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Pathology Flashcards

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1
Q

granular casts ‘muddy brown’

A

acute tubular necrosis

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2
Q

casts in urine indicate that the site of haematuria / pyuria is where?

A

glomerular or tubular in origin
i.e. haematuria due to bladder cancer -> haematuria without casts

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3
Q

fatty casts ‘oval fat bodies’

A

nephrotic syndrome
associated with Maltese cross sign

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4
Q

waxy casts

A

end stage renal disease / chronic kidney disease

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5
Q

hyaline casts

A

non-specific, can be normal function kidney with dehydration, exercise or diuretic therapy

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6
Q

pathophysiology of proteinuria in nephrotic syndrome

A

podocyte damage -> impaired charge barrier -> poteinuria

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7
Q

granular ‘stary sky’ appearance on immunoflourescence

A

post-infective glomerulonephritis due to IgG, IgM and C3 deposition along GBM and mesangium

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8
Q

what type of hypersensitivity reaction is post infective glomerulonephritis

A

type III

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9
Q

what type of hypersensitivity reaction is good pastures syndrome

A

type II

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10
Q

antibodies associated with microscopic polyangitis and eosinophillic granulomatosis with polyangitis

A

MPO
pANCA

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11
Q

antibodies associated with granulomatosis with polyangitis

A

PR3
cANCA

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12
Q

main cause of diffuse proliferative glomerulonephritis

A

SLE

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13
Q

wire loping of capillaries on light microscopy

A

diffuse proliferative glomerulonpehritis

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14
Q

features of Alport syndrome

A

x-linked dominant
type IV collagen mutation

eye problems, glomerulonephritis, SNHL

(cant see, cant pee, cant hear a bee)

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15
Q

basket weave appearance on electron microscopy

A

Alports syndrome
(baskets at the port)

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16
Q

GMB splitting and ‘tram-track’ on H&E and PAS stains

A

membrano-proliferative glomerulonephritis

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17
Q

effacement of podocyte foot processes

A

minimal change disease
focal segmental glomerulosclerosis

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18
Q

spike and dome appearance of subepithelial deposits

A

membranous nephropathy

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19
Q

eosinophillic casts resembling thyroid tissue

A

thyroidization of kidney
occurs in chronic pyeloonephritis

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20
Q

causes of acute interstitial nephritis

A

remember the causes of inflammation to your DRAINS;

D iuretics
Rifampicin
Antibiotics (penicillins, cephalosporins)
I - PPI’s
NSAIDS
Sulpha drugs

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21
Q

symptoms of acute interstitial nephritis

A

haematuria
fever
rash
pyuria
costovertebral angle tenderness

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22
Q

in the recovery phase of acute tubular necrosis, what electrolyte abnormality are you at risk of

A

hypokalaemia

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23
Q

features of renal papillary necrosis

A

sloughing of necrotic renal pappilae = gross haematuria

Associated with;
‘SAD papa with pappilary necrosis’
Sickle cell
Acute pyelonephritis
Analgesics i.e. NSAIDS
Diabetes

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24
Q

mutation in ADPKD

A

mutation in genes encoding polycystin protein;
PKD1 - chromosome 16
PKD2 - chromosome 4

