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Human Disease Systems > Renal/Endocrine > Flashcards

Renal/Endocrine Flashcards

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1
Q

Renal cortex or medulla?

A

Renal cortex

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2
Q

Renal cortex or medulla?

A

Renal medulla

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3
Q

What part of the nephron is shown here?

Apical transporters? Basolateral transporters? Diuretics?

A

Proximal Convoluted Tubule

Apical transporters: NHE3 antiporter (Na+ in, H+ out); vH+ ATPase transporter (H+ out)

Basolateral transporters: Na+/K+ ATPase; NBCe1 transporter (HCO3- out)

Carbonic anhydrase IV (lumen) and II (cytoplasm) function to shuttle HCO3- into the cell, which it is then shuttled out into interstitial tissue by NBCe1

acetazolamide blocks carbonic anhydrase

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4
Q

What part of the nephron is shown here?

Apical transporters? Basolateral transporters? Diuretics?

A

Distal Convoluted Tubule

Apical transporters: TRPV5 (Ca++ in), TRPV6 (Mg++ in), NCC (Na+ and Cl- in)

Basolateral transporters: NCX1 (Ca++ out, 3Na+ in), Na+/K+ ATPase, gCl- (Cl- out)

NCC is blocked by thiazides

impermeable to H2O

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5
Q

What part of the nephron is shown here?

Apical transporters? Basolateral transporters? Diuretics?

A

Collecting Duct

Apical transporters: ENaC (Na+ in), K+ channel (K+ out)

Basolateral transporters: Na+/K+ ATPase

amilorine, triamterene block ENac; spironolactone block aldosterone effects (prevent upregulation of ENac)

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6
Q

Pathology?

A

Acute Tubular Necrosis

often ischemic in nature

FENa >2% (except in contrast-induced nephropathy), BUN/creatinine < 20:1, SG = 1.010, muddy brown casts

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7
Q

Pathology?

A

Acute Tubular Necrosis

often ischemic in nature

FENa >2% (except in contrast-induced nephropathy), BUN/creatinine < 20:1, SG = 1.010, muddy brown casts

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8
Q

Pathology?

A

Acute Tubular Necrosis

muddy brown casts

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9
Q

Pathology?

A

Acute Tubular Necrosis

muddy brown casts

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10
Q

Pathology?

A

Acute Interstitial Nephritis

acute disease characterized by interstitial infiltrates; often reversible

causes: drug hypersensitivity reactions (antibiotics/sulfa drugs, proton pump inhibitors, NSAIDs), infection, autoimmune

microscopic hematuria, leukocyturia, WBC casts; eosinophiluria

treated with prednisone

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11
Q

Pathology?

A

Acute Interstitial Nephritis

acute disease characterized by interstitial infiltrates; often reversible

causes: drug hypersensitivity reactions (antibiotics/sulfa drugs, proton pump inhibitors, NSAIDs), infection, autoimmune

microscopic hematuria, leukocyturia, WBC casts; eosinophiluria

treated with prednisone

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12
Q

Pathology?

A

Granulomatous AIN

renal sarcoidosis

caused by nephrocalcinosis, interstitial nephritis, or glomerular disease (FSGS, membranous nephropathy)

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13
Q

Pathology?

A

WBC cast in AIN

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14
Q

Pathology?

A

WBC cast in AIN

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15
Q

Pathology?

A

WBC cast in AIN

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16
Q

Pathology?

A

Calcium oxalate crystals in urine

can be caused by ethylene glycol poisoning (treated with fomepizole to inhibit alcohol dehydrogenase)

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17
Q

Pathology?

A

Calcium oxalate crystals in urine

can be caused by ethylene glycol poisoning (treated with fomepizole to inhibit alcohol dehydrogenase)

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18
Q

Pathology?

A

Oxalate crystals

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19
Q

Pathology?

A

Oxalate crystals

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20
Q

Pathology?

A

Cast nephropathy from multiple myeloma

Bence Jones protein not detected on urine dipstick - urine protein electrophoresis required for diagnosis

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21
Q

Pathology?

A

Cast nephropathy from multiple myeloma

Bence Jones protein not detected on urine dipstick - urine protein electrophoresis required for diagnosis

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22
Q

Pathology?

A

Chronic Interstitial Kidney Disease

Interstitial infiltration with lymphocytes, monocytes, or macrophages; tubular atrophy/dilation; glomerulosclerosis; interstitial fibrosis

Urinary sediment is bland; anemia; nephrogenic diabetes insipidus can occur

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23
Q

Pathology?

A

Chronic Interstitial Kidney Disease

Interstitial infiltration with lymphocytes, monocytes, or macrophages; tubular atrophy/dilation; glomerulosclerosis; interstitial fibrosis

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24
Q

Pathology?

A

Chronic Interstitial Kidney Disease

Interstitial infiltration with lymphocytes, monocytes, or macrophages; tubular atrophy/dilation; glomerulosclerosis; interstitial fibrosis

