Renal Pathology

Question 1

What defines Azotemia?

Answer 1

Elevated blood-urea-nitrogen (BUN) and creatinine, due to decreased glomerualer filtration rate (GFR)

Question 2

What defines Uremia?

Answer 2

Azotemia plus other symptoms

Question 3

What are the three major clinical renal syndromes and their most prevalent symptom?

Answer 3

1. Acute nephrotic syndrome: hematuria
2. Nephrotic syndrome: severe proteinuria
3. Acute renal failure: oliguria/anuria

Question 4

What is hematuria?

Answer 4

Blood in urine

Question 5

In nephrotic syndrome, roughly how much protein will be seen in the urine?

Answer 5

> 3.5 grams per day

Question 6

What gene and protein are affected by Autosomal Dominant (Adult) Polycystic Kidney Disease?

Answer 6

PKD1 gene; polysystin-1

Question 7

What is a major complication of Adult Polycystic Kidney Disease?

Answer 7

Aneurysms affecting circle of Willis

Question 8

T/F: Adult Polycystic Kidney Disease leads to very large kidneys.

Answer 8

True

Question 9

T/F: Childhood Polycystic Kidney Disease is much more common than Adult Polycystic Kidney Disease.

Answer 9

FALSE

Adult more common

Question 10

T/F: Adult polycystic Kidney Disease is one of the major contributors to renal failure.

Answer 10

True

Question 11

What are three mechanisms for Glomerular Disease?

Answer 11

1. Immune complex deposits in GBM or mesangium
2. Anti-GBM antibody
3. Epithelial and endothelial injury

Question 12

T/F: Glomerular diseases will lead to nephritic syndrome.

Answer 12

FALSE

Nephrotic - heavy proteinuria

Question 13

What is the most obvious clinical sign of Nephrotic Syndrome?

Answer 13

Severe edema

Question 14

What is the most common cause of nephrotic syndrome in children?

Answer 14

Minimal change disease

Question 15

What diagnostic tactic is the only one that can help diagnose minimal change disease?

Answer 15

Electron Microscopy

Question 16

What is a common cause of adult nephrotic syndrome?

Answer 16

Focal segmental glomerulosclerosis

Question 17

What can be seen via light microscopy in a patient with focal segmental glomerulosclerosis?

Answer 17

Focal (some glomeruli) and segmental (part of the involved glomerulus) sclerosis with obliteration of capillary loops

Question 18

T/F: ____________ normally involves children and responds well to corticosteroid treatment. ___________ normally involves adults and does not respond well to corticosteroid treatment.

Answer 18

Minimal change disease; focal segmental glomerulosclerosis

Question 19

What is evident in light microscopy of a patient with Diabetes Mellitus?

Answer 19

Nodular glomerulosclerosis

Question 20

What is 2nd to MI as cause of death in patients with diabetes?

Answer 20

Renal failure

Question 21

T/F: Membranous nephropathy is a renal disease that will lead to nephrotic syndrome.

Answer 21

True

Question 22

Nephritic syndrome is characterized by __________.

Answer 22

Hematuria

Question 23

Nephritic syndrome is mostly mediated by _____________ problems. Nephrotic syndrome is normally mediated by _____________ problems.

Answer 23

Inflammation; immune

Question 24

What disease often occurs several weeks after streptococcal pharyngitis infection and can cause nephritic syndrome?

Answer 24

Acute postinfectious glomerulonephritis

Question 25

T/F: IgA Nephropathy is a cause of Nephritic syndrome that most often affects older adults.

Answer 25

FALSE Children and young adults

Question 26

IgA Nephropathy often occurs after __________ infection.

Answer 26

Respiratory

Question 27

IgA is characterized by by hematuria accompanied with ______________ purpura.

Answer 27

Henoch-Schonlein purpura

Question 28

What disease is characterized by severe oligouria and can lead to acute renal failure within a few weeks?

Answer 28

Rapidly progressive glomerulonephritis

Question 29

What will untreated glomerular disease eventually lead to?

Answer 29

Loss of glomeruli and tubules with fibrosis

Question 30

A patient is diagnosed with chromic glomerulonephritis, what is the likely cause of this?

Answer 30

Hard to tell. Often once diagnosed as chronic, cannot tell what the original renal disease is.

Question 31

What are the three types of biopsy evaluation techniques and where would they be useful?

Answer 31

1. Light microscopy: trachoma (collagen), Jones stains (basement membrane) 2. Immunofluorescence: immunoglobulins and compliment 3. Electron microscopy

Question 32

If you wanted to evaluate the basement membrane of a biopsy what technique would be used?

Answer 32

Jones stains

Question 33

If you wanted to evaluate collagen in a biopsy what technique would you use?

Answer 33

Trichrome stain

Question 34

If you were interested in evaluating immune factors in a biopsy what technique would you use?

Answer 34

Immunofluorescence