Pathology of the Renal System: Overview of Renal Pathology Flashcards
(121 cards)
1
Q
What is the normal ratio of cortex to medulla in domestic species?
A
Normal Ratio of cortex to medulla in domestic species is about 1:3.
2
Q
What species have a unilobar or unipyramidal kidneys?
A
Unipyramidal (unilobar): Cats, dogs, horses, sheep, and goats
3
Q
What species have a multipyramidal (multilobar) kidneys?
A
- Multipyramidal (multilobar): Pigs and cattle
4
Q
What is the renal medulla composed of?
A
Renal medulla is composed mostly by collecting ducts and tubules.
5
Q
What is another term for the renal crest?
A
Renal papilla
6
Q
What makes up the hillus?
A
- Renal artery and vein is what makes up the hillus
7
Q
What animal species is the only one with external lobulation of the kidney?
A
Bovine
8
Q
What is a multilobulated kidney like?
A
Each lobe is like a kidney
9
Q
Is kidney A normal or abnormal? Kidney B?
A
10
Q
What are the four structural units of renal architecture?
A
11
Q
What is the functional unit of the kindey? What is included in this ?
A
12
Q
What part of the kidneys receives blood supply first? What next?
A
13
Q
What is the order of blood supply through the kidney vasculaure?
A
14
Q
Why is the kidney called an end artery organ? What is the significance of this?
A
15
Q
In a normal kidney can you see glomeruli?
A
No
16
Q
What is indicated in blue in this image?
A
17
Q
What is being indicated in blue in this image? What is this structure?
A
Renal corpuscle is the structure. The area in blue is called the urinary space
18
Q
What are messangial cells and what do they do?
A
19
Q
What is visceral epithelium?
A
20
Q
What is the glomerulus?
A
21
Q
What is the difference between proximal and distal tubules?
A
Proximal tubules have brush borders in order to increase the surface area.
22
Q
What are the components of the glomerular filtration barrier?
A
23
Q
What is the function of the glomerular filtration barrier?
A
24
Q
A
25
What is important about the renal architecture?
26
What is the typical appearence of kidneys that have experienced chronic kidney disease?
shrunken and scarred kidney
27
What is the function of the kidneys in the body?
28
How is maintenance of normal concentrations of salt, water and electrolytes achieved?
Regulated by the glomerular filtration barrier and resorption/ secretion of molecules within tubular system
29
How is the regulation of acid-base balance achieved?
This is primarily through reclaimation of bicarbonate
30
What are the hormones produced by the kidneys?
Erythropoietin, Renin and Prostaglandins
31
What is the function of erythropoietin? What happens if there is an absence of it?
Function is to stimulate bone marrow to produce erythrocytes. Without this you will have a non regenerative anemia.
32
What is the function of Renin?
RAAS
33
What is the function of prostaglandins? Where does it act?
Prostaglandins act in the renal medulla and are important for renal blood flow regulation. It keeps blood vessels open and prevent ischemic damage.
34
How does the kidneys convert vitamin D to its active form? Why is it important?
Its important for ca++/ phos metabolism. Vit D facilitates calcium absorption in the intestines,
35
What pressure is required for adequate renal perfusion?
60 mmHg
36
When is renal disease detected?
Re nal disease is detected if any of these requirements are not met, and the outcome is always appropriately the same:
There is imbalance of salt and water, and of acids and bases, and there is retention of wastes.
37
What is seen with water and salt imbalance?
Edema
38
What is seen with waste retention?
Elevated BUN / Creatinine
39
What is the most commonly used index of failure of the kidneys?
The most commonly used index of failure is the amount of urea and/or creatinine that is retained!
40
What are the consequences of impairment of each renal function?
Impairment of:
1.) Excrete metabolic waste = UREMIA
2.) Maintenance of normal concentrations of salt and water = EDEMA
3.) Regulation of acid-base balance = ACIDOSIS
4.)Production of hormones - Erythropoietin, Renin and Prostaglandins = ANEMIA, HYPERTENSION, ISCHEMIC NECROSIS
5.)5.Vitamin D to active form - 1,25 dihydroxycholecalciferol (1,25(oh)2d3) = HYPOCALCEMIA →→ HYPERCALCEMIA
41
When there is impairment of renal function, and there is issues with vitamin D conversion and calcium modulation, what is the processes that cause initial hypocalcemia, and later hypercalcemia?
42
What is the hallmark of kidney disease?
The impairment of Vit D conversion and issues with calcium phosphorus homeostasis.
43
Is this kidney undergoing acute or chronic renal failure?
44
Is this kidney undergoing acute or chronic renal failure?
45
At what point will you start to see signs of renal function impairment?
* When renal function capacity is impaired approximately 75% or more
46
What are the typical characteristics post mortem of a kidney that has undergone acute renal failure?
47
What are the typical characteristics post mortem of a kidney that has undergone chronic renal failure?
48
What are the categories of types of acute renal failure?
- Prerenal
- Postrenal
- Renal
( which further breaks down to acute glomerular nephritis, acute interstitial nephritis, acute tubular necrosis)
49
What is the causes of prerenal acute renal failure?
Decreased renal perfusion/ blood supply to the kidney. Can occur with hypotension (i.e septic shock, shock, hypovolemia, dec cardiac output, CHF, Dec arterial blood volume ( in case of vomiting and diarrhea)
50
What is the causes of postrenal acute renal failure?
