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Urinary System Path

Pathology Lecture 11-12

Functional unit of the kidney Nephron
Nephron function acid base regulation water conservation ion regulation waste elimination endocrine
Endocrine functions of the nephron: Erythropoietin - PCV regulation, response to O2 tension Renin-angiotensin - juxtaglomerular apparatus, controls bp and Na Vitamin D - conversion to active form, facilitates Ca absorption
True or False, BOTH pre and post renal causes of renal failure can lead to true and irreversible renal damage TRUE
What is seen with uremic toxicosis acidosis, azotemia, electrolyte imbalance (high K+), hypertension
2ndary lesions of uremia pericarditis, pulmonary edema, pnemonitis, thrombosis, anemia, ulcers, secondary hyperparathyroidism, soft tissue calcification
Congenital or Developmental kidney lesions: progressive juvenile nephropathy, ectopic or fused kidneys, renal cysts, aplasia/hypoplasia/dysplasia
Who does progressive juvenile nephropathy affect young dogs 4 months to 2 years
______ in any animal are solitary and incidental kidney lesions while _______ are numerous and prgoressive with a familial inheritance (common to _________) 1. renal cysts 2. polycystic kidney dz 3. persian cats and cairn terriers
Circulatory problems in the kidney (5) hemorrhage, infarction, renal cortical necrosis, renal papillary necrosis, tubular necrosis
Distinguish a raised dark renal infarct, a tan raised renal infarct, and a tan depressed renal infarct: 1. acute hemorrhagic 2. acute ischemic 3. chronic
What is renal cortical necrosis also known as and what causes it? Schwartzman reaction due to gram negative septicemia and sever hypovolemia
What causes renal crest or papillary necrosis NSAID toxicity, medullary amyloidosis, pyelitis, renal calculi, obstructive pressure
What are the 2 main causes of tubular necrosis and which can regenerate and why 1. Ischemic - destroys BM, no regeneration 2. Nephrotoxic - may leave BM intact, regeneration possible
CS and mechanism of tubular necrosis CS: uremia, oliguric or anuric renal failure mechanism: obstruction, back leakage and decreased urine production
Lesions of tubular necrosis Grossly pale, swollen kidneys Scar or regeneration of BM if nephrotoxic Histo: coag necrosis of tubules
Ischemic causes of tubular necrosis include: Toxic causes of tubular necrosis include: 1. hypotension, shock, any cause of reduced blood flow, can be complicated by Hg 2. heavy metals, drugs, oxalates (EG), vitamin D, mycotoxins
Consequences of glomerular damage Loss of LMW proteins into urine (protein losing nephropathy) Decreased plasma oncotic pressure --> edema, ascites, pleural effusions
In immune complex glomerulonephritis, circulating immune complexes are deposited in the __________*** Glomerular Basement Membrane (GBM)
2 other characteristics of immune complex glomerulnephritis:*** Abs attack components of GBM Immune complexes from insitu form circulating antibody recogntition of nonglomerular Ag lodged in glomerulus
Gross lesions of immune complex glomerulonephritis: Acute: swollen, smooth, pale, red dots Chronic: shrunken, granular, thin cortex
What does immune complex glomerulonephritis look like histologically? minimal changes, proliferative (too many cells), membranous (too much interstitium), membranoproliferative, casts/adhesions/thrombi/dilated tubules, obsolescent glomeruli
How do you dx immune complex GN? document PLN histo changes detection if IgG, IgM, IgA, C3
What viral cause may cause GN and replicates in the capillary endothelium Canine Herpesvirus
What causes glomerular capillary thrombosis? capillary thrombosis or fibrin embolism Coagulopathy (DIC, idipoathic)
Which type of amyloidosis is more common? AA amyloid - acute phase reactant in chronic inflammatory disease or idiopathic
What does renal amyloidosis look like? Gross: large pale smooth to finely granular cortex Histo: acellular homogenous to fibrillar material in mesangium that obliterate capillaries
Who is affected by medullary amyloidosis Abyssinian cat and Shar pei dog
Consequences of renal amyloidosis: PLN, uremia, renal papillary necrosis, eventual secondary tubular atrophy and fibrosis
What causes interstitial nephritis? bacterial or viral sepicemia
Higher levels of bacteria, fungi, parasite, or virus may cause this type of interstitial nephritis: granulomatous
Define pyelonephritis inflammation of both the renal pelvis and renal parenchma
Who is commonly affected by an ascending urinary tract infection females
What is caused by an obstruction of urine outflow (unilaterally or bilaterally, partially or complete, acutely or chronically) and causes progressive dilation of renal pelvis Hydronephrosis
causes of hydronephrosis congenital, calculi, inflammation neoplasia, iatrogenic
How does renal fibrosis look grossly shrunken misshapen kidneys, firm, adherent capsule
What pattern of fibrosis is caused by chronic GN or amyloid?*** finely granular pattern of fibrosis throughout cortex
What pattern of fibrosis is seen with chronic interstitial nephritis secondary to pyelonephritis?*** patchy depressed areas of fibrosis with extension from pelvis to medulla to cortex
What pattern of fibrosis is seen with vascular obstruction? wedge shaped foci of fibrosis within cortex
How do you distinguish primary renal neoplasms from metastasis? Primary = typically single nodules
What is the most common primary renal neoplasm? Adenocarcinoma Followed by hemangiosarcoma and fibrosarcoma
Describe renal adenocarcinoma:** common, well-demarcated, compress remaining renal parenchyma, located one pole of kidney
Describe nephroblastoma Occurs in young animals**, another primary renal neoplasm, may contain cartilage, bone, or fat
Name 3 metastatic renal neoplasms: LSA (most common), hemagiosarc, and MCT
What tumor is easily confused with FIP? Lymphoma
Developmental anomalies of LUT: Ureteral aplasia Ectopic ureter Patent urachus
Predisposing factors to urolithiasis: pH, nutrition, hereditary, bacterial infections
What is FUS? Feline urologic syndrome --- common in male cats, crystals in a matrix plug causing a distended thin walled, flaccid bladder that can rupture (ucleration pssible)
With cystitis, the bladder appears: edematous with erosions, ulcers, exudate, hyperemia, and hemorrhage
For what disease is emphysematous cystitis pathopneumonic? Diabetes
Neoplasias of LUT: Transition cell carcinoma! Rhabdomyosarcoma Fibrosarcoma Papilloma
Created by: Sara2420



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