Renal Disorders Flashcards Preview

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Flashcards in Renal Disorders Deck (31):
1

Unilateral multicystic renal dysplasia

• MCC of abd mass in newborns
• Remove affected kidney

2

ADPKD

• Manifests in 30s
• Bilateral, cystic parenchyma w/ enlarged kidneys
• Hepatic cysts and cerebral aneurysms also common

3

ARPKD

• Extremely large, smooth kidneys w/ fibrosis
• Many die from pulmonary hypoplasia
• Hepatic fibrosis also common

4

Minimal change disease

• Children
• Causes nephrotic syndrome
• Effacement of podocytes
• Excess lipids deposit as hyaline droplets in tubular epithelial cells
• Often resolves with steroids

5

Focal segmental glomerulosclerosis

• Causes nephrotic syndrome
• Capillaries obliterated by ECM or accumulated cells
• Sclerotic segments show IgM and C3 under IF
• May be caused by pamidronate
• HIV can cause rapid variant of this disease

6

Membranous glomerulonephritis

• Whites and Asians
• Subepithelial immune complex deposition in glomerular capillaries

7

Nephronophthisis/medullary cystic disease

• Nephronophthisis: childhood-adolescence
• MCD: adolescence-adulthood
• Cysts at corticomedullary jxn, atrophic tubules with thick basement membranes
• Salt wasting, azotemia, renal failure

8

Medullary sponge kidney

• Epithelium-lined cysts in papillae
• Sx at age 30-60; flank pain, dysuria, hematuria, "gravel" in urine (stones from cysts)

9

Diabetic glomerulosclerosis

• Basement membrane thickening, mesangium expansion, Kimmelstiel-Wilson nodules, hyaline accumulations along capillaries
• IgG and other proteins trapped linearly in GBM

10

Amyloidosis

• AA amyloid most common, assoc. w/ chronic inflammation
• Eosinophilic, Congo red stain
• Deposits in mesangium, then capillary walls

11

Alport syndrome (hereditary nephritis)

• Type IV collagen mutation
• Also causes hearing loss
• Glomerular sclerosis, tubular atrophy, interstitial fibrosis, foam cells, thick GBM

12

Postinfectious glomerulonephritis

• After beta-hemolytic strep or staph infections
• Complement-rich IC deposits in glomeruli
• "Humps" (subepithelial dense deposits)

13

Membranoproliferative glomerulonephritis

• Late childhood/early adulthood
• Glomeruli distorted by monocyte infiltration and mesangial cell proliferation; cap wall and GBM thickening
• Granular deposits of complement (and sometimes Ig) in cap loops and mesangium

14

C3 glomerulopathy

• Mostly children
• "Dense deposit disease"
• Ribbon-like zone of increased density in center of GBM and mesangium

15

IgA nephropathy

• Exacerbations triggered by resp or GI infections
• IgA deposits in mesangium
• Occurs w/ Henoch-Schönlein purpura

16

Anti-GBM Ab disease

• Abs versus type IV collagen in GBM
• With lung involvement: Goodpasture syndrome
• Diffuse linear GBM staining for IgG
• Crescents, fibrinoid necrosis common
• Rapid progression

17

ANCA glomerulonephritis

• Glomerular necrosis and crescents
• Often presents with small-vessel vasculitis

18

Hypertensive nephrosclerosis

• Small kidneys with granular surfaces, thin CTX
• Hyaline arteriolosclerosis

19

Renal artery HTN

• Increased renin, angiotensin II, aldosterone
• Small kidneys

20

Hemolytic uremic syndrome

• Children
• E. coli GI infections
• Thrombotic microangiopathy

21

Drug-induced hypersensitivity tubulointerstitial nephritis

• Type IV hypersensitivity w/ eosinophils
• NSAIDs, diuretics, some Abx

22

Light-chain cast nephropathy

• Multiple myeloma
• Hyaline, crystalline casts in distal tubule + collecting duct
• Interstitial Ca deposits

23

Urate nephropathy

• Chronic: gout
• Acute: increased cell turnover from chemo, diuretics
• Uric acid crystals (yellow streaks) obstruct tubules

24

Kidney stones

• Infection from Proteus or Providencia spp. creates stones from struvite (magnesium ammonium phosphate) or apatite (calcium phosphate); may become staghorns
• Uric acid stones: yellow and radiolucent
• Cystine stones: hereditary cystinuria in children

25

Papillary renal adenoma

• Increased incidence with age
• Papillary growth

26

Renal oncocytoma

• Derived from collecting duct intercalated cells
• Abundant, finely granular cytoplasm

27

Medullary fibroma

• Common, small
• Small stellate or polygonal cells in loose stroma

28

Angiomyolipoma

• Strong association with tuberous sclerosis
• Adipose tissue, smooth muscle, thick-walled vessels

29

Mesoblastic nephroma

• Found in infancy
• Spindle cells; mass with irregular margins

30

Wilms tumor

• Children
• Large tumors with mixed blastema, stroma, epithelium; possibly other components

31

Renal cell carcinoma

• Middle age, men > women
• Common
• Can be associated w/ VHL
• Often produces ectopic hormones and paraneoplastic syndromes (PTH-like hormone, erythropoietin, renin)