Urinary System Flashcards
(137 cards)
0
Q
What normally surrounds a bovine kidney?
A
Peri-renal fat
1
Q
What is a distinction of the feline kidney?
A
Distinct vascular pattern on the cortical surface just under the capsule.
2
Q
What are 4 structures to examine histologically in the kidney?
A
- Glomerulus
- Proximal tubules
- Distal tubules
- Interstitium
3
Q
The absence of development of a kidney is known as what?
A
Renal aplasia
4
Q
What is the difference in the significance of unilateral and bilateral renal aplasia?
A
Unilateral is incidental and bilateral is fatal.
5
Q
Is renal aplasia a rare or common developmental abnormality?
A
Rare
6
Q
In what 3 species can you see renal aplasia?
What are 2 specific breeds?
A
- Swine, dogs, cattle
- Doberman pinscher and Beagle
7
Q
A quantitative defect caused by reduced mass of metanephric blastema is known as what?
A
Renal hypoplasia
8
Q
With what condition is the affected kidney reduced in size with otherwise normal architecture?
A
Renal hypoplasia
9
Q
A rare condition affecting the kidneys that is very difficult to diagnose grossly is what?
A
Renal dysplasia
10
Q
An abnormal and asynchronous differentiation of renal tissue is what?
A
Renal dysplasia
11
Q
What might severe bilateral dysplasia lead to?
A
Renal failure
12
Q
What are 3 examples of congenital infections that can cause renal dysplasia?
A
- Feline panleukopenia
- ## Canine herpesvirus
13
Q
A common congenital renal malformation found in pigs, calves and to a lesser extent other species is what?
A
Renal cysts
14
Q
What is the significance of finding renal cysts?
A
Usually incidental
15
Q
Grossly, kidneys containing numerous variably-sized cysts in both the cortex and the medulla are known as what?
A
Polycystic kidneys
16
Q
Normal kidneys in an abnormal location are known as what?
Is this more often unilateral or bilateral?
A
- Ectopic kidneys
- Unilateral
17
Q
What are 2 species where you can see ectopic kidneys?
A
- Dogs
- Pigs
18
Q
Ectopic kidneys are predisposing factors for what 2 conditions?
A
- Ureter obstruction
- Development of hydronephrosis
19
Q
A congenital malformation that results from a fusion of the cranial or caudal poles of the kidneys is know as what?
A
Horseshoe kidney
20
Q
Is a horseshoe kidney in a cat a significant or incidental finding?
A
Incidental
21
Q
What is a common post-mortem finding that causes the kidneys to become soft and friable?
A
Autolysis
22
Q
What is a pigment that stains the surface of the kidney black?
A
Pseudomelanosis
23
Q
What are 4 examples of pigmentary disturbances?
A
- Hemoglobinuria
- Myoglobinuria
- Lipofuscin
- Bile
24
What are the gross features of hemoglobin in the kidneys?
Dark red to black kidneys
25
Severe intravascular hemolysis and hemoglobinuria can cause what type of pigmentation to occur in the kidneys?
Hemoglobin
26
What are 4 possible causes of hemoglobin in the kidneys?
- Leptospirosis
- Bacillary hemoglobinuria
- Babesiosis
- Chronic copper poisoning
27
Hemoglobinuria in sheep can be seen secondary to what?
Copper poisoning
28
Dark red to black kidneys and dark red urine are gross findings with what type of pigmentation?
Myoglobin
29
When does myoglobin pigmentation occur?
Occurs when high levels of myoglobin are filtered into tubules (myoglobinuria).
30
What are 2 examples of conditions where myoglobin pigmentation can be seen?
- Rhabdomyolysis in capture myopathy in wild animals
| - Equine paralytic myoglobinuria
31
What type of pigmentation is an incidental finding in old cattle?
Lipofucsinosis
32
How do the kidneys appear grossly with lipofucsinosis?
Dark brown to black
33
T/F: A bovine kidney with lipofucsinosis is enlarged.
False - The size is normal.
34
How does lipofucsinosis appear in the bovine heart?
The cardiac parenchyma is uniformly dark brown.
35
In obstructive jaundice or severe liver disease, the kidneys excrete conjugated bilirubin resulting in what?
