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Urinary System Path
Pathology Lecture 11-12
| Question | Answer |
|---|---|
| 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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