Renal Pathology Part II - Glomerular Diseases Flashcards
(47 cards)
Glomerular structure
* ______ cells, _____ membrane, _____, _____ cell, ____ matrix, ____ cell and _____ capsule
Endothelial, basement, podocytes, mesangial, mesangial, parietal, Bowman’s
Endothelial cells line capillaaries
Mesengial cells produce mesangial matrix
Filtration barrier function: Filter blood and start forming primary urine or ? filtrate.
Label this image accordingly
Thick arrows = capillaries
Water and particles with radius < __ nm (ions like ____ and ____, ____ and other ____ molecules) pass through the glomerulus. Some of these molecules are ______ in the ____ tubules
3.5, potassium, sodium, glucose, small, reabsorbed, proximal
If the glomerular filtration barrier stops functioning, glomerulus will no longer filtertrate, and important molecules and proteins will leak into urinary space –> tubules -> excreted –> important molecules are albumin and ATH III
Molecules such as ____ and ______ __ stay in the
blood
albumin, antithrombin III
List the Indications of glomerular injury
- Proteinuria = the presence of abnormal
quantities of protein in the urine - tubular injury can also lead to proteinuria (small molecules only;
aminoaciduria and also glucosuria)
protein losing nephropathy
*Albuminuria → Hypoalbuminemia –> edema
*Loss of ATIII → Multiple thrombi
Ascites
Hydropericardium and hydrothroax
No fibrin; transculent; cat was losing protein somewhere
Pulmonary thrombus
Multiple thrombi formation
very common to see thrombus formation in the ?
What are the hallmarks of glomerular disease?
- Proteinuria
- Hypercoaguable state – Due to loss of Antithrombin III
- Nephrotic syndrome – Proteinuria + Hypoalbuminemia +
Generalized edema + Hypercoagulable state + Hyperlipidemia
Mechanism of hyperlipidemia: liver produces albumin, B/c albumin has low amount in the blood, the liver will start to produce more albumin to compensate. During this process liver produces cholesterol?
Define Glomerulitis.
inflammation restricted to glomerulus (acute septicemia [remember glomeruli are the first structure to receive blood])
Define glomerulonephritis
Glomerulonephritis = usually of _______ origin. Glomerular
disease + ________ ________ and _______ changes
◦ _____ vs _____ (> ___% vs < ____% of glomeruli)
◦ ____ vs _____ ( _____ glomerulus vs ___)
◦ _________ vs ______ (proliferation of (3) cells along with ______ cells
vs thickening of the (2))
immune, secondary tubulointerstitial, vascular, Diffuse, Focal, 50, 50, Global, Segmental, entire, part, Proliferative, Membranous, endothelial/podocytes/mesangial, inflammatory, basement membrane/mesangial matrix
Define glomerular amyloidosis
Glomerulitis
* Suppurative glomerulitis
* Actinobacillus equuli in foals
* Bacteria (arrow) enter the kidney via the vasculature (bacteremia) and lodge in the capillaries of glomeruli, where they replicate and induce necrosis and inflammation
What are the causes of glomerulonephritis?
Causes of glomerulonephritis
* Immune-mediated: Ag-Ab complex deposition and
complement activation
* Often associated with persistent infections or diseases that
have a prolonged antigenemia
- Dogs: Pyometra, pyoderma, chronic parasitism
(Dirofilaria), autoimmune diseases (SLE), and neoplasia
- Cats: FeLV, FIV, FIP
Immune-mediated glomerulonephritis
1. Preformed circulating ___-___ complexes - Associated with ________
infections/disease –> prolonged ________ –> formation of soluble
immune ______
2. _____ is trapped in glomerular capillary wall and circulating ______
form _____ with them
Ag-Ab, persistent, antigenemia, complexes, Antigen, antibodies, complexes
Location of immune complexes
Sites when the immunocomplexes are formed: Mesangial matrix, basement membranes of capillaries, between? prioces of podocytes, subepithelial (under epithelail cell layer)
Describe the mechanism of injury to the glomerular structures and the outcome.
Complement activation: C38, C58 attract neutrophils which release enzymes and form ROS that will damage glomerular filtration barrier structures.
Describe the mechanism of injury to the glomerular structures and the outcome.
What are the histological patterns of glomerulonephritis?
- Membranous GN: Thickened glomerular basement
membrane/mesangial matrix
◦ Most common form in cats - Proliferative GN: Characterized by hypercellularity
◦ Proliferation of mesangial cells + podocytes + influx of WBCs - Membranoproliferative GN: Combination of thickened GBM/matrix
and proliferation of mesangial cells and podocytes
◦ Most common form in dogs
List the types of glomerulonephritis
Normal
Proliferative
Membranoproliferative
