2 diabetes

26
Q

This is the bladder of a cat with type 2 diabetes - what has caused this?

A

Glycosuria in diabetes mellitus enhances bacterial growth

27
Q

What is the common name for this disease? What can cause it?

A

Renal infarction - Blockage of artery (neoplasia, embolism), damage of vasculature (toxins)

28
Q

Describe the gross appearance of this kidney

A

Multifocal small pale/white nectrotic foci

29
Q

Describe what is in these microscopic images of the kidney with multifocal white/red lesions. What is this condition know as?

A

Microabscesses centered on glomeruli - Bacterial, neutrophils and necrotic debris - Suppurative glomerulitis (embolic nephritis)

30
Q

What causes supprative glomerulitis?

A

Bacterial invasion - Haematogenous route and lodge in capillaries of glomeruli - Replicate and induce necrosis & inflammation

31
Q

How can immune mediated glomreulonephritis occur?

A

Formation of antibodies against entrapped nonspecific antigens withing the glomerular basement membrane

32
Q

What is glomerular amyloidosis commonly associated with? Why?

A

Chronic inflammatory disorders, systemic infectious diseases or neoplasia - Acute phase proteins cause amyloid deposits in glomeruli

33
Q

How can you diagnose that there is amyloid deposition in the kidney?

A

Stain with congo red - Amyloid is apple green when viewed under polarised light

34
Q

What is acute supprative glomerulitis also known as?

A

Bacterial or embolic nephritis

35
Q

What is seen in the kidney during acute suppurative glomerulitis?

A

Formation of microabscesses throughout the cortex

36
Q

What is glomerulosclerosis?

A

Reduction in number of functional glomeruli

37
Q

What is the most common cause of tubular disease?

A

Ischemia

38
Q

What is the response of tubules to injury?

A

Degeneration - Necrosis - Apoptosis - Cells slough into lumen forming cellular casts - Compensatory hypertrophy

39
Q

Why is it detrimental if the basement membrane undergoes necrosis as well as the tubule?

A

Nephrons don’t regenerate

40
Q

Name 3 congenital disorders of renal tubular function

A

Primary renal glycosuria (reduced glucose reabsorption) - Fanconi syndrome (reduced protein, glucose, phosphate and amino acid reabsorption) - Cystinuria (calculus formation & obstruction in male dogs)

41
Q

What is the most important cause of acute renal nacrosis? What causes it?

A

Acute tubular necrosis - Nephrotoxic or ischemic injury

42
Q

Why can muscle damage cause acute tubular necrosis?

A

Myoglobinuric nephrosis released from damaged muscle cells - Amplifies effects of toxins in combination with ischemia

43
Q

Give examples of toxins that can cause acute tubular necrosis

A

Heavy metal - Pharmaceutical agents (NSAIDs) - Fungal and plant toxins - Ethylene glycol (antifreeze) - Vitamin D - Bacterial toxins

44
Q

What is the renal interstitium?

A

Fibrovascular stroma that surrounds the nephron

45
Q

What can cause renal interstitial disease?

A

Ascending infection (pylonephritis) - Haematogenous (E. coli, Leptospira, Canine adenovirus) - Secondary to injury of vasculature/tubules/glomeruli

46
Q

What are the responses to interstitial injury?

A

Oedema - Haemorrhage - Inflammation - Fibrosis

47
Q

Why is any disease or damage to the renal vascular system detrimental?

A

Arterial blood supply to the cortex is terminal (no anastomoses) so will have a knock on effect to nephron blood supply

48
Q

What is the difference between hyperaemia and congestion?

A

Hyperaemia is an active processs where arterial dilation causes increased blood flow (inflammatory response) - Congestion is a passive process where blood accumulates in venous system (secondary to hypovolaemic shock/cardiac insufficiency/hypostatic)

49
Q

What is Virchow’s triad?

A

Major determinants of thrombosis - Endothelial injury, Dynamics of blood flow, Hypercoagulability of blood

50
Q

What is disseminated intravascular coagulation? What can cause it?

A

Serious manifestation of abnormal coagulation, generation of excess thrombin - Complication of any condition associated with widespread thrombin activation

51
Q

Whata re the main diseases of the renal pelvis?

A

Hydronephrosis - Pyelonephritis - Papillary necrosis

52
Q

What is the main cause of hydronephrosis?

A

Obstruction of urine outflow

53
Q

What has occured on this photo?

A

Hydronephrosis

54
Q

What is pyelonephritis?

A

Bacterial infection of the renal pelvis

55
Q

What has occured on this photo?

A

Pyelonephritis

56
Q
A

Pathology (3 decks)

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