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20 Cards in this Set
- Front
- Back
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What age-related changes occur in the glomerular basement membrane and mesangial cells?
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Glomerular BM becomes thickened
Increase # of mesangial cells |
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What age-related changes occur in the glomerular number and JGA?
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Decreased # glomeruli
JGA decreases in mass-->dec'd renin release |
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Renal Artery Stenosis is a [common/uncommon] cause of hypertension.
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Uncommon
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In fibromuscular dysplasia there is thickening of ______ and this layer of the vessel is most involved.
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Beaded thickening of Renal Artery; thickening by fibrous/muscular tissue
Media is most often involved |
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Renal Artery Embolism:
Source of Embolus |
Heart, Aorta, Renal Arteries
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Atheroembolism is likely to occlude which branches of the renal artery?
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Arcuate, interlobar (or glomeruli)
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Manipulation of the aorta at surgery, catheterization, or ballooning is likely to result in ______.
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Atheroembolism
Can occur from aorta, renal artery, or aortic valve |
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What defines a thrombotic microangiopathy?
Where do the thrombi originate? What lab results would you expect? |
Thrombotic Microangiopathy = endothelial injury and intravascular coagulation
Thrombi form in interlobar arteries, afferent arterioles, and glomerular capillaries Hemolytic anemia, thrombocytopenia, acute renal failure |
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Typical Hemolytic-Uremic Syndrome is a type of __________.
Describe its pathogenesis. |
THUS = Thrombotic Microangiopathy
Toxin from infection by E coli or Shigella (common in children) carried by nphils and causes glomerular capillaries to increase adhesion of leukocytes, inc production of endothelin, decrease NO Can also enter cells and cause cell death |
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Atypical Hemolytic-Uremic Syndrome is a type of __________.
Describe its pathogenesis. |
Atypical HUS = thrombotic microangiopathy
most common in ADULTS, no diarrhea, not related to Shiga toxin Due to mutation in complement genes (Factor H most commonly) |
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This thrombotic microangiopathy can result in post partum renal failure.
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Atypical HUS
Occurs after placental abruption in uncomplicated pregnancy |
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Other than genetic mutations, what are other causes of ATYPICAL HUS?
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Systemic sclerosis, malignant HTN
Chemotx or immunosuppression (mitomycin, cyclosporine) Radiation |
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Thrombotic Thrombocytopenic Purpura:
How does it differ from HUS? |
Rare, most common in young women
SEVERE neurological manifestations and less severe renal dz than HUS Due to acquired defect in cleavage of von Willebrand Factor protease (ADAMTS13) (HUS is due to endothelial damage and intravascular clotting) Defect in ADAMTS13 results in platelet adhesion and aggregation |
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Impaired blood flow in the vasa rectae results in ________.
Causes of impaired blood flow? |
Papillary necrosis
Causes: Acute pyelonephritis UTO DM Sickle Cell |
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Compression, phlebitis, renal tumors, and hypercoagulation syndromes can result in __________.
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Renal vein thrombosis
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How does RAS result in hypertension?
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Decreased renal blood flow
Inc'd renin-->AgII-->Aldo -->Vasoconstriction, Na retention, inc'd blood volume -->HTN |
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Describe the smooth muscle and sodium homeostasis hypotheses of hypertension.
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Sodium homeostat reset (reduced renal excretion of Na--->inc'd BV)
or Inc'd vasc resistance via vasoconstriction of hypertrophy of SM-->narrowing of lumens |
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What is hyaline artheriolosclerosis?
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Glassy thickening due to plasma components leaking across injured endothelium
Also due to inc'd ECM production by SM Consists of plasma prots, fibrin, collagen, BM material Common finding in HTN pts |
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Histologic finding of benign nephrosclerosis?
Malignant nephrosclerosis? |
Benign nephrosclerosis: Hyaline Arteriolosclerosis
Malignant: hyperplastic arteriolosclerosis |
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Histologic finding of severe malignant hypertension.
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Fibrinoid necrosis
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