Renal Pathology 2

Front 1

Function of the glomerulus

Back 1

Act as a filter for the ultrafiltration of plasma

Front 2

What is protein losing nephropathy

Back 2

Damage to the filter which results in the leakage of protein into the urine

Front 3

What are the characteristics of nephrotic syndrome

Back 3

Proteinuria

Hypoalbuminaemia

Hypercholesterolaemia

Oedema

Front 4

What causes hypercholesterolaemia

Back 4

Increased hepatic production and defective metabolism of VLDL

Pathogenesis is not well understood

Front 5

What is p:c ratio used for

Back 5

Quantify urinary protein loss in cats and dogs

Does not indicate the cause of proteinuria

Front 6

Causes of proteinuria

Back 6

Pre-glomerular or glomerular or post glomerular

Front 7

Example of preglomerular proteinuria

Back 7

Bence jones proteins in multiple myeloma

Front 8

Example of post glomerular proteinuria

Back 8

Pyelonephritis

Front 9

Example of familial renal disease

Back 9

Samoyed hereditary glomerulopathy - characterised by splitting of the BM components

Front 10

What is immune complex glomerulonephritis

Back 10

Deposition of circulating antibody - antigen complexes

Followed by compliment fixation and neutrophil chemotaxis

Front 11

Causes of immune complex glomerulonephritis

Back 11

Bacterial infection

Autoimmune disease

Neoplasia

Front 12

What is the basis of autoimmune glomerulonephritis

Back 12

Antibodies produced against the glomerular basement membrane

Front 13

What happens when compliment is activated at the GBM

Back 13

Endothelial hypertrophy

Podocyte fusion

GBM thickening

Inflammatory infiltration

Front 14

What is the gross pathology seen with acute GN

Back 14

Kidney is swollen and tense

Individual glomeruli may be prominent at pinpoint red dots on the surface of the cortex

Front 15

What is the pathology see n with gross chronic GN

Back 15

Interstitial nephritis resemblant

Shrinking and pitting of the capsule, cortical thinning and fibrosis

Front 16

Histopathology seen with gross chronic GN

Back 16

Cellularity increase in glomerular tufts

Thickening of the capillary basement membrane

Adhesions between the bowmans capsule and tuft

Thrombi in capillaries

Front 17

What is glomerulosclerosis

Back 17

Hypocellular and nonfunctional glomerul which result from severe and prolonged glomerular damage

Fibrosis of the glomeruli which may progress such that the glomeruli shrink and become hyalinised

Bowmanns capsule can rupture

Front 18

How can we diagnose amyloidosis

Back 18

Immunoflourescent staining - conjugate amyloid with antibodies

Front 19

Macroscopic appearence of amyloidosis

Back 19

Swollen and pale kidneys

Large with a smooth to granular capsular surface

Front 20

What are the 2 types of amyloidosis

Back 20

AL - amyloid light chain overproduction

AA - chronic inflammation -acute phase proteins

Front 21

What would you see histologically with amyloidosis

Back 21

HandE - homogeneous eosinophillic distending glomerulus

Congo red confirms

Front 22

Suppurative glomerulitis is also known as what

Back 22

Embolic nephritis

Front 23

What causes suppurative glomerulonephritis

Back 23

Localisation of bacteria within the glomeruli fomr bacteraemia

Front 24

What is viral glomerulonephritis

Back 24

Swelling of the glomeruli after viral attack of the endothelium

Front 25

What causes ATN

Back 25

Toxic insult to the renal tubular epithelial cells

Front 26

Why is the PCT most susceptible to injury

Back 26

High metabolic rate - susceptible to toxic injury

Front 27

How does the PCT protect itself from toxins

Back 27

P450 enzymes

Front 28

What happens if the tubular BM remains intact

Back 28

Regeneration from tubular stable cells

(as long as scaffold intact)

Front 29

What happens if the BM is destroyed

Back 29

Complete loss of scaffold and loss of function

Fibrosis and scarring

Front 30

What are the subtypes of ATN

Back 30

Ischaemic/Tubulorrhectic

Nephrotoxic

Front 31

What causes nephrotoxic ATN

Back 31

Heavy metals

Oxalates (ethylene glycol precipitation)

