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Flashcards in Renal Pathology Puthoff Lecture Deck (114)
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31

The general category of glomerular disorders is considered due to ____ disease

-immunologic (primary or secondary)
-but diabetes effect on kidney is largely hemodynamic not immunologic in terms of diabetic nephropathy

32

is glomerulonephritis due to infection? Difference bw glomerulonephritis and glomerulopathy

-in most cases no! but may have inflammatory infiltrates
-they are the same

33

How does the interstitium react to chronic kidney disease?

-by becoming fibrotic and may see some degree of inflammation and some edema of the interstitium as well

34

What diseases do you see nephrosclerosis?

-HTN
-diabetes
-other disorders that affect blood vessels

35

difference between azotemia and uremia?

-uremia is azotemia PLUS a constellation of clinical findings and biochemical abnormalities resulting from renal damage

36

Acute Kidney injury

-Rapid decline in GFR
-Most severe form exhibit oliguria or anuria
-May result from glomerular, interstitial, vascular or acute tubular injury (ATN)
-Can be reversible, or progress to CKD

37

CKD

-mild--clinically silent
-more severe--uremia
-defined with diminished GFR

38

ESRD

-GFR

39

Which disorders are characteristic of glomerular disease? And which disorders are characteristic of tubulointerstitial disease? Which are characteristic of both?

-Glomerular: nephritic syndrome, nephrotic syndrome, ASYMPTOMATIC hematuria or proteinuria

Tubulointerstitial: UTI, UT obstruction, renal tumors, nephrolithiasis

BOTH: renal tubular defects and acute renal failure

40

difference between neprholithiasis and nephrocalcinosis

-nephrolithiasis is kidney stones
-nephrocalcinosis is dystrophic calcification of kidney parenchyma

41

Why do you see lipids in nephrotic syndrome?

-bc when kidney is stressed it tries to make more proteins and the pathway it goes into makes lipoproteins that deposit primarily in proximal tubule

42

Glomerular disease characterized by severe proteinuria (albumin) (more than 3.5gm/day--less in children), severe edema, hyperlipidemia, and lipiduria

Nephrotic syndrome

43

Glomerular disease dominated by acute onset of grossly visible hematuria, mild to moderate proteinuria, and hypertension. Proteinuria and edema common but not as severe

-Nephritic syndrome

44

signs of nephritic syndrome with rapid decline (days-weeks) in glomerular filtration rate (GFR). Implies severe glomerular injury

-Rapidly progressive glomerulonephritis
-nephritic
-protein in urine but LESS than 3.5 gm/day;
-normal protein in urine is about UPTO 150mg/day

45

Isolated urinary abnormalities

-glomerular hematuria and/or subnephrotic range proteinuria

46

Where do you find endothelial cells?

-line ALL blood vessels

47

Where are podocyte foot processes located?

-directly on basement membrane which deep to the podocyte cells

48

Morphology of glomerulus

-initial nephron segment consists of a glomerulus and bowman's capsule (together make up the renal corpuscle) that captures and funnels the glomerular filtrate, the initial urinary stream into the tubular system

49

PAS stains what?

glycoproteins

50

Three layers of the basement membrane

-lamina densa
-lamina rara interna
-lamina rara externa
-within that are negatively charged anions--among those are HEPARIN which is how charge selectivity occurs

51

HEMATURIA, azotemia, oliguria, edema, HTN

Nephritic syndrome

52

Acute nephritic, proteinuria, and acute renal failure

RPGN

53

>3.5 gm/day PROTEINURIA, hypoalbuminemia, hyperlipidemia, lipiduria

Nephritic syndrome

54

Azotemia-->uremia progressing for months to years

Chronic renal failure

55

Glomerular hematuria and/or subnephrotic proteinuria

Isolated urinary abnormalities

56

edema usually seen in nephritic or nephrotic syndrome?

-NEPHROTIC

57

Pathologic responses of the glomerulus to injury

-hypercellularity
-basement membrane
-Hyalinosis and sclerosis

58

Pathologic responses of the glomerulus to injury--hypercellularity

-proliferation of native cells (mesangial cells, endothelial cells and visceral epithelial cells) and infiltrates of inflammatory cells (neutrophils, macrophages, etc mononuclear cells, etc)
-crescents: occur in Bowman's space--both necrotizing elements and cellular elements

59

Pathologic responses of the glomerulus to injury----Basement membrane

-thickening (breaks, sclerotic regions)
-deposits (electron dense deposits)

-glomerulus BM is not the same as glomerular filtration membrane!!
-glomerulus BM is PART of glomerular filtration

60

Pathologic responses of the glomerulus to injury----Hyalinosis and sclerosis

-Hyaline change
-sclerosis: acellular sclerotic pattern that involves small vessels of the microvasculature of glomerulus