renal pathology
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| clinical manifestations of nephrotic syndrom | massive proteinuria, hypoalbuminemia, edema, hyperlipidemia
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| minimal change disease | normal appearing glomeruli in light miscroscopy, but with the disappearance or fusing of epithelial foot process
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| minimal change disease | lipid laden renal cortices, most often seen in young children and responds well to corticosteriods
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| focal segmental glomerulosclerosis | similar to minimal change but occurs in older patients, characterized by sclerosis within capillary tufts of deep juxtamedullary glomeruli with focal or segmental distribution
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| nephrotic syndrom | a group of conditions characterized by increased basement membrane permeability
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| membranous glomerulonephritis | should be suspected in teens and young adults when nephrotic syndrom is accompanied by azotemia
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| membranous glomerulonephritis | characterized by greatly thickened capillary walls, immune complexes in intramembranous and epimembranous location and granular immunoflourescence, sometimes causing renal vein thrombosis
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| diabetic nephropathy | increase thickness of basement membrane and mesangial matrix wither diffuse or nodular glomerulosclerosis
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| nephritic syndrom | characterized by inflammatory rupture of glomerular capillaries
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| clinical manifestations of nephritic syndrome | oliguria, azotemia, HTN, and hematuria
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| post strep glomerulonephritis | group A beta hemolytic strep, complete recovery, characterized by innumerable punctate hemorrhages on the surface, enlarged hpercellular, bloodless glomeruli and lumpy bumpy immunoflourescence of IgG or C3
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| rapidly progressive glomerulonephritis | nephritic syndrome, progressing rapidly to renal failure, crescentic
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| good pasture syndrome | caused by anti-GBM antibodies, demonstrates linear immunoflourescence and is manifested by nephritic syndrom, pneumonitis with hemoptysis, affects men in their 20's
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| alport syndrome | hereditary nephritis associated with nerve deafness and ocular disoreders caused by a muation in the alpha5 chain of type IV colagen
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| IgA nephropathy | characterized by benign recurrent hamaturia in children usually following an infection
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| membranoproliferative glomerulonephritis | slow progression to chronic renal disease, basement membrane thickening and cellular proliferation, tram track appearance
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| PKD | manifests between the ages of 15 and 30, autosomal dominant
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| PKD | parital replacement of renal parenchyma by cysts, often associated with berry aneurisms of the circle of Willis, can cause polycythemia
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| infantile PKD | multiple cysts evident at birth, autosomal recessive, reults in death shortly after birth
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| renal papillary necrosis | ischemic necrosis of the tips of the renal papillae
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| renal papillary necrosis | often associated with diabetes mellitus or phenacetin, ocassionally a consequence of acute pyelonephritis
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| ATN | most common cause of acute renal failure
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| ATN | is reversible; patient may need dialysis as repair of tubules takes 2 weeks
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| ATN | can lead to cardiac arrest due to hyperkalemia, usually during th oliguric phase
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| ATN | most frequently precipitated by renal ischemia, also assocaited with crush injury with myoglobinuria, or direct injury from toxins
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| Fanconi Syndrome | manifestation of generilzed dysfunction of proximal tubule, may be hereditary, ccharacterized by impaired reabsorption of glucose, amino acids, phosphate, and bicarb
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| cystinuria | genetically determined impairment of tubular reabsorption of cystine, mainifests clinically as cystine stones
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| hartnup disease | genetically determined impairment of tubular reabsorption of tryptophan, leads to pellagra-like manifestations
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| chronic pyelonephritis | coarse asymmetric corticomedullary scarring and deformit of renal pelvis and calyces; stars as interstitial inflammatory infiltrate followed by fibrosis and tubular atrophy
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| chronic pyelonephtritis | results of chronic urinary tract obstruction, leads to renal hypertension and end-stage renal disease
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| uremia | azotemia, acidosis, hyperkalemia, abnormal control of fluid volume, hypocalcemia, anemia, HTN
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| prerenal azotemia | results from decreased blood flow and characterized by increased tubular reabsorption of sodium and water resulting in oliguria, concentrated urin, decreased urinary sodium excretion BUN/Creatinine ratio greater than 15
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| adenoma | bengn tumor, small and asymptomatic derived from renal tubules, may be a precursor to carcinoma
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| angiomyolipma | benign renal tumor that consists of fat, smooth muscle, and blood vessles
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| renal cell carcinoma | most common renal malignancy, originates in tubules most commonly in upper poles, frequently invades renal veins and vena cava
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| renal cell carcinoma | polygonal clear cells, can present with triad of flank pain, palpable mass, and hematuria, may have fever, secondary polycythemia, ectopic production of hormones
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| wilms tumor | most common renal malignancy of early childhood, highest incidence from 2-4 years, most often presents with palpable mass
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| transitional cell carcinoma | has been associated with phenacetin abuse, presents with hematuria, tends to spread by local extension to surrounding tissues (can be caused/ associated with benxidine or beta naphthylamine, cigarette smoking, and long term treatment with cyclophophamide)
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| squamous cell carcinoma | can result from chronic inflammatory process, can be associated with renal calculi
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