Renal Pathology

Question 1

Hydroureter

Answer 1

Accumulation of urine in the ureter

Question 2

Hydronephrosis

Answer 2

Enlargement of the renal pelvis and calyces

Question 3

ureterohydronephrosis

Answer 3

dilation of both the ureter and the pelvicaliceal system

Question 4

Urinary tract obstruction can be cause by ___ or ____ defect

Answer 4

anatomical or functional

Question 5

postobstructive diuresis

Answer 5

nephrogenic diabetes insipidus

Question 6

kidney stones are classified according to the ___ that make up the stone

Answer 6

minerals

Question 7

Kidney stones risk factors

Answer 7

sex and age
ethnicity
geographic location
seasonal factors
fluid intake
diet occupation

Question 8

kidney stone formation

Answer 8

supersaturation of one or more salts
precipitation of a salt from liquid to solid state
growth into a stone via crystallization or aggregation

Question 9

common kidney stone

Answer 9

calcium oxalate or calcium phosphate
struvite
uric acid

Question 10

other factors affecting stone formation

Answer 10

crystal growth inhibiting substances
particle retention
matrix

Question 11

evaluation of kidney stones

Answer 11

imaging studies
24 hr urinalysis

Question 12

kidney stone removal

Answer 12

percutaneous nephrolithotomy
ureteroscopy
ultrasonic or laster lithotripsy

Question 13

types of lower urinary tract obstruction

Answer 13

neurogenic bladder
- dyssynergia: detrusor hyper-reflexia vs detrusor areflexia
- overactive bladder syndrome
- obstruction: e.g. uretrhal stricture, prostate enlargement, pelvic organ prolapse

Question 14

kidney cancers/tumours

Answer 14

renal tumours:
- renal adenoma
- renal cell carcinoma
Bladder tumours: renal transitional cell carcinoma

Question 15

glomerulonephritis

Answer 15

Inflammation of the glomerulus
immunological abnormalities
ischemia
free radicals
medications or toxins
vascular disorders
infection

Question 16

mechanisms of glomerulonephritis

Answer 16

• Deposition of circulation soluble antigen- antiboy complexes (Type III hypersensitivity)
• Antibodies reacting in situ against planted antigens within the glomerulurs (Type II hypersensitivity-cytotoxis)
• Nonimmune (ischemia, metabolic disorders, medications, toxins, vascular disorders, infection)

Question 17

two major symptoms if severe glomerulonephritis

Answer 17

hematuria and RBC casts
proteinuria exceeding 3.5 g/day with albumin as the major protein

Question 18

types of glomerulonephritis

Answer 18

membranous nephropathy/glomerulonephritis

rapidly progressing glomeurlonephritis (Goodpasture’s syndrome)

chronic glomeurlonephritis

Question 19

Nephrotic Syndrome

Answer 19

excretion of 3.5 g or more of protein in the urine per day
caused by glomerular injury

Question 20

Nephritic syndrome

Answer 20

hematuria with RBC casts
mildd proteinuria
immune injury

Question 21

AKI can lead to

Answer 21

renal insufficiency
kidney failure
ESKD

Question 22

oliguria pediatric vs adult

Answer 22

infants: < 1ml/kg/hr
children: <0.5ml/kg/hr
adults: < 400ml/day

Question 23

prerenal cause of AKI

Answer 23

imparied renal blood flow
GFR declines b/f decrease in filtration pressure
both HTN And hypotension

Question 24

intrarenal causes of AKI

Answer 24

acute tubular necrosis

Question 25

postrenal cause of AKI

Answer 25

urinary tract obstructions that affect the kidneys bilaterally

Question 26

three phases of AKI

Answer 26

initiation phase: prevention of injury is possible maintenance (oliguric) phase: urine output is lowest, serum creatinine and blood urea nitrogen increases recovery (polyuric) phase

Question 27

AKI --> CKD

Answer 27

interstitial inflammation endothelial dysfunction fibrosis tubular epithelial injury

Question 28

CKD is divided in to __ stages based on albuminuria and/or renal function decline for a period longer than ____

Answer 28

5 stages over 3 months

Question 29

5 stages of CKD

Answer 29

normal (GFR > 90ml/min) mild (GFR 60-89) moderate (GFR 30-59) Severe (GFR 15-29) End stage (GFR < 15)

Question 30

signs and symptoms of CKD

Answer 30

Proteinuria and uremia Creatinine and urea clearance Fluid and electrolyte imbalance - metabolic acidosis Reduced renal phosphate excretion, hypocalcemia-> fractures Protein/carbohydrate/fat metabolism Anemia