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Questions and Answers
Which of the following is the primary effect of reduced nephron numbers on the remaining nephrons in chronic renal failure?
Which of the following is the primary effect of reduced nephron numbers on the remaining nephrons in chronic renal failure?
- Reduced mesangial cell activity.
- Decreased endothelial cell proliferation.
- Decreased glomerular pressure.
- Increased glomerular pressure. (correct)
What is a common cardiovascular finding associated with chronic renal failure (CRF) that can be a cause of death?
What is a common cardiovascular finding associated with chronic renal failure (CRF) that can be a cause of death?
- Concentric left ventricular hypertrophy (LVH) (correct)
- Right ventricular hypertrophy
- Mitral valve prolapse
- Aortic valve stenosis
Which of the following best describes the pathogenesis of proteinuria in the context of glomerular abnormalities?
Which of the following best describes the pathogenesis of proteinuria in the context of glomerular abnormalities?
- Reduced protein reabsorption in the proximal tubule.
- Enhanced protein secretion by podocytes.
- Increased protein filtration due to glomerular damage. (correct)
- Decreased protein production by tubular cells.
In the context of kidney pathology in Systemic Lupus Erythematosus (SLE), what is the significance of the WHO classification?
In the context of kidney pathology in Systemic Lupus Erythematosus (SLE), what is the significance of the WHO classification?
Which of the following is a key characteristic of kidney damage in diabetes mellitus (DM)?
Which of the following is a key characteristic of kidney damage in diabetes mellitus (DM)?
A patient with chronic renal failure (CRF) develops fibrinous pericarditis. Which of the following best describes this condition?
A patient with chronic renal failure (CRF) develops fibrinous pericarditis. Which of the following best describes this condition?
What is the typical timeframe by which diabetes mellitus (DM) antedates renal damage?
What is the typical timeframe by which diabetes mellitus (DM) antedates renal damage?
Which of the following pathological findings is associated with the most severe form of SLE kidney disease according to the WHO classification?
Which of the following pathological findings is associated with the most severe form of SLE kidney disease according to the WHO classification?
Which pathological change would suggest diabetic nephropathy?
Which pathological change would suggest diabetic nephropathy?
Upon electron microscopy (EM) of a kidney biopsy from a patient with Systemic Lupus Erythematosus (SLE), what pattern of immunoglobulin deposition is typically observed?
Upon electron microscopy (EM) of a kidney biopsy from a patient with Systemic Lupus Erythematosus (SLE), what pattern of immunoglobulin deposition is typically observed?
What vascular abnormality must be considered in pregnant patient with SLE?
What vascular abnormality must be considered in pregnant patient with SLE?
Which of the following represents the most common clinical manifestation of kidney disease in diabetes mellitus?
Which of the following represents the most common clinical manifestation of kidney disease in diabetes mellitus?
What describes the term 'uraemia' in the context of chronic renal failure?
What describes the term 'uraemia' in the context of chronic renal failure?
In the context of kidney disease, what is the clinical significance of proteinuria?
In the context of kidney disease, what is the clinical significance of proteinuria?
A patient with SLE presents with kidney involvement. A biopsy shows normal glomeruli under light microscopy but immunofluorescence is positive. According to the WHO classification, which type of SLE kidney disease does this represent?
A patient with SLE presents with kidney involvement. A biopsy shows normal glomeruli under light microscopy but immunofluorescence is positive. According to the WHO classification, which type of SLE kidney disease does this represent?
In electron microscopy of diabetic nephropathy, what characteristic finding is often observed in the glomerular basement membrane (GBM)?
In electron microscopy of diabetic nephropathy, what characteristic finding is often observed in the glomerular basement membrane (GBM)?
A patient with diabetes mellitus has developed kidney damage possibly due to hypertension and drug use. What additional factor could contribute to kidney damage?
A patient with diabetes mellitus has developed kidney damage possibly due to hypertension and drug use. What additional factor could contribute to kidney damage?
Which type of lesions are characterized as <50% gloms in SLE and the kidney?
Which type of lesions are characterized as <50% gloms in SLE and the kidney?
Which part of the nephron are directly affected by increased glomerular pressure?
Which part of the nephron are directly affected by increased glomerular pressure?
In SLE renal pathology, why is EM important?
In SLE renal pathology, why is EM important?
What finding characterizes Type 5 classification of SLE?
What finding characterizes Type 5 classification of SLE?
What part of the kidney does severe arteriolar sclerosis affect?
What part of the kidney does severe arteriolar sclerosis affect?
Other than prolonged drug therapies, what causes kidney damage?
Other than prolonged drug therapies, what causes kidney damage?
Which of the following statements encapsulates the definition of proteinuria?
Which of the following statements encapsulates the definition of proteinuria?
