Renal Pathology

Question 1

The kidney is capable of converting……… quantity of blood to …….. urine

Answer 1

1700 L to 1L

Question 2

The glomerulus is susceptible……. disease

Tubules and interstitium are susceptible to disras6caused by ……………

Answer 2

Autoimmune

Toxic or infectious agent

Question 3

What is azotemia?

Answer 3

Biochemical abnormality with elevated BUN and creatinine levels

Decrease GFR

No clinical signs and symptoms

Question 4

What are the classical features of nephritic syndrome

Answer 4

Hematuria (gross or microscopic) with dysmorphic RBC or RBC cast

Mild edema
Mild to moderate proteinuria
Sudden onset
Reduced GFR
Classic presentation of acute poststreptococcal glomerulonephritis

Question 5

What are the classical features of nephrotic syndrome

Answer 5

Massive proteinuria >3.5g/day
Hyperlipidemia
Lipiduria
Severe edema
Hypoalbuminemia

Question 6

What is AKI

Answer 6

It is the rapid decrease in GFR, with concurrent dysregulation of fluid and electrolytes and accumulation of waste products occurring as a result of glomerular, vascular, interstitial, or acute tubular injury

Question 7

What is CKD

Answer 7

It is the decrease in GFR to less than 60mL/min/1.7m2 persistently for 3 months

Leads to ESRD GFR less than 5%

Question 8

The classical signs of renal tubular defects are

Answer 8

Polyuria, nocturnal and electrolyte imbalances caused by direct damage to the tubules or specific functions of tubules which can be inherited or acquired

Question 9

Nephrolithiasis is characterized by

Answer 9

Spasms of severe colicky renal pain, hematuria, recurrent kidney stones

Question 10

UTI is characterised by…..

Answer 10

Bacteriuria and pyuria

Asymptomatic or symptomatic and can lead to pyelonephritis

Question 11

The anatomic region of the kidney is

Answer 11

T22 to L3
Retroperitoneal

Question 12

The kidney weighs approx …….. in both genders

Answer 12

125 -175 g in males
115 -155 g in females

Question 13

The coverings if the kidney are

Answer 13

Renal fascia, renal fat pad, renal capsule

Question 14

The kidney is divided into pyramids amd lobes by the …….

Answer 14

Renal column an extension of connective tissue

Question 15

The collecting route in the kidney …..

Answer 15

Collecting ducts—- renal papillae—— minor calyces—-major calyces—–ureter

Question 17

Mesangial cells are from which origin?

Answer 17

Mesenchymal origin

Question 18

Mesangial cells have the following features……..

Answer 18

Contractile
Phagocytic
Proliferative producing Collagen and matrix
Secrets biologically active materials

Question 19

Mesangial cells are similar too …….

Answer 19

Vascular smooth muscles and pericytes

Question 20

What part of the glomerulus secrets the major part of the GBM

Answer 20

Visceral epithelium

Question 21

The 5 major glomerular symptoms are

Answer 21

Nephrotic syndrome
Nephritic syndrome
Rapidly progressing glomerulonephritis
Chronic kidney disease
Isolated urinary abnormalities

Question 22

A kidney crescent is composed of …….

Answer 22

A proliferating parietal epithelium and infiltrating leukocytes

Question 23

Hypercellularity can occur in different forms they are ……….

Answer 23

Proliferating endothelial and mesangial cells

Infiltrating leukocytes
Or a combination Infiltrating leukocytes and proliferating endothelial/ mesenchymal cells referred to as endocapillary proliferation

Crescents

Question 24

GBM thickening appears as……. on light microscopy

Answer 24

Thickening of the capillary walls on light microscopy

Question 25

The commonly deposited substance in bm thickening are

Answer 25

Immune complexes.

Question 26

GBM thickening can occur innthe following ways.......

Answer 26

1. Deposition of amorphous, electron-dense materials usually immune complexes on either the endothelial or epithelial surfaces of the BM could be fibroid, amyloid etc 2. Increased synthesis of protein component of the BM e.g in DM glomeruloscelrosis 3. Formation of additional layers of BM matrices usually subendothelially

Question 28

What is hyalinosis?

Answer 28

Accumulation of homogeneous and eosinophilic materials by LM

Question 30

What are the criteria for diagnosing analgesic nephropathy

Answer 30

Cumulative ingestion of >3kg or >1g/day for 3 or more years of analgesic

Question 33

What is acute tubular injury

Answer 33

It is the acute reduction in renal function with or without morphological evidence of tubular damage. It signifies a reduction in renal function with a reduction in urine within 24 hours to less than 400mL