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Block 9; Week 5-M > Pictures > Flashcards

Flashcards in Pictures Deck (31)
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1
Q

What is shown here?

A

renal cortex

note the glomeruli everywhere

also DCT & PCT will be prevalent. PCT will be the ones w/ the fuzzy lumen.

2
Q

What’s this?

A

glomerulus

not the endothelium & PCT (fuzzy) etc.

3
Q

What is this?

A

glomerulus

E: endothelium

F: fenestration

C: capillary

BM: basement membrane

P2: secondary podocyte process

FS: filtration slit

4
Q

What is shown here? What’s the big black glob in the middle?

A

another glomerulus

big black glob is the nuclei of the mesangial cells. Lays down matrix in the middle there.

5
Q

What is this?

A

PCT. can tell b/c of the brush border of microvilli for increased absorption. found in the cortex.

6
Q

What’s the difference here b/w the DCT & PCT?

A

DCT smooth w/o microvilli of brush border.

7
Q

What’s this?

A

PCT

see the microvilli!

8
Q

What is the function of the cell marked J?

A

juxtraglomerular cells

secrete renin if they sense decreased renal blood flow b/c they assume–our systemic BP is too low! Let me fix that!

9
Q

What is this?

A

renal medulla

not cortex b/c you can’t see glomeruli

see arteries, veins, collecting tubules & ducts

note: vasa recta is found here!

10
Q

What is the thing labeled DB, PCS, U? What type of epithelium is found here?

A

uroepithelium!

DB: ducts of bellini

PCS: pelvicalyceal system

U: beginning of the ureter

11
Q

What is the problem here?

A

hypercellularity following glomerular injury

12
Q

What is the problem here?

A

Nothing! It’s normal : )

13
Q

What is the problem here?

A

basement membrane thickening as a result of glomerular injury

14
Q

What’s the problem here?

A

hyalinosis

see some eosinophils, sclerosis, collagen deposition

15
Q

What’s the problem here?

A

nothing, it’s normal! : )

16
Q

What’s the problem here?

A

sclerosis as a result of glomerular injury

17
Q

What is this?

A

Immunofluorescence shows granular pattern. Indicative of heymann in situ pattern of glomerular injury. Will also expect to be able to see antigen-antibody complex depositions on the subepithelium on electromicrograph.

18
Q

What is this?

A

electromicrograph shows complex deposition on subepithelium.

In situ Heymann form of glomerular injury

19
Q

What does this show?

A

this shows a linear pattern

consistent with in situ anti-GBM glomerular injury

antibody binds collagen in basement membrane

**won’t be able to see anything on electromicrograph b/c it is so consistent, & not really deposits

20
Q

What is this?

A

this electromicrograph of the glomerulus is free of any deposits b/c in situ anti-GBM glomerular injury is diffuse binding of antibody to collagen in the basement membrane. doesn’t show up on here.

21
Q

A 48-year-old man with a history of pyelonephritis presents to the emergency department with fever (38.4° C), nausea, vomiting, and sharp costovertebral pain. He had been diagnosed with pyelonephritis caused by Escherichia coli a month earlier and was treated with trimethoprim-sulfamethoxazole for two weeks. He is admitted to the hospital. His WBC count is 21,500/mm3 with a left shift. His hematocrit is 32 and he has an elevated ESR. Urinalysis shows leukocyte esterase (+) and nitrite (+). Urine culture grows E. coli, but blood cultures are negative. A CT scan of the left kidney reveals what? Treatment?

A

perinephric abscess

drain abscess percutaneously so that antibiotics can reach it.

IV antibiotics, here: ceftriaxone & gentamicin

22
Q

Those little wispy things are the virulence factors for what? which condition?

A

Type I Fimbrae for E coli

UTI!! Attaches to uroepithelial cells

23
Q

What do you see here? What could have caused this if it was related to a UTI?

A

big kidney stone

staghorn calculi

excess ammonium from proteus mirabilis producing urease

24
Q

What is this?

A

this UA shows the color of myoglobinuria

perhaps from rhabdomyolysis

25
Q

What do you see on this slide of a UA ?

A

white arrow: budding yeast

yellow arrow: bacteria

see hyaline cast

26
Q

What caused this pic on UA?

A

cystitis bleed

27
Q

What’s the deal with this UA microscopy?

A

these are dysmorphic RBCs, perhaps from an upper GI bleed. acanthocytes seen. Glomerulonephritis.

28
Q

What is this?

A

hyaline cast

29
Q

What is this?

A

RBC cast–think glomerulonephritis

30
Q

What is this?

A

WBC cast–think pyelonephritis, kidney inflammation

31
Q

What is this suggestive of on microscopy of UA?

A

granular casts w/ cellular debris

suggestive of acute tubular necrosis