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Kidney Pathology #2
Dr. Sultana
46
Science
Post-Graduate
11/01/2011

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Cards

Term
Causes of acute tubular necrosis
Definition
ischemia
nephrotoxins
heme proteins
Term
Ischemia (hypoperfusion) examples
Definition
hypovolemic shock (bleeding)
Sepsis
Burns
Prolonged surgical opera
Term
Nephrotoxins examples
Definition
Toxic chemicals
Heavy Metals
Drugs
Term
Heme Protein examples
Definition
Myoglobin (rehabomyolysis)
Hemoglobin (hemolysis)
Term
. Ischemic acute tubular necrosis (ATN) is a common consequense of renal hypoperfusion in patient with
Definition
hypovolemic or endotoxemic shock or circulatory collapse owing to pump failure(e.g.,myocardial infarct).
Term
Tubular necrosis leads to
Definition
oliguria;the oliguria is reversible, because the tubule regenerate.
Term
Patients placed on dialysis will
Definition
survive and enter a polyuric phase before fully recovering. The urine contains dark brown granular cast.
Term
PATHOLOGY OF ACUTE TUBULAR NECROSIS:
Definition
The Necrotic tubular cells slough off
Intra tubular cast in medulla
Regeneration of tubules with functionless cells occurs fast
Term
acute tubular necrosis is
Definition
the most common cause of acute renal failure
Term
Prognosis of acute tubular necrosis
Definition
is oliguria-anuria-polyuria
Term
Recovery of acute tubular necrosis
Definition
1-2 weeks
Term
Glomerulopathies of nonimmune origin are encountered in two systemic diseases,
Definition
diabetes mellitus and amyloidosis.
Term
Uremia(i.e.,end-stage kidney disease) may
Definition
ensue over time from any glomerular disease
Term
Diabetes affects the kidney by
Definition
leaking protein (albumin) into the urine
Term
Diabetic nephropathy is manifested by
Definition
the nephrotic syndrome
Term
Diabetic nephropathy Electron microscopy demonstrates a striking increase in
Definition
thickness of the glomerular basement membrane
Term
is one of the earliest morphologic changes in diabetes mellitus
Definition
Thickening of vascular basement membrane observable by electron microscopy
Term
An increase in mesangial matrix results in (1st characteristic)
Definition
Diffuse glomerulosclerosis is marked by a diffusely distributed increase in mesangial matrix.
Term
An increase in mesangial matrix results in (2nd characteristic)
Definition
Nodular glomerulosclerosis is marked by nodular accumulation of mesangial matrix material (
Term
(Kimmelstiel-Wilson nodules).
Definition
nodular accumulation of mesangial matrix material
Term
Renal amyloidosis is a cause of
Definition
nephrotic syndrome
Term
Renal amyloidosis characteristics are
Definition
Predominantly subendothelial and mesangial amyloid deposits
Term
Associations of Renal Amyloidosis are
Definition
chronic inflammatory diseases such as rheumatoid arthritis or plasma cell disorders such as multiple myeloma
Term
Renal Amyloidosis amorphous extracellular material in glomeruli is
Definition
Congo red positive
Term
Congo red positivity is also present in
Definition
the arteriolar walls.
Term
Acute (allergic) tubulointerstitial nephritis is most often caused by
Definition
by type IV hypersensitivity(cell-mediated) reaction to therapeutic drugs.
Term
Tubulointerstitial nephritis Pathologically, it is characterized by
Definition
tubular injury and renal interstitial infiltrate containing T lymphocytes, macrophages, and eosinophils.
Term
Tubulointerstitial nephritis Patients present with
Definition
acute renal failure.
Term
Tubulointerstitial nephritis Chronic (immune mediated) tubulointerstitial nephritis is
Definition
typical feature of chronic renal transplant rejection.
Term
RENAL INFARCTS
Causes:
Definition
Thromboemboli
Mural thrombi (M.I., atrial fibrillation)
Endocarditis
Aortic thrombi (atherosclerosis)
Cholesterol emboli
Term
RENAL CORTICAL NECROSIS
Definition
Cortical ischemia: thrombi, vasospasm
Complication: shock
Term
Cortex damage – medulla spared
Definition
Massive tubular necrosis
Term
Focal segmental glomerulosclerosis is characterized by
Definition
sclerosis within capillary tufts of deep juxtamedullary glomeruli with focal or segmental distribution.
Term
Focal distribution is involvement of
Definition
some, but not all of the glomeruli.
Term
Segmental distribution is involvement
Definition
only a part of the glomerulus
Term
Diffuse is
Definition
All or most (greater than 75-80%) of the glomeruli in a tissue section are diseased
Term
Focal is
Definition
Some glomeruli in a section are diseased (less than 75-80%). It's the opposite of diffuse..
Term
Global: This is when the process affects the
Definition
entire glomerulus, not just parts of it. Global diseases are usually also diffuse.
Term
Global is the opposite of
Definition
segmental
Term
global means that if a glomerulus is involved
Definition
portions of it are involved
Term
Direct toxic injury is
Definition
predictable and dose dependent

occurs in cancer patients receiving cytotoxic drugs
Term
Immunologic reaction presents as
Definition
acute tubulointerstitial nephritis( e.g., hypersensitivity to penicillin.
Term
Papillary necrosis: It is most often associated
Definition
with an abuse of analgesic (e.g.,phenacitin).
Term
Drugs that cause kidney injury inhibit
Definition
prostaglandin synthesis and cause ischemia of the renal medulla
Term
Crescents are
Definition
A moon-shaped fibrous tissue proliferation in the glomerulus which fills all or part of Bowman's space.
Term
Crescents indicate
Definition
severe damage to the glomerular basement membrane, and the presence of crescents is often an ominous risk factor for quick progression to end-stage renal disease.
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