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Path IV DJ > Renal Pathology > Flashcards

Renal Pathology Flashcards

1
Q

Compare the 4 cystic diseases of the kidney. (Don’t break down PKD on this one)

A

Simple cyst: thin walled w/ clear fluid, single or multiple, common with age. Benign.
Medullary sponge kidney: many small cysts throughout the kidney medulla. Benign.
PKD: genetic, lots of large cysts, leads to kidney failure.
Chronic dialysis cysts: pts on dialysis, smaller cysts, assoc w/ RCC

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2
Q

Adult vs Childhood PKD

A

Adult: AD, dz develops in adulthood, chronic renal failure in middle age, assoc w/ liver cysts.
Childhood: AR, dz congenital, renal failure early in life, assoc w/ fetal demise.

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3
Q

What are the three histological changes that may occur in glomerular disease?

A
  • Thickening of the glomerular basement membrane
  • Hypercellularity
  • Hyalinosis/sclerosis
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4
Q

What are the clinical characteristics of nephrotic syndrome?

A

Heavy proteinuria, hypoproteinemia, hyperlipidemia, anasarca

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5
Q

What are the clinical characteristics of nephritic syndrome?

A

PHAROH
Proteinuria, hematuria, azotemia, RBC casts, oliguria, hypertension
Immune-mediated!

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6
Q

What three diseases are characterized by nephrotic syndrome?

A

Lipoid nephrosis/minimal change disease
Membranous glomerulopathy
Focal-segmental glomerulosclerosis

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7
Q

Lipoid nephrosis

  • Is the MC…
  • Proteinuria selective/nonselective
  • Micro appearance
A
  • MC cause of nephrotic syndrome in kids (peaks age 2-3)
  • Selective proteinuria
  • Nothing on histo, no immune complexes.
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8
Q

Membranous glomerulopathy

  • Is the MC…
  • Etiology
  • Micro appearance
A
  • MC cause of nephrotic syndrome in adults
  • Immunologically mediated (Ab bind Ag in GBM –> local damage and inc permeability)
  • Thickening of capillary loops, BM may appear spiked
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9
Q

Focal-segmental glomerulosclerosis

  • Is the MC…
  • Micro appearance
A
  • MC cause of nephrotic syndrome in African Americans

- Collagenous fibrous changes leading to loss of function, affects only part (segmental) of some glomeruli (focal)

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10
Q

What is the most common cause of nephritic syndrome in the US?

A

Post-streptococcal glomerulonephritis

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11
Q

What is the most common cause of nephritic syndrome worldwide?

A

IgA Nephropathy (Berger’s disease)

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12
Q

Post-Strep glomerulonephritis

  • Definition
  • Micro appearance
  • Labs
A
  • Deposits of immune complexes trapped along basement membrane following GAS pharyngitis/impetigo
  • Hypercellularity, neutrophils, poorly defined capillary loops
  • High ASO titer
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13
Q

Crescentic glomerulonephritis

  • Definition
  • Micro appearance
A
  • Description of how some extremely acute diseases progress

- Capillary loop thickening, endothelial proliferation, crescentic figures, deposition of IgG along BM

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14
Q

IgA Nephropathy

  • Etiology
  • Micro appearance
A
  • Hypersecretion of IgA in response to infx

- Proliferation of mesangium

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15
Q

MC cause of nephrotic syndrome in kids

A

Lipoid nephrosis/Minimal change disease

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16
Q

MC cause of nephrotic syndrome in adults

A

Membranous glomerulopathy

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17
Q

MC cause of nephrotic syndrome in African Americans

A

Focal-segmntal glomerulosclerosis

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18
Q

MC cause of renal failure in US

A

Diabetic nephropathy

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19
Q

Diabetic nephropathy

  • Etiology
  • Micro appearance
A
  • Glomerular hyperfiltration –> BM & mesangial proliferation
  • nodular glomerulosclerosis
20
Q

Nodular glomerulosclerosis assoc w/ DM (special name)

A

Kimmelstiel-Wilson Disease

21
Q

Amyloidosis nephropathy

  • Etiology
  • Micro appearance
A
  • Amyloid accumulates in mesangium and capillary walls

- Amyloid is acellular, eosinophilic

22
Q

Goodpasture’s syndrome

  • Etiology
  • Micro appearance (late disease)
  • Other organ involvement
A
  • Circulating anti-basement membrane antibody
  • Crescentic figures (RPGN)
  • Respiratory
23
Q

Differentiate toxic vs ischemic acute tubular necrosis.

A

Toxic: proximal, acute, obliterated lumen
Ischemic: distal, mb acute, often dt chronic progressive atherosclerosis, skip lesions throughout tubule

24
Q

Characteristic UA finding of acute tubular necrosis (both toxic and ischemic)

A

Muddy brown casts

25
Q

Characteristic histo finding of malignant nephrosclerosis

A

Blood vessels that look like onion rings

26
Q

Gross finding of infarction vs histo finding of ischemia

A

Pale tissue, especially in a wedge

Poor uptake of vital stain

27
Q

Characteristic finding of chronic cystitis

A

Malakoplakia

28
Q

Characteristic histo finding of malakoplakia

A

Michaelis-Gutmann bodies

29
Q

Compare AIN and analgesic nephropathy

A

Both are drug-induced damage to interstitium
AIN is an allergic rxn to a single dose (edema, inflammatory infiltrate, thickening of BM)
Analgesic nephropathy is the result of analgesic abuse (ischemic injury)

30
Q

Give the types of renal stones.

  • Which is MC
  • Which is assoc w/ UTI
  • Which is assoc low urine pH
  • Which is MC in kids
A 
Calcium oxalate (MC 75%)
Triple phosphate/staghorn (2MC 15%, assoc w/ Proteus UTI)
Uric acid (3MC, pH
31
Q

Common cause of acute renal failure

A

Toxic ATN

32
Q

MC cause of HUS

A

E. coli O157:H7

33
Q

MC source of renal artery emboli

A

Heart

34
Q

MC renal malignancy

A

RCC

35
Q

MC primary renal tumor in kids

A

Wilm’s tumor

36
Q

MC cell of origin for RCC

A

Proximal tubule epithelium

37
Q

MC and second MC bladder cancer

A

Transitional cell carcinoma

Squamous cell carcinoma

38
Q

Very common, small renal tumor with frond-like pattern on histology.

A

Renal papillary adenoma

39
Q

Renal tumor with uniform, large, polygonal cells and numerous prominent mitochondria with stacked appearance

A

Oncocytoma

40
Q

Pediatric renal tumor with nests of primitive, basophilic cells and primitive nephrons on histology.

A

Wilm’s tumor

41
Q

Classic triad, major risk factors, and general age for RCC

A
  • flank pain, hematuria, palpable abdominal mass
  • tobacco, toxic exposure, acquired cystic dz
  • old age
42
Q

Gross and micro appearance of malakoplakia

A

Gross: pale, raised mucosal plaques
Micro: large, foamy M0 with Michaelis-Gutmann bodies, multinucleated giant cells

43
Q

Eosinophilic infiltrate in bladder

A

Eosinophilic cystitis

44
Q

Pathognomonic finding in interstitial cystitis

A

Hunner’s ulcers

45
Q

Wegener’s Granulomatosis

- Serology

A

C-ANCA

46
Q

What is the appearance of the crystals in the four main renal stones?

A

Calcium oxalate: rectangular, like envelopes
Triple phosphate: rectangular, like coffin lids
Uric acid: square, rhomboid, polygonal
Cystine: hexagon

Path IV DJ (6 decks)

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