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25
Pathology?
Papillary necrosis Seen in diabetics with urinary tract obstruction, analgesic nephropathy, sickle cell disease
26
Pathology?
Renal calculi
27
Pathology?
Polycystic Kidney Disease
28
Pathology?
Polycystic Kidney Disease
29
Pathology?
Double ureters Congenital anomaly; increases risk of developing UTI, pain, stones, hydronephrosis
30
Pathology?
Hydronephrosis Grossly dilated renal pelvis and collecting system; result of obstruction
31
Pathology?
Staghorn calculus Triple phosphate stones, made of magnesium ammonium phosphate Linked to proteus infection (urea-splitting), produces alkaline urine
32
Pathology?
Bladder exstrophy Bladder is outside of the abdominal wall and everted; requires surgical repair
33
Pathology?
Acute cystitis Mucosal erythema and edema
34
Pathology?
Interstitial cystitis (aka Hunner's Ulcer) Mucosal erythema in fissures in bladder as it is distended by fluid Intermittent or continuous pain over 6 months
35
Pathology?
Malakoplakia Peculiar host reaction to chronic infection wherein macrophages can't expel lysosomes containing bacteria (mostly E. coli)
36
Pathology?
Cystitis with malakoplakia PAS stains macrophage cytoplasm; dark Michaelis Gutman bodies (arrow)
37
Pathology?
Brunn's buds & nests Reaction to a variety of noxious agents; invagination of urothelium into lamina propria that can be detached Common (>90% of autopsies)
38
Pathology?
Cystitis glandularis et cystica Brunn's nests with dilated lamina (yellow star) and glandular metaplasia (black star) Sign of prolonged stimulation of urothelium
39
Pathology?
Nephrogenic metaplasia (adenoma) Reactive process anywhere in urothelium, usually bladder Small tubules with single layer epithelium
40
Pathology?
Transitional cell papilloma Benign bladder neoplasm; exophytic growth with multiple delicate branching structures attached to the mucosa by a stalk
41
Pathology?
Low grade papillary transitional cell carcinoma Most common malignant neoplasm of the bladder
42
Pathology?
High grade papillary transitional cell carcinoma Most common malignant neoplasm of the bladder
43
Pathology?
Papillary transitional cell carcinoma Most common malignant neoplasm of the bladder
44
Pathology?
Post-streptococcal GN
45
Pathology?
Post-streptococcal GN Scattered, irregularly spaced capillary wall and mesangial coarse granular staining for IgG and starry sky pattern for C3
46
Pathology?
IgA nephropathy Hypercellularity
47
Pathology?
IgA nephropathy IF: IgA, C3, properdin EM: mesangial deposits
48
Pathology?
Goodpasture syndrome Breaks in the GBM
49
Pathology?
Goodpasture syndrome Linear IF staining (IgG)
50
Pathology?
ANCA-associated GN See crescent formation and collapse of the glomerular tuft with fibrinoid necrosis
51
Pathology?
Lupus nephritis - class II Glomeruli normal or slight increase in mesangial cells; mesangial deposits of IgG and C3
52
Pathology?
Lupus nephritis Subendothelial deposits
53
Pathology?
Membranoproliferative glomerulonephritis
54
Pathology?
Minimal change disease Effacement of podocyte foot processes => nephrotic disease
55
Pathology?
Membranous nephropathy Immune complexes with Ab directed at podocytes activate complement pathway => damages podocytes => nephrotic disease Image shows spikes on membranes in silver stain
56
Pathology?
Membranous nephropathy Immune complexes with Ab directed at podocytes activate complement pathway => damages podocytes => nephrotic syndrome IF: granular pattern of polyclonal IgG, variable C3, granular capillary wall PLA2R staining
57
Pathology?
Focal segmental glomerulosclerosis Nephrotic syndrome
58
Pathology?
Diabetic nephropathy Nephrotic syndrome
59
Pathology?
Diabetic nephropathy Nodular glomerulosclerosis (Kimmelsteil-Wilson lesions) Nephrotic syndrome
60
Pathology?
Amyloidosis Congo-Red stain Nephrotic syndrome
61
Pathology?
Renal amyloidosis Nephrotic syndrome
62
Pathology?
Craniopharyngioma Cystic neoplasm of the hypothalamus
63
Pathology?
Craniopharyngioma Cystic neoplasm of the hypothalamus
64
Pathology?
Pituitary adenoma All cells are the same
65
Pathology?
Adrenal adenoma
66
Pathology?
Waterhouse Friedrichsen syndrome Hemorrhagic necrosis of adrenals
67
Pathology?
Pheochromocytoma Catecholamine-secreting tumor; large, fleshy mass
68
Pathology?
Pheochromocytoma Large cells with granular cytoplasm arranged in nets (zellballen)
69
Pathology?
Neuroblastoma Pseudorosettes
70
Pathology?
Lymphocytic insulinitis T cell invasion of pancreas; near time of T1DM clinical presentation
71
Pathology?
Amyloid deposition in islets of Type II DM
72
Pathology?
Increased islets Seen in non-diabetic newborns of diabetic mothers
73
Pathology?
Nodular glomerulosclerosis in diabetes
74
Pathology?
Thickened glomerular basement membrane in DM
75
Pathology?
Thickened renal tubular basement membranes in PAS stain (DM)
76
Pathology?
Diabetic arteriolar sclerosis
77
Pathology?
Hashimoto thyroiditis Lymphoid infiltrate, including germinal centers
78
Pathology?
Hashimoto thyroiditis Thyroid follicles showing atrophy with some colloid, and chronic inflammation with a lymphoid area on the right
79
Pathology?
Subacute granulomatous thyroiditis See multinucleated giant cells and fibrosis
80
Pathology?
Graves' disease Crowded, tall follicular cells project into the lumen; see scalloped margins of colloid
81
Pathology?
Thyroid adenoma Adenoma is top half of photo with capsule and non-lesional tissue below
82
Pathology?
Papillary carcinoma See papillary architecture and ground glass (Orphan Annie eye) nuclei
83
Pathology?
Papillary thyroid carcinoma See several Psammoma bodies and papillary architecture
84
Pathology?
Follicular thyroid carcinoma See monotonous, small follicles packed together tightly; small deposits of colloid
85
Pathology?
Medullary thyroid carcinoma See groups of polygonal cells and areas of dense stroma containing amyloid
86
Pathology?
Parathyroid adenoma
87
Pathology?
Parathyroid carcinoma (rare)

Human Disease Systems (11 decks)

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