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25
mutation in autosomal recessive polycystic kidney disease
PKHD1 encoding fibrocytin
26
condition that may be associated with renal cell carcinoma
Von hippel lindau
27
mutation associated with clear cell renal carcinoma
gene deletion on chromosome 3
28
most common subtype of renal cell carcinoma
clear cell
29
paraneoplastic syndromes associated with renal cell carcinoma
'PEAR' PTHrP Ectopic EPO ACTH Renin
30
polygonal clear cells filled with accumulated lipis and carbohydrates
renal cell carcinoma
31
large eosinophillic cells with abundant mitochondria without perinuclear clearing
benign renal oncycytoma
32
mutations associated with Wilm's tumour (nephroblastoma)
loss of function of tumour suppressor genes WT1 or WT2 on chromosome 11
33
risk factors associated with urothelial carcinoma of bladder
PEE SAC Smoking Aromatic amines (i.e. 2-Naphthylamine) Cyclophosphamide
34
risk factors associated with squamous cell carcinoma of the bladder
4 S's Schistosomiasis chronic Systitis (cystitis) chronic Stones Smoking
35
mechanism of diabetic nephropathy
non-enzymatic glycation of tissue proteins -> mesangial expansion, GBM thickening and increased permeability and hyperfiltration proteinuria
36
hexagonal crystals on urinalysis
cystinuria
37
testing modality for cystinuria
cyanide nitroprusside
38
features of cystinuria
recurrent kidney stones may have family history - autosomal recessive genetic mutations on chromsome 2 or 19 hexagonal crystals in urinalysis cyanide nitroprusside test is positive
39
proliferation of mesangial cells
IgA nephropathy
40
recurrent UTI's with urease-positive bacteria (i.e. proteus mirabilis) can increase risk of kidney stones of what composite ?
ammonium magnesium phosphate (struvite)
41
what syndrome may Wilm's tumour be associated with
beckwith-Wiedemann syndrome WAGR denys - drash syndrome
42
renal cell carcinoma (clear cell) arises from which part of the kidney
proximal convoluted tubule
43
microscopy - congo red stain shows apple green birefringence under polarised light
amyloidosis
44
extracellular deposition of an insoluble fibrillar protein
amyloidosis
45
most common causative organism of prostatitis
e.coli (gram negative)
46
most common composite of renal stone with cystinuria
cystine
47
most common composite of renal stone
calcium
48
most common composite of renal stone with gram negative urease bacteria
struvite
49
most common composite of renal stone with conditions with high cell turnover i.e. cancer
uric acid
50
what type of renal stones are radio-lucent and therefore may not be visible on xray
cystine stones uric acid stones
51
glomerulonephritis caused by igG antibodies and is positive for C3 on microscopy
membrano proliferative glomerulonephritis persistent activation of alternate complement pathway - GBM splitting and tram track on PAS stains
52
urine Na and osmolality if pre renal
Urine Na < 20 Urine osmolality > 500
53
subepithelial 'humps' caused by lumpy immune complex deposits
post strep glomerulonephritis - granular 'stary sky' appearance
54
what type of glomerulonephritis is associated with HIV
FSGS (focal segmental glomerulosclerosis) renal failure + proteinuria
55
linear antibody deposits along the basement membrane on immunoflourescence
anti-GBM disease (good pastures) renal failure + pulmonary haemorrhage
56
glomerular injury with normal light microscopy
minimal change
57
glomerular injury with small vessel haemorrhage
small vessel vasculitis i.e. granulomatosis with polyangitis, microscopic polyangitis, eosinophillic granulomatosis
58
how does minimal change disease cause increased prothrombotic risk
can cause renal vein thrombosis due to loss of anti thrombin
59
focal segmental glomerulosclerosis secondary causes
HIV, sickle cell, infection, obesity, congenital malformations
60
diffuse capillary and GBM thickening
membranous glomerulonephritis
61
kimmel-steil wilson lesions
diabetic nephropathy (eosinophillic glomerulosclerosis)
62
secondary causes of membranous nephropathy
drugs (NSAIDS, penicillamine, gold) infections (hepatits B and C, syphillis) SLE tumours
63
is fractional excretion of sodium high or low in pre renal AKI ?
< 2% (low) in pre-renal
64
WAGR features
