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Urinary Pathophysiology > Glomerular Diseases > Flashcards

Glomerular Diseases Flashcards

1
Q

what are the functions of the renal corpuscle/glomerulus?

A

plasma ultrafiltration
blood pressure regulation
peritubular blood flow regulation
tubular metabolism regulation
circulating macromolecule removal

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2
Q

what does primary glomerulopathy arise from?

A

involvement of glomeruli in processes that initiate renal injury

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3
Q

what is the hallmark finding that points to glomerular disease?

A

proteinuria

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4
Q

what can severe proteinuria cause?

A

protein-losing nephropathy (PLN)

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5
Q

what does early damage to the glomerulus lead to?

A

loss of negative charges
podocyte damage or loss

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6
Q

what is the general glomerular response to damage?

A

increased permeability of barrier to protein

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7
Q

prolonged, severe protein-losing nephropathy can result in _____________________

A

nephrotic syndrome

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8
Q

what is nephrotic syndrome defined by?

A

combination of 4 abnormalities:
marked renal proteinuria
hypoalbuminemia
hypercholesterolemia
ascites/generalized edema
+/- hypertension
partial more common

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9
Q

do isosthenuria and azotemia follow glomerular damage?

A

inconsistent findings

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10
Q

what in long term damage to glomeruli leads to decreased GFR?

A

secretion of endothelin by podocytes
mesangial cell proliferation
thickening of basement membranes and mesangial matrix
+/- leukocyte infiltration
eventual atrophy or fibrosis of glomerular tuft

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11
Q

what is the hypercoagulable state that can result from glomerular damage from?

A

loss of antithrombin: endogenous anticoagulant
low albumin and high cholesterol increase platelet aggregation

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12
Q

what is a downstream effect of proteinuria?

A

overload proximal tubule capacity to reabsorb: +/- eosinophilic “hyaline droplets” in renal epithelium

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13
Q

what are the two main categorizations of glomerular disease?

A

glomerulonephritis: inflammation
glomerulonephropathy

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14
Q

glomerulonephritis is usually caused by deposition of _____________________ within glomeruli

A

solute immune complexes

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15
Q

what size complexes are most damaging in deposition of solute immune complexes within glomeruli?

A

small or intermediate complexes: deposit on either side of basement membrane

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16
Q

what are some diseases known to cause immune-complex glomerulonephritis?

A

chronic infection
chronic parasitism
neoplasia
inflammatory diseases
certain drugs and foreign substances

17
Q

amyloid deposits in glomeruli stain with ________ and stand out on cut surface of kidney

A

iodine

18
Q

what is amyloid?

A

abnormally folded proteins: beta pleated sheets

19
Q

amyloid binds _________________: only amyloid is stained in orange red

A

congo red stain

20
Q

what is the most common form of amyloidosis?

A

reactive amyloidosis

21
Q

what is familial amyloidosis and shar pei fever?

A

immune system dysregulation
progressive renal failure and amyloid deposits in numerous tissues
renal deposits often in medullary interstitium

22
Q

in which cats is amyloidosis not uncommon?

A

abyssinian cats
siamese, oriental shorthair

23
Q

where do cats usually deposit amyloid if they have amyloidosis?

A

often in medulla

24
Q

can direct bacterial infection cause glomerular disease?

A

occasionally
bacteremia can cause bacteria to lodge in glomerular capillaries

25
Q

white spotted kidney in cows can be due to ______________________________________

A

an embolic shower of bacteria

26
Q

what is the histology of white spotted kidney?

A

multiple foci of inflammation: microabscesses

27
Q

what viruses can cause glomerular disease via direct viral insult?

A

canine hepatitis
avian polyoma virus
equine viral arteritis virus
hog cholera
porcine cytomegalovirus infection

28
Q

what do familial glomerulopathies vary in?

A

inheritance
age of onset
underlying structural disorders
microscopic abnormalities

29
Q

what emboli are most common in hypercoagulable state?

A

pulmonary thromboemboli
also in portal vein or other arteries

30
Q

how can glomerulosclerosis be identified?

A

trichrome stain

Urinary Pathophysiology (11 decks)

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