Pathology - Renal

Front 1

Focal Segmental Glomerular Sclerosis

Back 1

1. Proteinuria (non-specific)
2. Steroids don't help
3. Hyaline deposite in glomerulus
4. Not all glomeruli affected
5. ANA, ANCA negative
NPHS1 Gene for Nephrin and NPHS2 for Podocin

Front 2

Hypertensive Nephrosclerosis

Back 2

Associated with Malignant HTN Nephrosclerosis and Diabetes Nephrosclerosis
1. Dilated afferent arteriole by prostaglandins
2. Constricted efferent arteriole by Angiotensin II
3. NSAIDs will stop PGs, ACE Inhib stops Angio II
4. Kimmelstiel Nodules
5. Inc Creatinine, don't mention BUN

Front 3

Rapid Progressive Glomerulonephritis

Back 3

1. Crescents are epithelial cells (not muscle)
2. Wegener's is involved with URT ulcers
3. ANCA positive
4. ANA negative (Lupus is ANA positive)

Front 4

ADPKD vs ARPKD

Back 4

PKHD1 is Fibrocystin
PKD1/2 is polycystin-1/2

Front 5

Membranous Glomerularnephritis

Back 5

Most common nephrotic syndrome in adults
1. Diffusely thickened capillary loops on H&E by hyaline
2. Silver stain shows black "spikes" that look kind of like tram-tracks. "Domes" are larger. ENDOTHELIAL.
3. NO cellular proliferation
4. Captopril & Penicillamine (drugs) are implicated.
5. Assoc w/colon/lung cancer, melanoma. Lupus nephritis, chronic infection w/Hep B or C, malaria, schistosomiasis and syphilis. All may be underlying.
6. Look for IgG/C3, non specific proteinuria

Front 6

Chronic Pyelonephritis/Chronic Interstitial Nephritis

Back 6

1. Loss of parenchyma at poles
2. Histology: "round cells" - lymphocytes & plasma cells
2. Vesicoureteral reflux (congenital, presents late)
3. E. coli most common bacteria

Front 7

Struvite Stones

Back 7

1. Made of magnesium ammonium phosphate
2. Caused by bacterial infection because you see WBCs in urine
3. Infection may come from BPH w/urinary retention/ stasis

Front 8

Show cyst in liver. How does this have to do with the kidney and what paraneoplastic syndrome is associated.

Back 8

1. This is Renal Cell Carcinoma secondary to Adult PCKD
2. APCKD has cysts in other organs, such as the liver
3. Cysts in the liver produce EPO and polycythemia for high Hb/RBC blood chemistry

Front 9

Analgesic Nephropathy

Back 9

1. Look for brown/yellow papillae that they pass in urine.
2. Chr Renal Disease leads to reduced EPO. She could also have aspirin-induced ulcers in her GIT, which is why her anemia is so bad.

Front 10

Simple Cysts

Back 10

Remember, on CT you are looking from the feet up. Kidneys are slightly in front of the spine and in the retroperitoneal cavity.
1. Fluid filled cysts look like large, grey balloons with smooth contours.
2. They may cause pain if blood hemorrhages into them.
3. The kidneys continue to function with as little as half of one kidney remaining.
4. Inherited cysts are small and very extensive. Sporadic occurrences have fewer cysts.

Front 11

Hydronephrosis

Back 11

Look for enlarged renal calyces filled with fluid. On CT it looks like a "cut orange"
If there is a bright triangle peice, that is a staghorn clculus which is associated with bacterial pyelonephritis.