What is the primary mechanism by which increased glomerular pressure in remaining nephrons contributes to progressive glomerulosclerosis?
What is the primary mechanism by which increased glomerular pressure in remaining nephrons contributes to progressive glomerulosclerosis?
Which of the following best describes the relationship between uraemia and systemic effects in chronic renal failure?
Which of the following best describes the relationship between uraemia and systemic effects in chronic renal failure?
In the context of kidney disease associated with Systemic Lupus Erythematosus (SLE), what is the key distinction between Type 3 and Type 4 lesions according to the WHO classification?
In the context of kidney disease associated with Systemic Lupus Erythematosus (SLE), what is the key distinction between Type 3 and Type 4 lesions according to the WHO classification?
Among the various classes of SLE kidney disease according to the WHO classification, which class is most likely to present with nephrotic syndrome?
Among the various classes of SLE kidney disease according to the WHO classification, which class is most likely to present with nephrotic syndrome?
In the context of SLE-related kidney pathology, what is the primary significance of detecting thrombotic microangiopathy (TMA)?
In the context of SLE-related kidney pathology, what is the primary significance of detecting thrombotic microangiopathy (TMA)?
What is the significance of the 'fallacy of pre-diabetic Type 2 renal damage' in the context of diabetic nephropathy?
What is the significance of the 'fallacy of pre-diabetic Type 2 renal damage' in the context of diabetic nephropathy?
What is the primary mechanism by which glycosylation of lipoproteins contributes to kidney damage in diabetes mellitus?
What is the primary mechanism by which glycosylation of lipoproteins contributes to kidney damage in diabetes mellitus?
In a patient with diabetic nephropathy, what is the significance of observing Kimmelstiel-Wilson lesions on renal biopsy?
In a patient with diabetic nephropathy, what is the significance of observing Kimmelstiel-Wilson lesions on renal biopsy?
Which structural component of the glomerulus is primarily affected by severe arteriolar sclerosis in the context of chronic kidney disease?
Which structural component of the glomerulus is primarily affected by severe arteriolar sclerosis in the context of chronic kidney disease?
What distinguishes nephrotic syndrome from nephritic syndrome in terms of pathophysiology?
What distinguishes nephrotic syndrome from nephritic syndrome in terms of pathophysiology?
Which aspect of patient history is most critical when evaluating kidney disease in the context of Systemic Lupus Erythematosus (SLE)?
Which aspect of patient history is most critical when evaluating kidney disease in the context of Systemic Lupus Erythematosus (SLE)?
What is the best approach to describe the cause of death for somebody suffering from chronic renal failure (CRF) with concentric left ventricular hypertrophy (LVH)?
What is the best approach to describe the cause of death for somebody suffering from chronic renal failure (CRF) with concentric left ventricular hypertrophy (LVH)?
What should be considered when a pregnant Systemic Lupus Erythematosus presents with kidney issues?
What should be considered when a pregnant Systemic Lupus Erythematosus presents with kidney issues?
What best describes the classification based on severity of kidney damage of kidney disease in Systemic Lupus Erythematosus?
What best describes the classification based on severity of kidney damage of kidney disease in Systemic Lupus Erythematosus?
If a patient has segmental glomerular lesions and <50% gloms. Which of the following WHO categories would the patient belong to?
If a patient has segmental glomerular lesions and <50% gloms. Which of the following WHO categories would the patient belong to?
If somebody is suffering from chronic renal failure, what kind of heart issue could they have?
If somebody is suffering from chronic renal failure, what kind of heart issue could they have?
What is a common cause of death for chronic renal failure?
What is a common cause of death for chronic renal failure?
In diabetic patients, after what time after being diagnosed with diabetes does renal damage occur?
In diabetic patients, after what time after being diagnosed with diabetes does renal damage occur?
What causes kidney damage?
What causes kidney damage?
If a patient with diabetes mellitus has kidney damage, which other condition can cause kidney damage?
If a patient with diabetes mellitus has kidney damage, which other condition can cause kidney damage?
Which of the following is the most insidious finding in kidney disease?
Which of the following is the most insidious finding in kidney disease?
Apart from the glomerulus itself, which other part of the kidney is particularly susceptible to damage from increased glomerular pressure due to reduced nephron numbers?
Apart from the glomerulus itself, which other part of the kidney is particularly susceptible to damage from increased glomerular pressure due to reduced nephron numbers?
Which statement describes Proteinuria?
Which statement describes Proteinuria?
In cases of SLE, what does a positive result on FM indicate?
In cases of SLE, what does a positive result on FM indicate?
In the context of kidney disease, what does severe arteriolar sclerosis often affect?
In the context of kidney disease, what does severe arteriolar sclerosis often affect?
Flashcards
Haematuria
Haematuria
Presence of blood in the urine.
Glomerulonephritis
Glomerulonephritis
Inflammation of the glomeruli.
