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Flashcards in Kidney Deck (379)
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360

Renal amyloidosis: Histopathology (4).

Glomeruli: Thickening of basement membranes; mesangial nodules.

Tubules: Thickening of basement membranes.

Arterioles: Intimal nodules.

361

Renal amyloidosis: Electron microscopy.

Non-branching, randomly organized fibrils, 9-11 nm in diameter.

362

Renal amyloidosis vs. light-chain-deposition disease.

In the latter, there are finely granular, electron-dense deposits.

363

Acute tubular injury:

A. Presentation.
B. Laboratory finding.

A. Acute renal failure with oliguria or anuria.

B. Granular casts.

364

Acute tubular injury: Causes.

Ischemia (90%).

Nephrotoxins.

365

Acute tubular injury: Most vulnerable part of nephron.

The distal part.

366

Acute tubular injury: Histopathology (4).

Tubular epithelial cells:
− Loss of brush border.
− Necrosis in a minority of tubules.
− Regenerative changes.

Glomeruli and blood vessels: No change.

367

Acute tubular injury: Special stain.

PAS reveals loss of brush borders.

368

Drug-induced interstitial nephritis: Classic triad.

Hypersensitivity reaction.

Maculopapular rash.

Eosinophilia.

369

Drug-induced interstitial nephritis: Laboratory findings (3).

Mild proteinuria.

Microscopic hematuria.

Eosinophiluria.

370

Drug-induced interstitial nephritis: Causes (4).

NSAIDs.

Antimicrobials.

Diuretics.

Others.

372

Drug-induced interstitial nephritis: Electron microscopy.

NSAIDs: Diffuse injury to podocytes, with a effacement of foot processes.

373

Acute obstructive nephropathy: Causes (3).

Cast nephropathies:
− Myeloma.
− Myoglobin.
− Hemoglobin.

374

Myeloma cast nephropathy: Histopathology (3).

Fractured or crystalline-appearing casts surrounded by giant cells.

Reactive epithelial cells in the affected tubules.

Interstitial fibrosis and lymphocytic inflammation.

375

Myeloma cast nephropathy: Special stain.

Negative for PAS (Tamm-Horsfall casts are positive).

376

Hypertensive nephropathy: Other histologic changes (3).

Glomeruli: Global sclerosis.

Tubules: Atrophy.

Interstitium: Fibrosis.

377

Hypertensive nephropathy: Histologic changes in arteries (3).

Intimal fibrosis, medial hypertrophy, duplication of the elastic lamina.

378

Hypertensive nephropathy: Histologic change in arterioles.

Hyalinization.

379

Drug-induced interstitial nephritis: Histopathology (3).

Interstitial edema and inflammation, often including eosinophils.

Inflammation of tubules in the active phase.

Granulomas can be seen.