Renal Flashcards Preview

Pathology > Renal > Flashcards

Flashcards in Renal Deck (57)
Loading flashcards...
1

What characterizes Renal dysplasia?

Undifferentiated Tubular Structures surrounded by primitive mesenchyme, sometimes with heterotropic tissue such as smooth muscle and cartilage

2

What does renal dysplasia result from?

metanephric differentiation

3

What are the subtypes of RENAL DYSPLASIA?

Aplastic
Multicystic
Diffuse Cystic
Obstructive

4

What is the most common cause of an abdominal mass in newborns? What otheer mass can be palpated in newborns with this disease?

Unilateral multicystic renal dysplasia

Flank mass

5

What characterizes Medullary sponge kidney?

Multiple small cysts in the renal papillae

6

What are the symptoms of AD PKD?

Heaviness in the loins
B/L Flank Mass
Passage of Blood Clot in the Urine
Azotemia
1/2 progress to uremia (clinical renal failure)

7

Morphological changes in what part of the kidney do the following syndromes share in common (Amyloid nephropathy, FSGS, Hereditary Nephritis, Membranous glomerulopoathy)?

Glomeruli

8

What causes Amyloid Nephropathy?

Deposition of secreted lambda or kappa light chains in the glomerular basement membranes and mesangial matrix. Amorphous acellular material expands the mesangium and obstructs the glomerular capillaries.

The immunoglobulin chains are secreted by neoplastic plasma cells.

9

Where else other than GBM can deposits of AL amyloid appear?

Tubular Basement membranes
Walls of Renal Vessels

10

Amyloid deposits are identified by? not identified by?

Congo Red apple-green
Not PAS - it is not PAS positive

11

What does Renal amyloidosis lead to ?

Nephrotic Syndrome
Renal Failure

12

What characterizes MCD?

Fusion (effacement) of visceral epithelial foot processes on EM (from cell selling as seen in all cases in nephrotic range proteinuria)
Normal glomeruli in light microscopy

13

Where are granular deposits found in the glomeruli of patients affected by Membranous proliferative glomerulonephritis?

Glomerular capillary Loops and Mesangium

14

What are the range of possible prognosis of membranous glomerulonephropathy?

Spontaneous Remission (25%)
Persistent proteinuria and stable/partial loss of renal function (50%)
Renal Failure (25%)

15

Subendothelial deposits of immune complexes are found in what diseases?

Lupus Nephritis
Membranoproliferative glomerulonephritis

16

What might distinguish membranous nephropathy due to lupus from idiopathic membranous nephropathy?

Membranous nephropathy of lupus also features mesangial and subendothelial deposits of immunogloobulins. (not just along BM)

17

Granulomatous lesions resulting from Wgener granulomatosis can be found where in the body?

The nose, sinuses, lungs, and is associated with renal glomerular disease

18

Wegner granulomatous necrotic lesions are characterized by?

Parenchymal necrosis
Vasculitis
Granulomatous inflammation (composed of neutrophils, plasma cells, and macrophages)

19

What characterizes ANCA glomerulonephritis?

It is an aggressive, Neutrophil-mediated disease characterized by glomerular necrosis and crescents.

Neutrophils adhere to endothelial cells, release toxic oxygen metabolites, degranulate, and kill the endothelial cells.

Exudation of inflammatory cells through the disrupted, segmentally necrotic basement membrane leads to the formation of the crescents.

20

In FSGS, what findings are expected upon light microscopy?

Varying numbers of glomeruli with segmental obliteration of capillary loops

( obliteration caused by increased collagen and the accumulation of lipid or proteinaceous material.)

21

ON renal biopsy, what is the diagnostic findings of Berger Diseaes?

Intense Mesangial staining for IgA often accompanied by C3 staining (activates complement through the alternative pathway)

(There is a range of nephropathies seen on light microscopy: no changes to chronic sclerosing glomerulonephritis)

22

What groups of diseases demonstrate Focal proliferative glomerulonephritis pathology?

Lupus Nephritis
Nephritis that accompanies several vasculitides, Henoch-Schonlein Purpura, IgA Nephropathy (Berger Disease)

23

Ultrastructural features of acute postinfectious glomerulonephritis include

Subepithelial dense deposits shaped like 'humps'.

Deposits are accompanied by mesangial and subendothelial deposits which may be more difficult to find but more important in pathogenesis because of their proximity to inflammatory mediator systems in the blood.

24

What is Diffuse proliferative glomerulonephritis?

Severe form of lupus nephritis, characterized by widespread involvement of glomeruli and diffuse proliferation of mesangial and endothelial cells and even of epithelial cells.

25

What is most common complication of SLE?

Nephritis

26

What are microscopic findings of proliferative glomerulonephritis

EM: Deposits of immune complexes on both sides of the basement membrane, in the mesangial areas, and even inside the capillary loops

Thickened BM of the glomeruli are known as "wire loop" lesions.

27

90% of patients with what glomerular patholgoy have glomerular crescents(crescentic glomerulonephritis)

Patients with anti-GBM glomerulonephritis

28

What does Anti-GBM glomerulonephritis typically present with?

Rapidly Progressive Renal Failure
Nephritic Signs and Symptoms

Linear immunofluorescence for Ig G is seen along the GBM

29

Secondary membranous nephropathy causes

Autoimmune Disease (ex SLE)
Infectious Diseases (Hep B)
Therapeutic Agents (ex. Penicillamine)
Malignancy (Paraneoplastic Syndrome is membranous nephropathy)

30

What bacteria causes 80% of acute pyelonephritis? What is a typical finding in these cases?

Escherichia coli
Bacteriuria