Choluria
36
How do the kidneys appear grossly with bile pigmentation?
Yellow-green
37
What are 2 examples of other tissues where evidence of jaundice/icterus can be seen with bile pigmentation?
- Mucous membranes
| - Connective tissue
38
What are 3 examples of circulatory disturbances that can be seen with the kidneys?
- Hyperemia and congestion
- Hemorrhage
- Ischemia
39
How do the kidneys appear grossly with hyperemia and congestion?
Bright or dark red
40
T/F: Hyperemia can be physiologic.
True
41
What is common as a result of prolonged prostration and circulatory failure?
Hypostatic congestion
42
What are commonly seen in kidneys as a result of vasculitis or vascular necrosis?
Hemorrhages
43
Renal hemorrhages can come in what 2 forms?
- Petechial
| - Ecchymotic
44
What has to usually be removed in order to see renal hemorrhages?
The renal capsule.
45
What are preferentially affected with renal hemorrhage?
Glomeruli
46
How do cortical hemorrhages appear grossly?
Speckled appearance
47
What are 4 examples of causes of renal hemorrhage?
- Coagulopathies
- Viral infections
- Septicemia
- Toxins
48
Extensive vascular injury or platelet consumption leading to disseminated intravascular coagulation (DIC) can cause what in the kidneys?
Renal petechia
49
What are 3 examples of acquired or congenital clotting defects that can cause renal petechia?
- Sweet clover- coumarin poisoning
- Vitamin K deficiency
- Hemophilia A and B
50
What are 3 examples of viremia sources that can cause renal petechia and ecchymosis?
- Hog cholera leading to endothelial damage.
- African Swine Fever leading to platelet destruction.
- Canine herpes virus in neonatal puppies.
51
What are 3 examples of bacteremias that can cause renal petechia?
- Erysipelas
- Streptococcal infections
- Salmonellosis in pigs
52
If septicemia is suspected, tissues from what 3 organs should be sent for bacteriological examination?
- Lung
- Kidney
- Liver
53
What are 3 examples of toxins that can cause renal petechia?
- Oak toxicity
- Endotoxins
- Enterotoxins
54
What are 2 possible causes of renal ischemia?
- Renal torsion
| - Renal infarcts
55
What are typically triangular in shape with the apex pointing towards the medulla?
Renal infarcts
56
What are renal infarcts associated with?
Thrombosis of renal vessels (usually the interlobular artery).
57
What does the size of a renal infarct depend on?
The size of the affected vessels.
58
What color are renal infarcts in acute cases?
| Why?
- Red
| - Hemorrhage
59
What is a common cause of renal infarcts?
Valvular endocarditis
60
What can prolonged ischemia lead to in the kidneys?
Infarction/coagulative necrosis
61
How will the area affected by chronic renal infarcts heal?
By fibrosis.
62
What causes retraction of the parenchyma and characteristic depression on the renal cortex of kidneys with healed renal infarcts?
Fibrosis
63
Renal infarcts are most commonly seen with what condition in cattle and pigs?
Vegetative valvular endocarditis of the left heart.
64
Renal infarcts are most commonly seen with what condition in cats?
Left atrial thrombosis associated with cardiomyopathy.
65
Renal infarcts are most commonly seen with what condition in dogs?
Renal amyloidosis due to loss (through the urine) of plasma anticoagulants such as antithrombin III.
66
Renal infarcts from endotoxin-mediated thrombosis can be due to what?
What is an example?
- Gram-negative sepsis or endotoxic shock.
| - Dogs with suppurative prostatitis.
67
Heterogenous group of diseases due to deposition of amyloid in tissues is known as what?
Amyloidosis
68
What is one of the most important targets of amyloidosis?
Kidneys
69
What type of nephropathy is glomerular amyloidosis?
A protein-losing nephropathy.
70
What are 2 types of amyloidosis?
- Primary amyloidosis
| - Secondary (reactive) amyloidosis
71
Which type of amyloidosis is rare in domestic animals?
Primary amyloidosis
72
Primary amyloidosis is due to the deposition of what?
| What is this derived from?
- Deposition of amyloid AL.
| - Derived from Ig light chains produced by abnormal plasma cells.