Nephrotic Syndrome
Nephrotic Syndrome
A kidney disorder characterized by proteinuria, hypoalbuminemia, edema, and hyperlipidemia.
Nephritic Syndrome
Nephritic Syndrome
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Post-infectious Glomerulonephritis
Post-infectious Glomerulonephritis
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Glomerulosclerosis
Glomerulosclerosis
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Kidney involvement in SLE
Kidney involvement in SLE
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Uraemia
Uraemia
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LVH
LVH
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Fibrinous pericarditis
Fibrinous pericarditis
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SLE Type 3 and 4
SLE Type 3 and 4
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Butterfly rash
Butterfly rash
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Proteinuria
Proteinuria
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Immunoglobulin deposits in SLE
Immunoglobulin deposits in SLE
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Diabetic nephropathy
Diabetic nephropathy
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Nodular mesangial expansion
Nodular mesangial expansion
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Kimmelstiel-Wilson lesion
Kimmelstiel-Wilson lesion
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Arteriolar sclerosis
Arteriolar sclerosis
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Effects of Reduced Nephrons
Effects of Reduced Nephrons
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SLE and Kidney Disease
SLE and Kidney Disease
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Kidney in SLE
Kidney in SLE
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SLE Thrombotic Vascular Lesions
SLE Thrombotic Vascular Lesions
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SLE Kidney - Type 1
SLE Kidney - Type 1
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SLE Kidney - Type 2
SLE Kidney - Type 2
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SLE Kidney - Type 3
SLE Kidney - Type 3
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SLE Kidney - Type 4
SLE Kidney - Type 4
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SLE Kidney - Type 5
SLE Kidney - Type 5
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Diabetes Mellitus
Diabetes Mellitus
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Glycosylation
Glycosylation
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Study Notes
- Pathology and immunological aspects of medical kidney disease are covered in Renal Pathology 5.
Renal Pathology 5 Objectives
- Explain the pathophysiology of haematuria and list its causes.
- Explain the pathophysiology of glomerulonephritis.
- Define nephrotic syndrome, including its causes and pathophysiology.
- Define nephritic syndrome, including its causes and pathophysiology.
- Explain the pathogenesis of post-infectious glomerulonephritis.
- Describe kidney pathology in Systemic Lupus Erythematosus (SLE).
Clinical Presentation of Chronic Renal Failure
- Reduced nephron numbers lead to overworked the remaining nephrons.
- Increased glomerular pressure impacts the mesangium, endothelial cells, and epithelial cells.
- Progressive glomerulosclerosis results.
Clinical Effects of Chronic Renal Failure
- Uraemia occurs.
- It is caused by chronic diseases described in presentations 1-4.
- Small, scarred kidneys are present.
- All systems are affected by chronic renal failure.
- There is more substantial discussion in Medicine.
Heart Conditions Linked to Renal Failure
- Concentric Left Ventricular Hypertrophy (LVH) is a common cause of death in Chronic Renal Failure (CRF).
- Fibrinous pericarditis ("bread and butter") can occur in CRF.
Kidney in Systemic Lupus Erythematosus (SLE)
- It is an immune complex deposition disease with WHO classification based on severity.
- Thrombotic vascular lesions are important in pregnancy.
- Effects of prolonged drug therapy, such as NSAIDs, are a factor.
SLE and the Kidney: WHO Classification
- Type 1: Normal glomeruli that are positive on FM.
- Type 2: Mesangial proliferation.
- Type 3: Segmental lesions affecting less than 50% of glomeruli.
- Type 4: Segmental lesions affecting more than 50% of glomeruli.
- Type 5: Membranous type pattern, similar to Membranous Glomerulonephritis (GN).
- Type 5 can occur with type 3 or type 4.
- A butterfly rash is associated with SLE.
- All immunoglobulins are positive on EM in SLE, with EM deposits in all components of the glomerulus
- Segmental glomerular acute inflammation occurs in SLE.
- Large subendothelial deposits form in SLE.
The Kidney in Diabetes Mellitus (DM)
- This applies to both Types 1 and 2.
- Renal damage is typically antedated by DM for 10-15 years.
- There is a fallacy of pre-diabetic Type 2 renal damage.
- Damage may be due to hypertension and drugs.
- Proteinuria is present in the nephrotic range.
- Glycosylation occurs of lipoproteins in mesangium and basement membranes with secondary effects on epithelial cells.
- Nodular mesangial expansion, severe nodular mesangial expansion, and Kimmelstiel Wilson lesions form
- Markedly thickened Basement Membrane (BM) is seen on EM.
- Severe arteriolar sclerosis occurs.
Proteinuria
- Protein is present in the urine.
- It is an insidious finding indicating glomerular abnormality.
- The amount signifies the extent/volume of glomerular involvement.
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