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Hugh's MD1 Renal > Kidney Pathology > Flashcards

Kidney Pathology Flashcards

1
Q

What are more common in Australia, tubular or glomerulus diseases?

A

Tubular

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1
Q

What are three consequences of ATN?

A
  1. Reduced GFR
  2. Loss of electrolytic balance
  3. Accumulation of creatinine and urea in blood
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2
Q

Where are mesangial cells located in the glomerulus?

A

In the stalk that supports the capillaries

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2
Q

What are some causes of nephrotic syndrome/proteinuria?

A

Diabetes mellitus

Some forms of glomerulo-nephritis

Inherited syndromes

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2
Q

What does diffuse means in the context of GN?

A

All glomeruli in the kidney are affected

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2
Q

Which kidney disease is systemic lupus erythematosis commonly associated with?

A

Glomerulonephritis

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2
Q

How do kidneys with appear macroscopically in end stage renal disease?

A

Pale, atropied, nobbly, scarred

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3
Q

What is glomerulonephritis?

A

Acute or protracted damage to the glomerulus

Usually due to deposition of immune complexes that leads to complement activation

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3
Q

Do acute post infectious GN ever develop into chronic renal failure?

A

Yes, depends on how severe the initial injury is

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4
Q

When is GN likely to develop to chronic renal failure?

A

When the injurious stimuli remains present eg Lupus nephritis

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5
Q

What does the term global mean in the context of GN?

A

The whole glomerulus is affected

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5
Q

What are the most important causes of injury to kidney tubulointerstitium?

A

Ischaemia (or toxins rarely) = ATN

Infection = acute pyelonephritis

Acute or chronic tubulointerstitial nephritis

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5
Q

What are some causes of acute interstitial nephritis?

A

Allergic reaction to drugs

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6
Q

What is the histological abnormality in acute interstitial nephritis?

A

Immune cells in the interstitium - particularly eosinophils

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7
Q

What condition is more prevalent in forest Finns?

A

Inherited nephrotic syndrome: mutation in the Nephrin protein

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9
Q

What is the leading cause of chronic renal failure in Australia?

A

Diabetic nephropathy

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11
Q

What are some renal causes of acute renal failure?

A

Acute tubular necrosis

Acute glomerulonephritis

Acute interstitial nephritis

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13
Q

Why isn’t protein usually filtered?

A
  1. Negatively charged basement membrane
  2. Physical obstruction of the basement membrane and epithelials
  3. Fine proteins that connect the spaces between podocytes appendages
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14
Q

What happens to necrosed cells in ATN?

A

The fall off the basement membrane

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16
Q

What is the most common cause of acute glomerulonephritis in Australia?

A

IgA nephropathy

17
Q

T/F Glomerulonephritis only causes oliguria renal failure

A

False, it can cause haematuria or proteinuria too

18
Q

What can occur to the interstitium in renal disease?

A

Oedema

Expansion/fibrosis

19
Q

What are the symptoms of acute pyelonephritis?

A

Chills, fever, pain, lumber tenderness

Dysuria (Pain on urination)

20
Q

What is the GFR in end stage kidney disease?

A

<15mL/min/1.73m2

22
Q

What are three way that the glomerulus can react to immune complex deposition?

A
  1. Glomerulus cell proliferation
  2. Immune cell infiltration
  3. Basement membrane proliferation
23
Q

What are the top three causes of end stage kidney disease in Australia?

A

Diabetes mellitus

Glomerulonephritis

Hypertension

24
Q

What is the most common cause of acute tubular necrosis?

A

Ischaemia eg during hypotension

25
Q

What parts of the kidney can be effected in pyelonephritis?

A

Renal parenchyma

Calyses

Renal pelvis

26
Q

T/F Type III hypersensitivity is the second highest cause of damage to kidney tubules

A

False, infection is

Type III hypersensitivity is much more of a problem in glomeruli

27
Q

What is the pathogenesis in toxic acute tubular necrosis?

A

Mitochondrial function and oxidative phosphorylation are disturbed

28
Q

What is Nephrotic syndrome another name for?

A

Severe proteinuria

29
Q

If a patient presents with signs of kidney damage after antibiotic use what are the two differential diagnoses?

A

Post infective glomerulonephritis

Acute interstitial nephritis

30
Q

T/F ATN is irreversible

A

False, it is reversible

32
Q

How do you differentiate different types of GN?

A

Clinical findings (eg blood tests etc)

Light microscopy

Immunostaining for ab subtype

Electron microscopy

33
Q

Why are tubule cells more susceptable to ischaemic damage than the glomeruli?

A

They have a greater O2 and blood demand than the glomeruli

34
Q

T/F Renal function is lost in pyelonephritis

A

False, it’s usually preserved

36
Q

T/F Acute glomerulonephritis never progresses to chronic renal failure

A

False, it can eg in cases of IgA nephropathy

37
Q

T/F Acute renal failure is a term for any acute kidney problem

A

False, it specifically refers to a reduced GFR as reflected by serum creatinine

38
Q

Is it possible to differentiate the cause of damage in end stage kidney disease?

A

No, damaged kidneys will the look same at this point

39
Q

When do you get ‘crescents’ in the glomeruli?

A

In severe, acute glomerulonephritis with necrosis

They consist of monocytes and epithelial cells

40
Q

Had do kidneys with pyelonephritis appear macroscopically when dissected?

A

White streakas = pus filled tubules

41
Q

What are the signs of nephrotic syndrome?

A

Proteinuria

Oedema (whole body)

Hypoalbuminaemia

Hyperlipidaemia

42
Q

What causes hyperlipidaemia in nephrotic syndrome?

A

Liver damage of some sort

43
Q

Which type of GN is crescent necrosis associated with?

A

None of them! It’s non-specific

45
Q

What are the 4 common aetiological agents of acute pyelonephritis?

A

E. coli

Klebsiella sp.

Proteus

Pseudomonas

46
Q

What is the most common cause of acute renal failure?

A

Acute tubular necrosis

47
Q

What type of acute glomerulonephritis is most seen in NT Aboriginals?

A

Acute Post-infectious GN - typically after Grp A Strep

48
Q

How do bacteria appear in H&E stains?

A

Purple

49
Q

When do symptoms appear in end stage kidney disease?

A

When there is 10% of renal function remaining

Hugh's MD1 Renal (11 decks)

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