Flashcards in XIV - The Kidneys and Its Collecting System (with pics) Deck (154)
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T-cell mediated immune reaction of the kidneys to an offending agent, characterized by interstitial inflammation, with abundant eosinophils and edema.
Drug-induced interstitial nephritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 564
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Renal changes in benign hypertension, associated with hyaline arteriolosclerosis, appearing as homogenous, pink hyaline thickening of arterial walls. Larger blood vessels show fibroelastc hyperplasia.
Benign nephrosclerosis. SEE SLIDE 14.13. (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 566
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The kidneys show small, pinpoint petechial hemorrhages, "flea-bitten" appearance. Concentric arrangement of cells, described as "onion-skin" lesions cause marked narrowing of arterioles and small arteries (hyperplastic arteriolosclerosis).
Malignant hypertension. SEE SLIDE 14.14. (TOPNOTCH)Robbins Basic Pathology, 9th Ed. p. 540
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Characterized by widespread thrombosis and presence of fibrin thrombi in glomeruli and small vessels resulting in acute renal failure. Consequence of childhood HUS and TTP.
Thrombotic microangiopathies(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 568
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One of the main causes of acute renal failure in children.
Hemolytic Uremic Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 568
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Innocuous lesions of the kidney, 1-5cm in diameter, translucent, lined by a gray, glistening, smooth membrane, filled with clear fluid. Composed of a single layer of cuboidal or flattened cuboidal epithelium, usually confined to the cortex.
Simple renal cyst(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 569
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Autosomal dominant. Kidneys are enlarged, composed solely of cysts without intervening parenchyma. Cysts are filled with clear or turbid fluid. Cysts may arise at any level of the nephron, with variable, often atrophic lining.
Adult polycystic kidney disease (APKD)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 569
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What is the pathology behind APKD?
Defective gene PKD1,which codes for polycystin-1.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 569
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Function of policystin-1?
Protein that is involved in cell-cell or cell-matrix adhesion.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 569
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Autosomal recessive. There are numerous small cysts in the cortex and medulla, giving the kidney a "sponge-like" appearance. Cysts have uniform cuboidal epithelium. Associated with multiple cysts in the liver.
Childhood Polycystic Kidney Disease (CPKD)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 570
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An under-recognized cause of chronic kidney disease in children and young adults, associated with mutations in several genes that encode neohrocystins that may be involved in ciliary function. Kidneys are contracted and contain multiple cysts.
Medullary cystic disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 571
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Calculus formation at any level of the urinary collecting system.
Urolithiasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 571
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Most common composition of kidney stones.
Calcium oxalate and/or calcium phosphate(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 571
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Most important cause of kidney stone formation.
Supersaturation(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
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Kidney stones occuring in patients with alkaline urine due to UTI, particularly Proteus vulgaris and Staphylococci.
Struvite stones(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
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Component of struvite stones.
Magnesium ammonium phosphate(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
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Kidney stones seen in patients with gout and leukemias. Urine pH is decreased.
Uric acid stones(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
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Kidney stones associated with a defect in the renal transportation of certain amino acids. Forms in acidic urine.
Cystine stones(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
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Branching structures which create a cast of the renal pelvis and calyceal system.
Stagnorn calculi(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
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Most common composition of staghorn calculi.
Magnesium ammonium phosphate (Struvite)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
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Dilation of the renal pelvis and calyces, accompanied by atrophy of the renal parenchyma, caused by obstruction to urine outflow. Histologically, there is tubular dilation followed by atrophy and fibrous replacement of the tubular epithelium.
Hydronephrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
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Dilation of the ureters secondary to obstruction.
Hydroureter(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 573
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Most common malignant tumor of the kidney.
Renal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 573
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Tumors derived from renal tubular epithelium, located primarily at the cortex. With three common forms, clear cell, papillary renal cell and chromophobe renal carcinomas.
Renal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 573
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Most common form of renal cell carcinoma and associated with homozygous loss of the VHL tumor suppressor gene.
Clear cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th Ed. p. 549
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Renal carcinoma, usually solitary and large, spherical masses reaching up to 15cms in diameter. Cut surface show yellow orange to gray-white, with prominent areas of cystic softening and hemorrhage. Cells appear vacuolated or may be solid. Often invades the renal vein. SEE SLIDE 14.14.
Clear cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th Ed. p. 549
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Renal carcinoma exhibiting varying degrees of papilla formation with fibrovascular cores. Cells have clear to pink cytoplasm. Associated with increased activity of MET oncogene. Tend to be bilateral.
Papillary renal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th Ed. p. 549
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Renal cell carcinoma which tends to be tan-brown, cells have clear, flocculent cytoplasm with very prominent, distinct cell membranes. Nuclei surrounded by halos of cleared cytoplasm.
Chromophobe-type renal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 574
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Tumor of the urinary bladder, characterized as small, frond-like structures having delicate fibrovascular core covered by multilayered, well-differentiated transitional epithelium.
Benign papilloma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 575
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