73
What is the most common form of amyloidosis seen in domestic animals?
Secondary (reactive) amyloidosis
74
Secondary (reactive) amyloidosis is due to the deposition of what?
Where does it originate?
- Deposition of amyloid AA
| - Originates from serum alpha-globulin
75
Secondary (reactive) amyloidosis is associated with what?
| What are 3 examples?
- Chronic antigenic stimulation
| - Chronic inflammation, infection, neoplasia
76
What is the gross appearance of kidneys with amyloidosis?
Enlarged, pale and have a finely granular surface.
77
What would you stain fresh kidneys with to reveal many solid black dots which correspond to glomeruli filled with amyloid protein?
Iodine solution
78
Do kidneys with amyloidosis have rough edges or rounded edges?
Rounded edges
79
What are 2 ways the cortical surface of a kidney with amyloidosis may appear?
- Smooth and pale
| - Slightly granular
80
How does the cut surface of a kidney with amyloidosis appear grossly?
Pale and waxy
81
Deposition of pink amorphous material in glomeruli (most species) or in medullary interstitium (cats and cattle) are seen microscopically in what condition?
Renal amyloidosis
82
Signs of renal amyloidosis can be seen in the medullary interstitium in what 2 species?
- Cats
| - Cattle
83
What are 2 specific locations the pink homogenous relative acellular material known as amyloid is deposited?
- Mesangial matrix
| - Along the adjacent basement membrane
84
What are 2 stains that can be used to microscopically confirm amyloidosis?
- Congo red (polarized light)
| - Thyoflavine-T (fluorescence)
85
What are 2 species in which familial renal amyloidosis can occur?
- Abyssinian cats
| - Chinese Shar Pei dogs
86
What type of amyloidosis is characterized by medullary deposits of amyloid, with fibrosis and papillary necrosis?
Familial renal amyloidosis
87
Amyloidosis can lead to thrombosis of pulmonary arteries or renal veins due to hypercoagulable state caused by what 2 things?
- Stimulation of production of acute-phase proteins such as fibrinogen.
- Simultaneously losing (due to increased glomerular permeability) low-molecular weight anticoagulants, such as antithrombin III.
88
An acute and severe ischemia of the renal cortex due to vasospasm of cortical vessels is known as what?
Bilateral renal cortical necrosis
89
Bilateral renal cortical necrosis has been traditionally associated with what?
Endotoxemia
90
What parts of the cortex may be involved with renal cortical necrosis?
All or part of the cortex.
91
The renal cortex has a mosaic (patchy) appearance with intermixed areas of red and yellow discoloration can be seen with what condition?
Renal cortical necrosis
92
What condition is caused by a localized ischemia of the renal medulla?
Renal medullary (papillary) necrosis
93
What is a cause of medullary necrosis in cats?
Amyloidosis
94
What are 4 possible causes of medullary necrosis?
- Pyelonephritis
- Diabetes mellitus
- Urinary obstruction
- Use of anti-inflammatory and analgesic drugs
95
What are 3 examples of anti-inflammatory and analgesic drugs that may cause medullary necrosis?
- Phenylbutazone
- Phenacetin
- Aspirin
96
Acute necrosis of tubular cells is the primary process of what?
Nephrosis
97
What type of renal tissue is highly susceptible to ischemia or to toxic damage?
Why?
- Renal tubular epithelium (especially proximal tubules).
| - It is metabolically very active.
98
T/F: Grossly, acute tubular nephrosis is easy to diagnose.
False - It is difficult to diagnose.
99
What is the gross appearance of kidneys with acute tubular nephrosis?
Kidneys are swollen, capsular surface is pale and moist and bulges on the cut surface.
100
What are 4 differential diagnoses for diffusely pale kidneys?
- Amyloidosis
- Acute nephrosis
- Glomerulonephritis
- Lymphosarcoma
101
Histologically, most cases of nephrosis are what with minimal to absent what?
- Acute to per-acute
| - Inflammatory cell infiltration
102
Cases of what type of necrosis are characterized by fibrosis, tubular loss, architectural disorganization, regeneration and limited inflammatory response?
Chronic nephrosis
103
Are most cases of nephrosis acute to per-acute or chronic?
