Path Nephro

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Path Nephro
2011-11-26 13:40:48
Path Nephro

Path Nephro
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  1. Autoimmune dz affect what part of the kidney?
    Drugs and toxins affect what part of the kidney?
    • glomerulus
    • Interstistium and tubules
  2. Distribution
    Chronic or acute
    Systemic symptoms
    What are the 5 types of Lupus Nephritis?
  3. 5 types of Lupus Nephritis?
    • No change/minima
    • Mesangial
    • Focal Proliferative
    • DIffuse Proliferative--most common TYpe IV
    • Membraneous--GBM involvement
  4. Wire Loop Glomeruli are seen in what systemic autoimmune disease?
  5. Which Lupus nephritis has cresents?
    Diffuse proliferative nephritis
  6. PAS positive mesangial cells are seen in what disorder?
    Plasma cell Dycriasis
  7. Bence Jones tubular casts are seen in what condition?
    MM affecting the kidney--amorphous pink material
  8. Subendothelial and mesangial deposits of criss-cross fibrillary pattern are seen in what condition of the kidney?
  9. Flea bitten kidney results from what kidney condition?
    Malignant hypertension
  10. What accounts for the flea bitten appearance of the kidney?
    petechial hemorrhages of the glomeular of tubular capillaries
  11. What are the 2 pathological changes seen in the blood vessels of malignant hypertension?
    • fibrinoid necrosis---fibrin, neutrophils
    • Onion skinning----collagen, proteoglycans, plasma proteins
  12. Cause of Renal artery stenosis?
  13. Atherosclerosis differes from Fibromuscular dysplasia how?
    • FMD--women in 3rd or 4th decade
    • Atherosclerosis--men in 5th or 6th decade
  14. WHat makes up the casts and obstructs the lumen of the tubule?
    necrotic epithelial cells after they loose their polarity from ischemia
  15. Eosinophilic casts are indicative of what kidney disorder?
    Interstitial nephritis due to drug hypersensitivity
  16. What kind of ischemic injury to epithelial cells lining tubules is seen in toxin caused acute kidney necrosis?
    With ischemia?
    • PCT
    • PCT and ascending loop of henle
  17. Rupture of basement membrane i.e tubulorrhexis is seen in what acute tubular necrosis? Toxin or ischemic?
  18. What is responsible for oliguria in Acute tubular necrosis?
    sloughed off epithelial cells blocking the lumen of the tubule
  19. What electrolyte disturbance is seen in the 1st or initiation stage of ATN?
    • hyperkalmeia
    • metabolic acidosis
    • Azotemia--BUN and Creatitine increased
  20. Muddy brown granular casts are indicative of what?
    Acute tubular necrosis
  21. WBC casts arre indiciative of what?
    pyelonephritis and transplant rejection
  22. RBC casts are indicative of what?
    • glomerulonephritis
    • ischemia
  23. 2 Causes for Acute tubular necrosis (ATN)
    • ischemia
    • Toxins/Drugs
  24. 2 types of Acute tubular necrosis?
    • ischemic
    • Toxigenic---Drugs, x ray contrast, myoglobin and other foreign substances
  25. What is the pattern of damage in ischemic vs toxic tubular necrosis?
    • ischemic--all parts of nephron affected
    • Toxic--only proximal part if affected
  26. WHat is acute pyelonephritis?
    • infection of renal pelvis
    • tubules
    • interstitium
  27. 2 causes for Renal artery stenosis?
    • atherosclerosis
    • fibromuscular dysplasia
  28. What virulence factors are needed by bacteria to colonize distal urethra/
    • fimbriae
    • pili
  29. 4 virulence factors of h.pylori?
    • urease
    • fimbriae
    • coxa gene
    • pili
  30. What are the p?redisposing factors to acute pyelonephritis
    • distal urethral colonization
    • obstruction
    • vesicourethral reflux
    • intrarenal refulx
  31. 3 glomerulopathies that produce foot processes effacement?
    • minimal change dz
    • membranous
    • Focal segmental glomerulosclerosis
  32. Diff between membranous and DM nephropahty?
    • membranous only has gbm thickning
    • dm has gbm thickening, mesangial thickening/nodular glomerulosclerosis
  33. Hormones produced by the RCC?
    • PTH
    • Renin
    • Corticosteroid
    • gonadotropins
    • renin
  34. What caused Diffuse cortical necrosis?
    ischemia to the kidney i.e DIC, obstetric complication, atrial/ventricular thrombus
  35. What causes Acute tubular necrosis?
    • ischemia/hypoxia--patchy involvement of the tubules
    • toxins--proximal tubules involved
  36. How does Drug interstitial nephritis present?
    eosinophils in urine
  37. causes of Renal papillary necrosis?
    • analgesic nephropathy
    • DM
    • Sicke cell
    • acute pyelonephritis
  38. Bladder Exstrophy is associated with what other congenital anomaly?
  39. Classic pathology of kidney seen with DM?
    nodular glomeruloscleorosis in the glomerulus
  40. 4 causes for oligohydramnios?P
    • Posteriour urethral valve
    • renal agenesis
    • Multicystic renal dysplasia
    • autosomal recessive
  41. vasculitis affecting medium sized bv?
    • PAN
    • Kawasaki
    • Buerger
  42. vasculitis affecting large blood vessels?
    • takayasu
    • Giant cell arteritis
  43. ARPKD causes what?
    • renal cysts
    • hepatic cysts
    • hepatic fibrosis