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