Acute to per-acute
104
Is there inflammatory cell infiltration seen with nephrosis?
Minimal to absent
105
Cases of chronic nephrosis are characterized by what 5 factors?
- Fibrosis
- Tubular loss
- Architectural disorganization
- Regeneration
- Limited inflammatory response
106
Histologically, acute tubular nephrosis is characterized by what?
Swelling of the tubular epithelium
107
How does the cytoplasm appear with acute tubular nephrosis?
| The nucleus?
- Vacuolated
| - Pyknotic, karyolytic or karyorrhetic
108
What are 3 features of the tubules in acute tubular nephrosis?
- Hypocellular
- Often dilated
- Contain necrotic cellular debris and hyalinized casts
109
If the basement membrane is intact with tubular necrosis, regeneration of the proximal convoluted tubules can be seen as early as when?
3 days after the toxic insult is removed.
110
Nephrosis can be caused by the ingestion of what?
| Some substances precipitate as what?
- Exogenous substances
| - Crystals in tubules
111
What are 6 examples of heavy metals that can cause toxic nephrosis?
- Mercury
- Lead
- Cadmium
- Chromium
- Copper
- Phosphorus
112
What are 2 examples of insecticides that can cause toxic nephrosis?
- Carbon tetrachloride
| - Chlorinated-hydrocarbon
113
What are 2 examples of nephrotoxic plants?
- Pigweed
| - Oaks
114
What can pigweed cause in pigs and cattle?
Tubular degeneration and peri-renal edema
115
Oak poisoning can occur in what 2 species?
- Cattle
| - Horses
116
Oak toxicity can cause what?
Acute tubular necrosis
117
The proposed pathogenesis of what type of poisoning involves the binding of tannic acid to endothelial cells causing necrosis of the epithelium?
Oak poisoning
118
What is embolic nephritis caused by?
Bacteremia
119
What pattern is seen with embolic nephritis?
Multifocal suppurative glomerulitis
120
With embolic nephritis, bacterial colonies are seen where?
In glomerular and interstitial capillaries.
121
What may develop as a result of embolic nephritis?
Chronic renal micro-abscesses
122
What are 2 heterogenous groups of diseases in which the main morphologic change takes place in the glomeruli?
- Glomerulonephritis
| - Glomerulopathies
123
Glomerulonephritis is largely, but not exclusively, associated with what?
Immune-mediated injury
124
What are the 2 main mechanisms of glomerulitis and glomerulonephritis related to immune-mediated processes?
- Deposition of antigen-antibody (Ag/Ab) complexes
| - Auto-antibodies directed against the GBM (anti-basement membrane disease)
125
Persistent antigens in the blood result in deposition of antigen-antibody complexes where?
What are 3 examples of persistent antigens sources?
- Glomerular basement membranes
| - Viral, bacterial, parasitic
126
Is anti-basement membrane disease common or rare in domestic animals?
Rare
127
Are the gross lesions seen with acute glomerulonephritis subtle or obvious?
What are 2 examples of these changes?
- Subtle
| - Swollen and pale
128
What is the gross appearance of chronic glomerulonephritis?
Kidneys are shrunken and granular.
129
What are 3 morphologic types of glomerulonephritis?
- Membranous glomerulonephritis
- Proliferative glomerulonephritis
- Membrano-proliferative glomerulonephritis
130
Membranous glomerulonephritis is characterized by what?
Thickening of the basement membrane.
131
Proliferative glomerulonephritis is characterized by what?
Increased cellularity
132
Membrano-proliferative glomerulonephritis often lead to what?
Glomerular sclerosis
133
Inflammatory infiltration in the interstitium affecting tubular functions such as impaired reabsorption, concentration and/or excretion can be seen with what?
Interstitial (tubulo-interstitial) nephritis
134
What 2 types of distribution can be seen with interstitial nephritis?
- Multifocal
| - Diffuse
135
How do kidneys appear grossly with the acute form of diffuse interstitial nephritis?
Kidneys swollen with a mottled appearance.
136
Is multifocal interstitial nephritis considered a common or rare condition?
Is it an incidental or significant finding?
- Common
| - Incidental
