Urinary Tract Pathology

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Renal agenesis

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Developmental disorder - missing kidney

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Solitary horse shoe kidney

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Developmental disorder - kidneys fuse to form one

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Polycystic kidney disease mode of inheritance

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Autosomal dominant

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Hyperlipidemia in

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Nephrotic syndrome

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Hematuria, inflammation, and increased blood pressure in

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Nephritic syndrome

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3 causes of nephrotic syndrome

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Minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy

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Lipoid nephrosis also known as

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Minimal change disease or nil lesion disease

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Most common cause of nephrotic syndrome in children

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Lipoid nephrosis

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Lipoid nephrosis light microscopy

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No change

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Lipoid nephrosis electron microscopy

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Fusion of foot processes of podocytes

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Lipoid nephrosis responds clinically to

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Steroids

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Membranous nephropathy

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Immune-mediated diffuse thickening of glomerular basement membrane with massive deposition of immune complexes

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Most common cause of nephrotic syndrome in adults

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Membranous nephropathy

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Membranous nephropathy inflammation

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No signs

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Membranous nephropathy cellular changes

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None

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Granular immune deposits present in

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Membranous nephropathy

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Acute post-infectious glomerulonephritis

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Anti-strep antibodies formed, Ag-Ab complexes trapped in glomerular basement membrane, complexes activate complement, attract inflammatory cells to glomerulus

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Acute post-infectious glomerulonephritis causes

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Nephritic syndrome

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Crescentic glomerulonephritis

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Exudate in glomerular space, antibodies to basement membrane collagen, crescents compress capillary loops to decrease blood flow (decreasing filtration and causing anuria)

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Crescentic glomerulonephritis occurs after

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Focal necrosis of capillaries from Goodpasture's Syndrome (ANCA)

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Acute post-infectious vs crescentic glomerulonephritis outcome

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Recovery common in acute, rare in crescentic (dialysis)

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Kidney changes from diabetes mellitus

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Thickened basement membrane, mesangial expansion, basement membrane disease (proteinuria)

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Pyelonephritis

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Bacterial infection

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Pyelonephritis spread

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Blood (hematogenous) or up from urethra and bladder (ascending infection)

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Acute pyelonephritis

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Suppurative infection (pus)

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Chronic pyelonephritis

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Evolves from acute - destruction of renal parenchyma (extensive scarring)

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Renal cell carcinoma

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Nodules or masses, cells similar to normal tubular cells, filled with lipid (yellow)

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Renal cell carcinoma triad

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Flank pain, hematuria, abdominal mass

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Wilms' tumour

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Nephroblastoma - renal mass replacing kidney - malignant

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Nephrolithiasis and calculi refer to

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Renal stones

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Calcium stones

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Most common - associated with abnormal calcium metabolism

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Struvite stones

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Complication of infection

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Uric acid stones

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Gout

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Cystine stones

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From cystinosis (inborn error of amino acid metabolism)

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Staghorn calculi caused by

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Struvite stones

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Kidney stones 2 symptoms

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Hematuria, renal colic

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BPH exacerbated by

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Estrogen - related to hormonal changes

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BPH symptom

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Compression of urethra, so urinary retention