Renal Path Quiz 2- part 3 Flashcards Preview

Pathology IV > Renal Path Quiz 2- part 3 > Flashcards

Flashcards in Renal Path Quiz 2- part 3 Deck (33):
1

acute tubular necrosis (ATN) is characterized by what?

proximal tubular involvement
either toxicity or ischemia of the epithelium
results in epithelium necrosis of the proximal tubules

2

In toxic ATN what is the characteristic appearance?

anuclear and homogenous cytoplasm that stains darkly eosinophilic
maintains normal shape

3

toxin related ATN usu causes what?

acute renal failure

4

what's pathognomonic for acute tubular necrosis (ATN)?

presence of "muddy brown casts" of epithelial cells in urine
also epithelial casts that obliterate the lumen

5

Ischemic ATN specifically causes

skip lesions through the tubules due to differences in perfusion within the kidney

6

Acute interstitial nephritis (AIN) is the result of

an allergic response to a drug or following infxn

7

where does acute interstitial nephritis (AIN) occur

renal parenchyma

8

which of these cases would most likely present with marked eosinophils in urine?

acute interstitial nephritis (makes sense because it's an allergic response)

9

AIN patients will present with acute renal failure in

40-50% of cases
with discontinuation of medication there is generally full recovery

10

what if you have acute interstitial nephritis, discontinue medication and don't recover?

then you have chronic interstitial nephritis
no cure exists

11

microscopically, how does chronic interstitial nephritis appear?

The interstitial area is expanded by fibrosis with distortion of tubules and peri-glomerular fibrosis. Glomeruli do not show pathologic changes

12

Fanconi's syndrome falls under what classification of conditions?

Renal tubular acidosis (RTA)
RTA involves the accumulation of acid in the body due to a failure of the kidneys to appropriately acidify the urine

it's type 2 or proximal tubule involvement

13

In light microscopy, fanconi's syndrome reveals

atrophic and hyalinized glomeruli typical of end-stage kidney disease.

14

analgesic nephropathy occurs after

ingestion of large amnts of analgesics OVER A LONG PERIOD OF TIME (in contrast to AIN which can occur with a single dose)

15

analgesic nephropathy damages what part of the kidney?

papillary necrosis
dark hemorrhagic areas are renal papillae that are necrotic

16

whats the disease where you have atherosclerotic changes in renal blood vessels?

benign nephrosclerosis

17

benign nephrosclerosis is a sequelae to which common condition?

HTN

18

the gross appearance of benign nephrosclerosis is what?

the surface of the kidney looks granular
due to focal loos of parenchyma from ischemia

19

what conditions is a consequence of sever hypertension?

malignant nephrosclerosis
more severe changes in renal architecture

20

what is the characteristic changes seen in arterioles in malignant nephrosclerosis?

onion ring appearance (hyperplastic arterioles)

21

most common cause of secondary hypertension

renal artery stenosis

22

renal artery stenosis (narrowing or blockage of the renal artery) is due to

atherosclerosis
fibromuscular dysplasia of the renal artery
atheroembolic renal disease
scar formation in the renal artery

23

Hemolytic uremic syndrome (HUS) is a condition that presents with a clinical triad of:
(HUS is widespread formation of hyaline thrombi in the microcirculation)

acute renal failure
microangiopathic hemolytic anemia
thrombocytopenia

24

what is the most common bacteria to cause HUS?

E. coli

25

most common cause of acute renal failure in children and is

hemolytic uremic syndrome

26

childhood HUS is most frequently associated with intestinal infection by which Shiga-like toxin

verocytotoxin

27

HUS is characterized by sudden onset of sx that follow a

gastrointestinal infection or flu like illness

28

_______ develops in ~ half of all childhood HUS patients

HTN

29

Microscopically HUS appears as

fibrin thrombi and packed red blood cells are visible in the lumina

30

if adults get HUS, they are likely to have which other condition

TTP (thrombotic thrombocytopenic purpura)

31

which adult population is most at risk for HUS/TTP?

pregnant or postpartum women

32

renal artery emboli usually come from a

cardiac source such as atrial fibrillation

33

the most important non-cardiac source of renal emboli comes from

ruptured aortic atheromatous plaques
rupture may occur spontaneously or as a result of surgery