51
What are the causes of the 3 types of renal- acute renal failure?
52
What is the most common type of acute renal failure?
Acute tubular necrosis (nephrotoxins or ischemia)
53
What are the hallmark clinical signs seen that indicate the patient is experiencing acute renal failure by tubular necrosis?
Oliguria and anuria
54
How does tubular necrosis acute renal failure cause oliguria and anuria?
55
What is seen in this image?
56
What is seen in this image?How can you describe it? What is indicated by the blue line?
57
What are you seeing in these two histologic slides of a kidney with acute renal failure via tubular necrosis?
58
How does death occur in accute renal failure?
59
What is seen in this image?
Lungs with pulmonary edema. Lungs are wet, you will see alot of foamy fluid inside if cut open. This is because of fluid retention/ edema.
60
What is chronic renal failure? What is the typical causes?
61
What are the hallmark clinical signs indicating chronic renal failure?
Polyuria and polydipsia
Increased urination and increased thirst
62
What other signs can be present in patients with chronic renal failure?
63
What is a hallmark sign of chronic renal failure?
64
What can be seen in this histological slide of a kidney with chronic kidney disease?
65
What characteristics are seen in this image and what kind of kidney disease (acute or chronic) is seen?
66
What is azotemia? What kind of renal disease is it seen?
Azotemia: Biochemial abnormality characterized by elevation of
blood urea and/or creatinine, but without obligatory of clinical
manifestation of renal disease. Prerenal, renal, post-renal.
67
What is uremia? What is often seen with it? What is the prognosis of a patient with uremia?
Uremia literally means urine in the blood. It is a clinical syndrome of
renal failure, caused by biochemical disturbances, and is often
accompanied by extrarenal lesions.
Prognosis is not good.
68
What is seen in this image? What is the cause of these lesions?
UREMIC GASTROPATHY (Dogs and Cats)
* Ulcers and hemorrhage secondary to vasculitis
* Mucosal calcification (less common) (can also be seen; cause is Alteration in Ca/P metabolism)
69
What is seen in this image? What is the typical cause?
* Mucosal calcification (less common)
Alteration in Ca/P metabolism
70
What is seen in this image?
Necrosis of blood vessel
71
What is seen in this image? What animals is it typically seen in? What is the cause?
72
What is seen in this image? What is the cause?
73
What is seen in this image? What is the cause?
74
What is seen in this image? What is the cause?
75
What is seen in this image? What is the cause?
76
What are the 3 mechanisms caused by renal impairment that are the causes of the extra renal lesions?
77
What is seen in this image? What is circled in blue? What is circled in yellow? What is circled in orange?
78
What is seen in this image? What is the cause? What other sign may be present in these patients?
79
What is seen in this image? What is the cause?
80
What is seen in this image?What is the cause?
81
What is seen in this image? What is the cause?
82
Where do you see uremic endocarditis usually?
L atrium
83
What is seen in this image? What is the cause?
84
What is seen in this image? What is the cause? What is indicated by the blue line?
85
What is seen in this image? What is the cause?
86
In parathyroid hyperplasia, which cell is hyperplastic?
Chief cells
87
What is seen in this image? What is the cause?
88
What is seen in this image? What is the cause?
Rubber Jaw
89
What is the cause of primary hyperparathyroidism?
parathyroid adenoma
90
What is the cause of secondary hyperparathyroidism?
- Nutritional (usually large animals with increased phosphorus diets)
- renal
91
What is seen in this image? What is the cause?
92
93
What is renal agenesis? What breeds is it common in? Does it usually cause alot of problems?
94
What is seen in this image? What is the cause?
95
What is renal hypoplasia? What is the criteria for diagnosis?
96
What is seen in this image? Why is one kidney larger than the other?
97
What will you usually see if you have renal hypoplasia?
Complasia hypertrophy of the other kidney
98
What is seen in this image? What is the cause?
99
What are the characteristics of a kidney with renal dysplasia?
100
What is renal dysplasia?
101
What is juvenile nephropathy?
102
What is familial/ breed nephropathy? What age is it developed at?
103
What is seen in this image?
104
What is seen in this image?
105
What is seen in this image? What kind of stain is used?
106
What is an ectopic kidney?
107
What is seen in this image?
108
What is seen in this image? What is the cause?
109
What is seen in this image? What is the cause?
110
What are the categories of renal cysts?
- Congenital
- Acquired
111
What are the characteristics of congenital cytsts?
112
What are the characteristics of acquired cysts?
113
What kind of cyst is seen in this image?
114
What kind of cyst is seen in this image? What is indicated by the blue circles?
Blue circles: mineralization and scarring
115
What is feline polycystic kidney? What is the patter of inheritence? What breeds are predisposed?
116
What is the genes affected in feline polycystic kidney disease? What do these genes do?
PDK -1 and PDK-2
-Mutation in PKD1 and PKD2 (encodes polycystin-1 and -2), which is part of the primary cilia of the tubular epithelial cells - This cilium senses fluid movement through the lumen
117
What is the mechanism of polycystic kidney disease of persian cats?
118
Where else can you see cysts in cats with polycystic kidney disease?
- Cysts also present in pancreas and liver
119
What do they cysts usually look like with Polycystic kidneys? Where do they occur?
120
What is the mean age of cats developing signs of renal failure when having polycystic kidneys (persian)?
3 years is mean age
121
What is seen in this image? What is the cause?