Antibacterials

Front 32

What causes ischaemic ATN

Back 32

Hypotension

Haemoglobinurea

Front 33

Tubulorrhexis

Back 33

BM damage and disruption in the tubules

Front 34

Tubulointerstitial disease

Back 34

Affecting the tubules and the interstitium

Front 35

Causes of TID in dogs

Back 35

Leptospirosis - leptospira canicola

Infectious canine hepatitis virus

Front 36

Causes of TID in cattle

Back 36

E.coli septicaemia (can be incidental if not severe) "white spotted kidney"

Malignant catarrhal fever

Front 37

What causes TID in horses

Back 37

Equine viral arteritis

Actinobacillus equuili in foal

Front 38

How does leptospira cause TID in dogd

Back 38

Localisation of bacteria in renal capillaries

Migration through vascular endothelium into the renal interstitium

Migration through the intercellular junctions of the renal tubular epithelial cells

Tubular lumen and associated epithelial migrovilli

Persistance in phagosomes

Degeneration of epithelium and inflammatory reaction

Front 39

What causes granulomatous nephritis

Back 39

Chronic systemic disease sequalae e.g. FIPV

Front 40

What does granulomatous nephritis look like

Back 40

Multiple irregular cortical foci

Bulge from capsular surface

Front 41

T. Canis lesions

Back 41

2-3mm granulomas

Subcapsular renal cortex

Front 42

Diotophyma renale

Back 42

Giant kidney worm

Renal pelvis

Resulting in hydronephrosis

Front 43

Stephanurus dentatus

Back 43

Affects adult pigs in USA

Encyst in perirenal fat or in kidney itself

Front 44

Pyelonephritis

Back 44

Inflammation of pelvis and parenchyma

Front 45

Pyelitis

Back 45

renal pelvis inflammation

Front 46

What causes pyelonephritis

Back 46

Ascending from lower UT or haematogenous *descending*

Front 47

Grossly seen with pyelonephritis

Back 47

Variable amounts of mucopus

Medulla exhibits streaks of inflammatory debris which extend into kidney substance

Bilateral

Chronic deformation and scarring

Can look like calculi (dryer)

Front 48

Histologically seen with pyelonephritis

Back 48

oRganisms in tubules

Inflammatory reaction in interstitial tissue

Degeneration and fibrosis of bowmans capsule in ascending infections

Fibrosis in chronic cases

Front 49

Pyonephrosis

Back 49

Infection and obstruction (calculi in ureter) results in the kidney filling with pus

Front 50

Pulpy kidney

Back 50

c perfringens type D toxin

Rapid autolysis of organs such as kidney (can be hard to differentiate from PM change)

widespread haemorrhage

Front 51

Back 51

Glomerulonephritis gross

Front 52

Back 52

RBC

Inflammatory cells and infiltrate

Glomerulonephritis histo

Front 53

Back 53

Bovine amyloid kidney

Swolen, greasy, granular

look like fatty change

Heavy and granular

Fatty would be smooth

Front 54

Back 54

Iodine dip to identify presence of SAA

Front 55

Back 55

Amyloid is space occupying

Doesnt elicit inflammatory response

Even staining pink material is the amyloid

Notice the protein in the tubulear lumen

Physical presence causing ishcaemia and pressure atrophy

Front 56

Back 56

Acute tubular necrosis caused by crystals - ethylene glycol

Front 57

Pathogenesis of leptospirosis

Back 57

Bacteraemia

Organisms localise in the renal capillaries

Interstitium

MIgrate through the epithelial intercellular junctions

into tubules

persist - necrosis and degeneration of the tubules

Front 58

Back 58

Canine leptospirosis (silver stain)

Front 59

Back 59

Tubulointerstitial neprhitis caused by leptospira

Heavily w

Front 60

Back 60

White spotted kidney sequalae to E. coli infection

Chronic - previous

usually incidental on pm

tubulointerstitial nepritis

Front 61

Back 61

Causes tubulointerstitial disease

Front 62

Back 62

Granulomatous nephritis from FIP

Front 63

Back 63

Suppurative pyelonephritis dog

Front 64

Back 64

chronic pyelonephritis

Front 65

pyelonephrosis

Back 65

pyelonephritis and hydronephrosis

Front 66

Back 66

Pulpy kidney

C Perfringens type D toxin

Rapid autolysis