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Block 9 Week 5 > Renal Pathology II- FUNG > Flashcards

Renal Pathology II- FUNG Flashcards

(59 cards)

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1
Q

What is the most cost effective method of analyzing urine?

A

urine dipstick

Urinalysis is also inexpensive

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2
Q

What does the urine dipstick analyze?

A 
pH
Specific gravity
Protein
Glucose
Ketones
Nitrite
Leukocyte esterase
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3
Q 
What are these:
Specific gravity
Protein
Glucose
Ketones
Hemoglobin
Bile
Urobilinogen
A

chemical exams of urine

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4
Q 
What are these:
Casts
Organisms
Red cells
White cells
Epithelial cells
Crystals
A

Microscopic exam

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5
Q

What are these:
Color
Turbidity

A

Macroscopic exam

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6
Q

What are the causes of AKI?

A

Ischemia, Direct toxic injury, acute tublointerstitial nephritis, obstruction

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7
Q

What are the ischemic causes of AKI?

A

HUS, DIC, vasculitis, hypertension, shock

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8
Q

What are the direct toxic injury causes of AKI?

A

drugs, contrast dye, myoglobin, hemoglobin, radiation

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9
Q

What is the cause of acute tubulointerstitial nephritis that causes AKI?

A

hypersensitivity reactions

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10
Q

What is the most common cause of acute renal failure? What will your tubules look like?

A

AKI

injured

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11
Q

What areas are most damaged in ischemic acute tubular necrosis?

A

PCT and loop of Henle

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12
Q

What areas are most affected by toxic acute tubular necrosis?

A

PCT!!!!!! and a little bit of loop of Henle

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13
Q

What is tubulointerstitial nephritis?

A

group of renal disease characterized by histologic and functional alterations predominantly involving the tubules and interstitium.

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14
Q

What is acute tubulointerstital nephritis like?

A

rapid in onset

-histologically: edema, acute inflammatory infiltrate, focal tubular necrosis

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15
Q

What is chronic tubulointerstital nephritis like?

A

mononuclear infiltrate, interstitial fibrosis, widespread tubular atrophy

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16
Q

What are the causes of tubulointerstitial nephritis?

A 
Infection 
Toxins 
Metabolic disease
Obstruction
Neoplasms
Vascular
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17
Q

What is the evolution of tubulointerstitial nephritis?

A 
in the early phase (easy to distinguish from glomerular disease):
-inability to concentrate urine
-metabolic acidosis
-defects in tubular secretion/absorption
Late stage (difficult to distinguish)
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18
Q

What is pyelonephritis?

A

common disorder affecting the tubules, interstitium and renal pelvis

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19
Q

Pyelonephritis is an acute or chronic complication of (blank)

A

cystitis

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20
Q

What are the infecting organisms that cause pyelonephritis?

A

E. coli
Proteus
Klebsiella
Enterobacter

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21
Q

The infecting organisms of pyelonephritis are most commonly derived from patients (blank)

A

fecal flora

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22
Q

What are the organisms that cause hematogenous infection that leads to tubulointerstitial nephritis?

A

staph

E. coli

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23
Q

What is acute pyelonephritis?

A

acute suppurative inflammation caused by a microbial infection

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24
Q

What are the predisposing factors that cause acute pyelonephritis?

