Pyelonephritis and Nephritis

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson
Download our mobile app to listen on the go
Get App

Questions and Answers

What is the main cause of pyelonephritis?

  • Fungal infection
  • Parasitic infection
  • Viral infection
  • Bacterial infection (correct)

What is a predisposing factor for pyelonephritis in females?

  • Short and wide urethra (correct)
  • Long and narrow urethra
  • Urinary tract obstruction
  • Diabetes mellitus

What is the term for inflammation of the renal pelvis?

  • Pyelonephritis
  • Pyelitis (correct)
  • Urinary tract infection
  • Nephritis

What is the route of infection in pyelonephritis through the urethra during endoscopy or catheterization?

<p>Ascending infection (C)</p> Signup and view all the answers

What is the term for inflammation of the interstitial tissue of the kidney?

<p>Nephritis (C)</p> Signup and view all the answers

What is a complication of pyelonephritis in pregnant women?

<p>Urinary stasis (D)</p> Signup and view all the answers

What is the typical clinical course of E/M in terms of response to corticosteroids?

<p>Dramatic response to corticosteroids with recurrence (D)</p> Signup and view all the answers

What is the most common cause of nephrotic syndrome in adults?

<p>Membranous GN (C)</p> Signup and view all the answers

What is the primary mechanism of idiopathic membranous GN?

<p>Immune deposits against renal auto-antigen on the basal surface of visceral epithelial cells (A)</p> Signup and view all the answers

What is a characteristic feature of membranous GN on electron microscopy?

<p>Subepithelial deposits with spikes (C)</p> Signup and view all the answers

What is the typical proteinuria pattern in membranous GN?

<p>Non-selective proteinuria (C)</p> Signup and view all the answers

What is the frequency of hypertension in membranous GN?

<p>30% (C)</p> Signup and view all the answers

What is the primary cause of minimal change glomerulonephritis (GN) in adults?

<p>Idiopathic (C)</p> Signup and view all the answers

What is the characteristic appearance of membrano-proliferative GN on PAS stain?

<p>Tram track appearance (D)</p> Signup and view all the answers

What is the type of proteinuria seen in minimal change GN?

<p>Selective proteinuria (B)</p> Signup and view all the answers

What is the prognosis of minimal change GN in response to cortisone?

<p>Dramatic response to cortisone (A)</p> Signup and view all the answers

What is the characteristic deposit seen in membrano-proliferative GN by EM?

<p>Sub-endothelial deposits (B)</p> Signup and view all the answers

What is the type of nephrotic syndrome seen in focal segmental GN?

<p>Non-selective nephrotic syndrome (D)</p> Signup and view all the answers

What is the characteristic feature of membrano-proliferative GN on light microscopy?

<p>Bilateral enlarged kidneys (A)</p> Signup and view all the answers

What is the fate of 2/3 of patients with membrano-proliferative GN?

<p>Nephrotic syndrome (A)</p> Signup and view all the answers

What is the primary difference in terms of age between MCG and MGN?

<p>MCG is typically seen in adults, while MGN affects children (C)</p> Signup and view all the answers

What is the difference in proteinuria between MCG and MGN?

<p>MCG has selective proteinuria, while MGN has non-selective proteinuria (A)</p> Signup and view all the answers

How do MCG and MGN respond to cortisone?

<p>MCG responds dramatically to cortisone, while MGN is resistant (D)</p> Signup and view all the answers

What is a characteristic of the electron microscopy picture in Type I MGN?

<p>Subendothelial electron dense deposits are present (D)</p> Signup and view all the answers

What is the pathogenesis of Type II MGN?

<p>Activation of the alternative complement pathway (C)</p> Signup and view all the answers

What is the typical prognosis of Type II MGN?

<p>The disease recurs in transplantation (B)</p> Signup and view all the answers

What is the typical gross picture of MGN?

<p>Bilateral enlarged kidneys (C)</p> Signup and view all the answers

What is the characteristic microscopic picture in MGN?

<p>Glomeruli with hypercellularity and lobular accentuation (D)</p> Signup and view all the answers

What is the characteristic feature of Acute Tubular Necrosis (ATN)?

<p>Acute decline in renal function (C)</p> Signup and view all the answers

What is the more common type of Acute Tubular Necrosis (ATN)?

<p>Ischemic ATN (C)</p> Signup and view all the answers

What is the effect of tubular damage on the rennin/angiotensin system in ATN?

<p>Stimulates the rennin/angiotensin system (B)</p> Signup and view all the answers

What is the effect of cast formation in ATN?

<p>Increases intra-tubular pressure (B)</p> Signup and view all the answers

What is the characteristic feature of the gross picture of Ischemic ATN?

