patho 938-844 vascular diseases Flashcards
(24 cards)
what is the term used for the renal pathology associated with sclerosis of renal arterioles and small arteries and is strongly associated with hypertension
nephrosclerosis
what 2 processes participate in the arterial lesions of nephrosclerosis
medial and intimal thickening and hyalinization of arteriolar walls
what is the loss of mass with nephrosclerosis due mainly to
cortical scarring and shrinking
what does the patchy ischemic atrophy of nephrosclerosis consist of
foci of tubular atrophy and interstitial fibrosis; variety of glomerular alterations
what is the renal vascular disorder (nephrosclerosis) associated with malignant or accelerated hypertension
malignant nephrosclerosis
what is a frequent cause of renal failure in individuals with systemic sclerosis
malignant nephrosclerosis
what is the fundamental lesion in malignant nephrosclerosis
vascular injury
what do patients with malignant hypertension that have malignant nephrosclerosis have elevated levels of
plasma renin
what are the 2 histologic alterations characterizing the blood vessels in malignant hypertension
fibrinoid necrosis of arterioles and intimal thickening caused by proliferation of elongated, concentrically arranged smooth muscles (known as onion skinning)
what does the lesion hyper plastic arteriolitis correlate with
renal failure
what is hypertension secondary to renal artery stenosis caused by
increased production of renin from the ischemic kidney
what is the most common cause of renal artery stenosis
narrowing at the origin of the renal artery by an atheromatous plaque
what is the second most common cause of renal artery stenosis
fibromuscular dysplasia of the renal artery
what 2 syndromes are included in thrombotic microangiopathy
thrombotic thrombocytopenia purport (TPP) and hemolytic-uremic syndrome (HUS)
what is typical HUS most commonly associated with
consumption of food contaminated by bacteria producing shiva-like toxins
what is ADAMTS13 and what disorder is it typically deficient in
it is a plasma metalloprotease that regulates the function of von willebrand factor; deficient in TPP
what are the pathogenic triggers that dominate in thrombotic microangiopathies
endothelial injury and excessive platelet activation & aggregation
what does typical HUS typically follow
a prodrome of influenza-like or diarrheal symptoms
what is the most common deficiency in adults that acquire atypical HUS
deficiency of factor H
what pentad is TPP most classically manifested by
fever, neurologic symptoms, microangiopathic hemolytic anemia, thrombocytopenia, renal failure
what is the dominant feature of TPP
CNS involvement
what are the most common abnormalities with sickle cell nephropathy
hematuria and diminished concentrating ability (hyposthenuria)
when does diffuse cortical necrosis most frequently occur
after obstretric emergency
where are the alterations that occur with diffuse cortical necrosis
sharply limited to the renal cortex