Study These Flashcards
A 
obstruction
instrumentation
vesicoureteral reflux
female 
diabetes
25
What are the symptoms of acute pyelonephritis?
- Pain at costovertebral angle - fever - malaise - dysuria - frequency - urgency - WBC casts
26
What is chronic pyelonephritis?
chronic tubulointerstitial inflammation and renal scarring w/ involvement of the calyces
27
What are the 2 types of chronic pyelonephritis?
- reflux nephropathy | - chronic obstructive pyelonephritis
28
How do drugs and toxins produce renal injury?
- acute hypersensitivity nephritis - direct toxicity - chronic injury and chronic renal insufficiency - analgesic nephropathy (Directly toxic) - NSAID nephropathy (Directly toxic)
29
What is multiple myeloma?
Cancer of the plasma cells resulting in abnormal protein formation that results in kidney problems
30
What are the findings of multiple myeloma affecting the kidney?
- bence jones proteinuria - amyloidosis - progresses to light chain deposition disease
31
What are the 2 ways that hypertension manifests and what does it cause?
benign nephrosclerosis | malignant nephrosclerosis
32
What can renal artery stenosis cause?
hypertension
33
What is thrombotic microangiopathy characterized by?
- Microangiopathic hemolytic anemia - Thrombocytopenia - Renal failure
34
What are the 2 forms of thrombotic microangiopathies? | How can you tell the difference?
Hemolytic uremic syndrome Thrombotic thrombocytopenic pupura TTP has fever, neurological symptoms
35
What causes hemolytic uremic syndrome (HUS)?
shiga toxin from E. coli
36
Wht causes TTP?
ADAMTS13 (can't cleave von willebrand factor into smaller monomers)
37
What are the types of cystic kidney diseases?
- simple cysts - acquired cysts - polycystic kidney disease - medullary cystic disease
38
How do you get adult polycystic kidney disease?
- autosomal dominant - PKD1 chromosome 16p12.3 - PKD2 chromosome 4q21
39
What are the extra renal anomalies associated with adult polycystic kidney disease?
- polycystic liver disease - intracranial berry aneurysms - mitral valve prolapse
40
in adult PKD you acquire cysts throughout life but dont present until (Blank) decades of life
4th-5th
41
What are the forms of childhood polycystic kidney disease and what are the most common forms? what is it caused by? What is it associated with?
perinatal, neonatal, infantile, juvenile -perinatal and infantile PKHD1-chromosome 6p21-23 associated with hepatic fibrosis
42
What are the three types of medullary cysts?
- medullary sponge kidney - nephronophthisis - adult-onset medullary cystic disease
43
What does medullary cysts present with and when does it present?
tubular defects | presents earlier in life (except the adult-onset form)
44
What are the most common causes of obstruction?
tumors and calculi
45
What is hydronephrosis?
increased pressure in the pelvocalyceal system -> leads to dilation of the pelvis and atrophy of the kidney parenchyma
46
Why does nephrolithiasis occur and what are the four types?
occurs sporadically and genetic predisposition 4 types: -calcium oxalate (70%) -Struvite (magnesium ammonium phosphate (15% caused by proteus UTIs) -Uric acid (5-10%) -Cysteine (1-2%)
47
In order for calculi to form, there must be (blank)
supersaturation
48
What are calcium oxalate stones caused by?
Hypercalcuria
49
What are struvite crystals due to?
Post UTI by proteus
50
What are uric acid stones due to?
idiopathic, gout, leukemia (leukemia->increased cell turnover-> increased uric acid)
51
What are cystein stones due to?
genetic defects in renal absorption of AAs
52
What are the benign neoplasms found in the kidney?
Papillary adenoma Angiomyolipoma Oncytoma
53
What are the malignant neoplasms found in the kidney?
- Renal cell carcinoma (several variants; clear cell is the MOST COMMON; chromophobe is pink and can be confused with oncocytes) - Urothelial carinoma (common) - Wilms Tumor
54
What is this: benign tumor composed of BVs, smooth muscle and mature adipose tissue. What is it associated with?
``` Angiomyolipoma Tuberous sclerosis (25% of pnts) ```
55
What are the three types of renal cell carcinoma? How are they typically caused?
most are sporadic, some are hereditary - Von Hippel-Lindau (inactivation of VHL gene) - Hereditary clear cell carcinoma (chromosome 3 defect) - Hereditary papillary carcinoma (chromosome 7 defect)
56
Where do most RCC's arise from?
the PCT
57
What is the most common malignant renal tumor in children (average age 3)?
wilms tumor- comprised of blastema
58
What diseases is Wilms tumor associated with?
WAGR syndrome, denys-Drash syndrome, beckwidth-wiedemann syndrome
59
What is the most common type of lower urinary tract cancer and usually arises in the bladder. A major risk factor is cigarette smoke. It is a malignant tumor rising from the urothelial lining of the renal pelvis, ureter, bladder, or urethra and is associated with early p53 mutation.
Urothelial carcinoma

Block 9 Week 5 (5 decks)

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