<p>Enlarged kidney, with pale cortex and congested medulla (C)</p> Signup and view all the answers

What is the prognosis of Ischemic ATN?

<p>Worse (D)</p> Signup and view all the answers

What is the characteristic feature of the micro picture of tubules in Ischemic ATN?

<p>Distal convoluted tubules are affected (B)</p> Signup and view all the answers

What is the effect of back leak of tubular fluids in ATN?

<p>Increases interstitial edema (D)</p> Signup and view all the answers

Flashcards are hidden until you start studying

Study Notes

Inflammation of the Kidney

  • Pyogenic abscess: a type of infection of the kidney
  • Specific inflammation:
    • T.B. (Tuberculosis)
    • Bilharziasis
    • Hydatid disease
    • Pyelonephritis

Pyelonephritis

  • Definition: inflammation of the interstitial tissue of the renal pelvis and kidney followed by affection of tubules and glomeruli
  • Causes:
    • Mainly bacterial infection (E.coli, Klebsiela, Proteus, Enterobacter, and Pseudomonas)
    • Predisposing factors:
      • Urinary tract obstruction (strictures, stone, tumors, enlarged prostate)
      • Diabetes mellitus
      • Females are commonly affected due to short and wide urethra and pregnancy-related urinary stasis
  • Routes of infection:
    • Hematogenous: the organism reaches the kidney from a distant focus (septicemia, pyemia)
    • Ascending infection: through urethra, bladder mucosal damage or urine retention, or bladder infection and atony with incompetent vesico-ureteral valve
    • Direct: from adjacent infected organ

Nephritis

  • Nephritis: inflammation of the interstitial tissue of the kidney
  • Pyelitis: inflammation of the renal pelvis
  • Types of Nephritis:
    • Minimal change GN
    • Membranous GN
    • Focal segmental GN
    • Membrano-proliferative GN

Minimal Change GN

  • Type: nephrotic syndrome in children
  • Causes:
    • URT infection
    • Auto-immune diseases
    • Atopy
  • Grossly: normal kidneys
  • LM: normal only lipid deposition in proximal convoluted tubules
  • EM: only effacement to foot process
  • I/F: no deposits
  • Fate: selective proteinuria, dramatic response to cortisone

Membranous GN

  • Type: nephrotic syndrome in adults
  • Causes:
    • Primary: idiopathic
    • Secondary: autoimmune disease
  • Grossly: bilateral enlarged kidneys
  • LM: thick basement membrane
  • EM: sub-epithelial deposits, effacement to foot process
  • I/F: sub-epithelial deposits
  • Fate: non-selective proteinuria, resistance to cortisone, hematuria in 15%

Focal Segmental GN

  • Type: nephrotic syndrome in children
  • Causes:
    • Auto-immune disease
    • Heroin
  • Grossly: bilateral enlarged kidneys
  • LM: some glomeruli normal others are fibrosed
  • EM: denuded basement membrane, effacement to foot process
  • I/F: sub-epithelial deposits
  • Fate: non-selective proteinuria, resistance to cortisone

Membrano-proliferative GN

  • Type: mixed nephritic and nephrotic
  • Causes:
    • URT infection
    • Auto-immune diseases
    • Idiopathic
  • Grossly: enlarged kidneys
  • LM: "tram track appearance" by PAS stain
  • EM: type I: sub endothelial deposits, type II: intramembranous deposits (DDD)
  • I/F: according to its type deposits
  • Fate: 2/3 with nephrotic syndrome, 15% with hematuria, 1/3 mixed nephritic with nephrotic

Mechanism of Nephrotic Syndrome

  • Massive and selective proteinuria
  • Dramatic response to corticosteroids
  • Recurrence is common with steroid dependence
  • Improve at puberty
  • May be associated with Hodgkin's disease and NSAID therapy

Mechanism of Nephritic Syndrome

  • Type I: idiopathic, diffuse thickening of GBM by immune deposits
  • Type II: secondary, by circulating Ag-Ab complexes
  • Antibodies develop against renal auto-antigen on the basal surface of visceral epithelial cells

Acute Tubular Necrosis (ATN)

  • Definition: a clinicopathological disease characterized by damage of tubular epithelial cells and acute decline in renal function
  • Types: ischemic or toxic
  • Reversible, but may pass to acute renal failure
  • Causes of oliguria in ATN:
    • Tubular damage
    • Glomerular damage by toxins

Ischemic ATN

  • More common
  • Causes: arterial occlusion, shock, poisons, severe dehydration, sepsis, transfusion reactions
  • Gross picture: enlarged kidney, with pale cortex, congested medulla
  • Microscopic picture: distal convoluted tubules, focal, disrupted
  • Prognosis: worse

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

More Like This

Use Quizgecko on...
Open
Browser
Browser