Whitney Renal Pathophysiology

Question 1

Two distinguishing factors of Malignant Nephrosclerosis

Answer 1

1. Thick onion layers around vasculature

2. Over 130 Dia with lots of signs of renal failure

Question 2

Focal renal disease

Answer 2

Affects few glomeruli

Question 3

When do symptoms show for ADPKD?

Answer 3

30 and up

Question 4

3 things you may notice in Chronic Glomerulonephritis

Answer 4

1. Thin Cortex with cysts
2. Lots of Tubular Casts
3. Lots of Sclerosis

Question 5

2 Main Tubular/Interstitial Diseases

Answer 5

1. Acute Pyelonephritis: Non-Glomeruli infection that hits the renal pelvis with neutros
2. Chronic Pyelonephritis: Prolonged infection/obstruction scar parenchyma usually get renal backflow

Question 6

Local/Segmental renal disease

Answer 6

Affects small portion of glomerulus

Question 7

What is a Wilms Tumor and how does it present?

Answer 7

• kidney tumor from blastemal tissue growth

- Intestinal impingement may cause constipation, fever, and increased bp.

Question 8

Nephritic Syndrome main cause and mnemonic

Answer 8

1. Driven by Glomerular Capillary Rupture

2. “Less Urine more messy”

Question 9

Distinguishing factor of Acute Pyelonephritis

Answer 9

Lots of neutrophils in the renal pelvis with widened interstitium.

Question 10

4 Nephrotic syndromes

Answer 10

1. Membranous Glomerulonephritis: immune makes bm thick
2. Membranoproliferative Glomerulonephritis: mesangial cells inflammation response making bm thick
3. Minimal Change: unknown immune trigger altering GBM charge/causing fusion
4. Focal Segmental Glomerulosclerosis: faulty cardio system/ HTN play some role

Question 11

Most Nephrotic and Nephritic disorders are treated by______.

Answer 11

Steroids

Question 12

Two facts about IgA Nephropathy? (Nephritic)

Answer 12

1. Most common renal disease worldwide

2. IgA buildup in the mesangium

Question 13

Best treatment for diabetic nephropathy?

Answer 13

ACE Inhibitors and Dialysis

Question 14

Two mechanisms of Diabetic Nephropathy

Answer 14

1. Non-enzymatic glycosylation

2. POLYOL tissue swelling

Question 15

Describe what you see with a light microscope with Minimal Change disease.

Answer 15

Nothing. You need SEM to see foot process fusion.

Question 16

2 Distinguishing factors of Chronic Pyelonephritis

Answer 16

1. Commonly ascending infections cause Urine backflow b/c Vesicoureteral valve gets messed up
2. Occasionally hemtagoneous infections end up causing this

(This all happens when there is obstruction or cyst that raises bladder pressure)

Question 17

Which 5 kidney diseases can target children?

Answer 17

1. Membranoproliferative Glomerulanephritis
2. Minimal Change Disease
3. Acute-Proliferative Glom.Nephritis
4. PKD
5. Wilms Tumor

Question 18

Which 3 kidney diseases are not cured by steroids? (Include ones with no known treatment)

Answer 18

1. Focal Segmental Glomerulosclerosis
2. Chronic Glomerulonephritis
3. All Renal/Vasculature disorders

Question 19

Two distinguishing factors of Benign Nephrosclerosis

Answer 19

1. Onion layers around vasculature

2. Lots of BS b/c Glom wrinkles

Question 20

Nephrotic Syndrome 4 Main symptoms that cascade from Proteinuria and Hypoalbuminemia

Answer 20

1. Hypercoagulability
2. Less Igs
3. Edema
4. Hyperlipoproteinemia

Question 21

Two key distinguishing factors of Membranoproliferative Glomerularnephritis

Answer 21

1. Very little Bowman’s Space

2. Doughnut double membrane capillaries

Question 22

What effect does arPKD have on patients’ urine?

Answer 22

Leaves it dilute b/c the collecting ducts get hit hard.

Question 23

Global renal disease

Answer 23

Affects entire Glomeruli

Question 24

3 Main Renal Blood vessel Diseases

Answer 24

1. Benign Nephrosclerosis: Small onion layers compressing around vasculature usually asymptomatic
2. Malignant Nephrosclerosis: Big onion layers compressing around vasculature
3. Diabetic Nephropathy: Tissue damage b/c HTN and Hyperglycemia with lots of scarring and narrowing

Question 25

How long do arPKD patients live?

Answer 25

1 or 2 years

Question 26

Are endogenous or exogenous immune complexes present in Membranous Glomerulonephritis?

Answer 26

Endogenous, it's the body attacking self!

Question 27

Hydronephrosis

Answer 27

- Distention of kidney usually because of obstruction - Dilated tubules are permanent and ARE still FUNCTIONAL - Chronic could lead to acute renal failure

Question 28

3 Nephritic Disorders

Answer 28

1. Acute proliferative: non-kidney disease (strep) causes immune complexes to build up and results in rupture! 2. IgA Nephropathy (Berger): IgA builds up and causes rupture! 3. Chronic Glomerulonephritis: Long-term late stage everything gets wrecked.

Question 29

6 main signs of nephritic Syndrome

Answer 29

1. P proteinuria 2. H hematuria 3. A azotemia 4. R rbc casts 5. O oliguria 6. H hypertension

Question 30

Diffuse renal disease

Answer 30

Affects many glomeruli

Question 31

Nephrotic Syndrome two main causes

Answer 31

1. Driven by altered Glom. Permeability | 2. Usually inflammation of antigen either endo or exogenous

Question 32

Proliferative Renal Disease

Answer 32

Growth upon Podocyte, Mesangial, and Endothelial cells

Question 33

Key distinguishing factor in Acute Proliferative Renal disease? (Nephritic)

Answer 33

A butt-load of neutrophils inside the glomerulus.

Question 34

Which 6 kidney diseases are mainly seen in adults?

Answer 34

1. Membranous Glom.nephritis 2. Focal Segmental Glom.Sclerosis 3. Chronic Glom.Nephritis 4. Neph.Sclerosis 5. Diabetic Nephropathy 6. Clear Cell carcinoma

Question 35

Renal Tubular and interstitial diseases are driven by _____

Answer 35

Back-leak of filtration on damaged epithelium