Term
| Are uremia-associated lesions that develop in organs other than the kidneys occur more frequently in acute or chronic renal failure? |
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Definition
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Term
| What are the four general mechanisms by which uremia-assoc lesions developing outside the kidneys? |
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Definition
-endothelial damage
-ammonia secretion
-altered CA: P met
-inc RBC fragility & loss of erythropoietin pdn
-LAST 2 ONLY HAPPEN IN CKD!!! |
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Term
| What si the mechanism behind uremia-assoc endothelial damage? |
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Definition
-high conc of uremic toxins in blood damages endothelium
-hypertension |
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Term
| What lesions result from endothelial damaged induced by uremia in the lugns? What do we see on histo? |
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Definition
-PUlmonary edema (aka uremic pneumonitis)
-intraalveolar proteinaceous fluid and inc in luminal macrophages w/ hypercellularity of intralveolar setae |
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Term
| What lesions result from endothelial damage induced by uremia in the heart? |
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Definition
-fibrinous pericarditis: fine fibrin on epicardial surgace
-uremic endocarditis w/ or w/o atrial and aortic thrombosis |
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Term
| What do we see due to uremia in the lower GI tract? What does it look like? |
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Definition
-ammonia secretion causes uremic gastritis (ulcerative and hemorrhagice)
-bloody mucus, thickened edematous wall or rugae, small ulcers mainly along rugae |
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Term
| What do we see due to uremia in the upper GI tract? What does it look like? |
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Definition
lcerative and necrotic stomatitis due to ammonia secretion
-ulcers along lateral margins and underside of tongue, usually covered by fibrin or yellow/brown necrotic material |
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Term
| What chronic uremic lesions are assoc w/ altered Ca-P metabolism? |
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Definition
-parathyroid hyperplasia: enlarged due to inc chief cells
-fibrous osteodystrophy
-soft-tissue mineralization |
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Term
| Describe the fibrous osteodystrophy we see with altered Ca=P metabolism w/ chronic uremia. |
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Definition
-Rubber Jaw: mandible is soft an d teeth loose
-Pathologic fractures: long bones and ribs
-HYperostotic fibrous osteodystrophy: regular bone repalced by fibrous CT and gets huge |
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Term
| What is the most common site of soft-tissue mineralization due to altered Ca-P metabolism that occurs during chronic uremia? |
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Definition
-stomach: gritty when cut
-also in kidneys, lungs, parietal pleura in dogs, endocardium, great vessels |
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Term
| How does soft-tissue mineralization present at necropsy in the lungs? |
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Definition
-visceral pleura thickened and crack when touched
-intralveolar septae mineralize
-fails to collapse due to edema + mineralization |
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Term
| How does parietal pleura mineralization w/ chronic uremia present at necropsy? In which animals is it most common? |
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Definition
-subpleural mineralization overlying the intercostal mm like a ladder (more severe = cranial)
-most common in dogs
-CAN BE PATHOGNEUMONIC FOR CKD |
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Term
| What functional lesiosn occur due to dec erythropoitin pdn and inc RBC fragility w/ uremia? |
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Definition
| -non-regen anemia: everything pale |
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