wilms tumour aniridia (partial loss of iris) genital anomalies range of developmental delays
65
RENAL TUBULAR MEDHCANISM IN ALKALOSIS CAUSED BY VOMITING
increased Na/H exchange in proximal convoluted tubule
66
cause of hypernatraemia with urine high urine osmolality and low urinary Na
non-renal water loss i.e. vomiting, burns
67
loss of heparan sulphate proteoglycans
nephrotic syndrome
68
Na in serum, urine and urine osmolality found in nephrogenic diabetes insipidous
hypernatraemia, low urine Na, low urine osmolality
69
how does NSAIDS cause renal damage
afferent arteriolar constriction
70
defect in amino acid reabsorption in proximal convoluted tubule
cystinuria --> kdiney stones
71
what type of kidney stones can be caused by a urine infection with urease producing bacteria
struvite stones
72
intestinal malabsorption of fat can cause what type of stones
calcium oxalate
73
rapid destruction of blood erythrocytes can cause what type of stones
urate
74
kidney stones can cause a rise in what urinary substrates
calcium uric acid oxalate
75
electrolyte effects of mannitol
hyponatraemia with high serum osmolality (as mannitol remains in the circulation = high osmolality, it draws water out of cells = hyponatraemia)
76
what electrolyte abnormality would chlorthiazide cause?
hypercalcaemia (causes excretion of water and chloride and retains calcium)
77
acetazolamide causes excretion of what substances
sodium chloride and bicarbonate
78
what UTI causing bacteria produces urease
staph. saprophyticus
79
what UTI causing bacteria ferments lactose and forms pink colonies on McCockney agar
E.coli
80
what UTI causing bacteria produces hydrogen sulphide
proteus salmonella
81
action of ADH
acts on V2 receptors in the collecting ducts
82
wilms tumour, nephrotic syndrome, dysgenesis of gonads
denys drash syndrome (diffuse mesangial sclerosis)
83
wilms tumour, macroglossia, organomegaly, hemihyperplasia, omphalocele
beckwith-wideman syndrome
84
chromosome affected in wilms tumour
chromosome 11
85
how to convert glucose mg/dl to mmol/l
x by 0.0555
86
hyponatraemia, urine Na low and low urine osmolality
psychogenic polydypsia
87
pathophysiology of hepatorenal syndrome
vasodilatation of splanchnic arterial vasodilatation causes shunting of blood from the kidneys to the gut rapid onset of AKI without evidence of renal ischaemia or insult normal histology of he kidney no improvement with albumin
88
Mesangial and subendothelial IgM, C3 l, and k light chains
membrano-proliferative glomerulonephritis
89
Subepithelial deposition of IgG, C3, and leukocytes
post strep glomerulonephritis
90
common mets in wilms tumour
lung and liver
91
does nephrogenic diabetes insipidous respond to vasopressin
no due to ADH resistance (volume depletion leads to elevated ADH levels but this doesnt increase water due to resistance)
92
complications of polycystic kidney disease
cerebral aneurysms hepatic cysts cardiac valvular lesions
93
UTI with lack of nitrite on urinalysis and by culture on bile esculin agar
enterococcus
94
UTI with lack of nitrite on urinalysis
gram positive - staph or enterococcus
95
UTI caused by bacteria with blue green pigment, fruity odour and is drug resistant
pseudomonnas
96
UTI caused by bacteria which produces urease and causes struvite stones, motility causes swarming on agar
proteus
97
UTI caused by bacteria that produces red pigment
serratia marcescens
98
thinning and splittig of glomerular basement membrane
alport syndrome
99
renal changes in response to haemorrhage
increase renin from juxtaglomerular cells + constriction of afferent and efferent arterioles to retain Na and constrict vessels to increase blood pressure
100
features of siADH
euvolaemic hyponatraemia serum osmolality < 275 urine osmolality > 300 urine Na <> 40 reduced free water clearance first line treatment - water restriction. consider tolvaptan/domeclocycline
101
antihypertensive that causes metabolic alkalosis with low K
thiazide like diuretics
102
where does wilms tumour originate from?
metanephric blastema
103
renal disease, loss of deep tendon reflexes, ECG changes, nausea
low magnesium
104
what chromosome is affected in ADPKD
chromosome 16

Renal (7 decks)

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