PATHOLOGY - Patterns of Renal Disease

Question 1

What are the three portals of entry for renal disease?

Answer 1

Haematogenous
Ascending from the lower urinary tract
Direct entry

Question 2

What are the six patterns of renal disease?

Answer 2

Developmental
Vascular
Tubular
Tubulointerstitial
Renal pelvis/ascending
End stage kidney disease

Question 3

What are the three renal defence mechanisms against disease?

Answer 3

Basement membranes
Mesangial cells
Host immune system

Question 4

List six examples of developmental kidney disease

Answer 4

Renal aplasia
Renal hypoplasia
Renal dysplasia
Ectopic kidneys
Fused (horseshoe) kidneys
Polycystic kidney disease

Question 5

In which animal is polycystic kidney disease most common?

Answer 5

Feline (cats)

Question 6

What are the two types of vascular lesions seen in the kidneys?

Answer 6

Infarction
Haemorrhage

Question 7

What are two common causes of renal infarction?

Answer 7

Thromboemboli
In situ thrombosis

Question 8

What causes renal haemorrhage?

Answer 8

Renal haemorrhage can be caused by any systemic vascular injury

Question 9

List three systemic vascular injuries which can be the cause of renal haemorrhage

Answer 9

Septicaemia
Vasculitis
Disseminated intravascular coagulation (DIC)

Question 10

List four examples of glomerular disease

Answer 10

Glomerulonephritis
Glomerulonephropathy
Glomerular amyloidosis
Glomerulosclerosis

Question 11

What is the endpoint of glomerular disease?

Answer 11

Protein-losing nephropathy

Question 12

What is the most common cause of Glomerulonephritis?

Answer 12

Immune complex deposition (autoimmune disease) resulting in damage to the glomerular basement membrane due to podocyte effacement

Question 13

What is the gross appearance of Glomerulonephritis?

Answer 13

Glomerulonephritis typically has a normal gross appearance

Question 14

What should be done to diagnose Immune-mediated Glomerulonephritis?

Answer 14

Renal biopsy followed by histology, electron microscopy and immunofluorescence

Question 15

What is the histological appearance of Immune-mediated Glomerulonephritis?

Answer 15

Immune complex deposits seen as red dots along the glomerular capillaries

Question 16

What is Glomerular amyloidosis typically associated with?

Answer 16

Glomerular amyloidosis is typically associated with chronic inflammation

Question 17

What is the gross appearance of Glomerular amyloidosis?

Answer 17

Enlarged, pale and waxy kidney(s)

Question 18

What stain should be used to diagnose Glomerular amyloidosis?

Answer 18

Congo-red stain

Question 19

What is Glomerulosclerosis?

Answer 19

Glomerulosclerosis is fibrosis (scarring) of the glomerulus

Question 20

What is Glomerulosclerosis typically associated with?

Answer 20

Glomerulosclerosis is typically associated with chronic inflammation and necrosis

Question 21

What are two common causes of acute tubular necrosis?

Answer 21

Nephrotoxins
Ischaemia

Question 22

Give an example of a nephrotoxin that can cause acute tubular necrosis

Answer 22

Ethylene glycol forming calcium oxalate crystals leading to oxalate nephrosis and acute tubular necrosis

Question 23

Give an example of a disease which can cause tubulointerstitial nephritis

Answer 23

Leptospirosis

Question 24

What stain can be used to identify Leptospirae within the tubulointerstitium?

Answer 24

Warthin-starry stain

Question 25

What are two common causes of renal pelvis lesions?

Answer 25

Hydronephrosis Pyelonephritis

Question 26

What is Hydronephrosis?

Answer 26

Hydronephrosis is dilation of the renal pelvis caused by urine accumulation

Question 27

What is a common cause of Hydronephrosis?

Answer 27

Hydroneprhosis is often caused by an obstruction of urine outflow due to a build up of calculi

Question 28

List three examples of renal neoplasia

Answer 28

Renal carcinoma Transitional cell carcinoma Nephroblastoma

Question 29

(T/F) Renal tumours are very common

Answer 29

FALSE. Renal tumours are very rare however do have malignant potential

Question 30

What is the typical appearance of a renal tumour?

Answer 30

Renal tumours are typically one solid white mass at one pole of the kidney

Question 31

What is the gross appearance of end-stage kidney failure?

Answer 31

Pale, shrunken, pitted, firm and fibrotic kidney(s)

Question 32

What is the histological appearance of end-stage kidney failure?

Answer 32

Increased connective tissue, atrophied tubules and sclerotic glomeruli