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Questions and Answers
What is the primary mechanism by which reduced nephron numbers contribute to progressive glomerulosclerosis?
What is the primary mechanism by which reduced nephron numbers contribute to progressive glomerulosclerosis?
- Reduced endothelial cell proliferation
- Diminished epithelial cell turnover
- Decreased mesangial cell activity
- Increased glomerular pressure (correct)
Which of the following is the most direct consequence of chronic renal failure affecting the cardiovascular system?
Which of the following is the most direct consequence of chronic renal failure affecting the cardiovascular system?
- Small scarred kidneys
- Fibrinous pericarditis (correct)
- Decreased erythropoietin production
- Reduced calcium absorption
In the context of Systemic Lupus Erythematosus (SLE) and kidney involvement, which of the following is the basis for the WHO classification?
In the context of Systemic Lupus Erythematosus (SLE) and kidney involvement, which of the following is the basis for the WHO classification?
- Severity of the disease (correct)
- Specific autoantibodies present
- Affected kidney size
- Patient's age at the time of diagnosis
Which of the following best describes the typical glomerular finding in Type 1 SLE kidney disease, according to the WHO classification?
Which of the following best describes the typical glomerular finding in Type 1 SLE kidney disease, according to the WHO classification?
Which of the following characteristics is most indicative of Type 4 SLE kidney involvement, based on the WHO classification?
Which of the following characteristics is most indicative of Type 4 SLE kidney involvement, based on the WHO classification?
Why are thrombotic vascular lesions in the kidney of particular concern in pregnant women with Systemic Lupus Erythematosus (SLE)?
Why are thrombotic vascular lesions in the kidney of particular concern in pregnant women with Systemic Lupus Erythematosus (SLE)?
What pathological process is most directly indicated by the presence of proteinuria?
What pathological process is most directly indicated by the presence of proteinuria?
In the context of the kidney's role in maintaining overall health, what is the primary implication of determining the amount of proteinuria?
In the context of the kidney's role in maintaining overall health, what is the primary implication of determining the amount of proteinuria?
In diabetic nephropathy, what is the primary mechanism by which glycosylation contributes to renal damage?
In diabetic nephropathy, what is the primary mechanism by which glycosylation contributes to renal damage?
In the context of diabetic nephropathy, what is the significance of the term 'Kimmelstiel-Wilson lesion'?
In the context of diabetic nephropathy, what is the significance of the term 'Kimmelstiel-Wilson lesion'?
In the context of the kidney's overall function in individuals with diabetes mellitus, what is the primary clinical relevance of detecting proteinuria?
In the context of the kidney's overall function in individuals with diabetes mellitus, what is the primary clinical relevance of detecting proteinuria?
How does chronic disease described in prior lectures typically manifest in the context of chronic renal failure?
How does chronic disease described in prior lectures typically manifest in the context of chronic renal failure?
What is a key distinction in the underlying pathophysiology between nephrotic and nephritic syndromes?
What is a key distinction in the underlying pathophysiology between nephrotic and nephritic syndromes?
Which of the following pathological processes is most directly linked to the development of uraemia in individuals with chronic renal failure?
Which of the following pathological processes is most directly linked to the development of uraemia in individuals with chronic renal failure?
Which factor primarily determines the classification of SLE-related kidney disease according to the WHO?
Which factor primarily determines the classification of SLE-related kidney disease according to the WHO?
Which of the following is the primary effect of reduced nephron numbers on individual glomeruli?
Which of the following is the primary effect of reduced nephron numbers on individual glomeruli?
What is the most common cause of death?
What is the most common cause of death?
How does the presence of immune complex deposits in various components of the glomerulus contribute to the pathogenesis of SLE-related kidney disease?
How does the presence of immune complex deposits in various components of the glomerulus contribute to the pathogenesis of SLE-related kidney disease?
What distinguishes Type 5 SLE kidney involvement from other types in WHO classification?
What distinguishes Type 5 SLE kidney involvement from other types in WHO classification?
Which of the following is not a pathological feature commonly observed in the kidneys of individuals with Systemic Lupus Erythematosus (SLE)?
Which of the following is not a pathological feature commonly observed in the kidneys of individuals with Systemic Lupus Erythematosus (SLE)?
What is the clinical significance of observing severe arteriolar sclerosis in the kidney?
What is the clinical significance of observing severe arteriolar sclerosis in the kidney?
In the context of diabetic nephropathy, what structural alteration of the glomerulus is specifically referred to as a 'Kimmelstiel-Wilson lesion'?
In the context of diabetic nephropathy, what structural alteration of the glomerulus is specifically referred to as a 'Kimmelstiel-Wilson lesion'?
In the context of renal pathology associated with diabetes mellitus, what is a notable characteristic of renal damage?
In the context of renal pathology associated with diabetes mellitus, what is a notable characteristic of renal damage?
Select the option that best describes the pathogenesis of the butterfly rash seen in many SLE patients.
Select the option that best describes the pathogenesis of the butterfly rash seen in many SLE patients.
According to the WHO classification, what dictates the types in SLE?
According to the WHO classification, what dictates the types in SLE?
What is the primary implication of increased glomerular pressure due to reduced nephron numbers?
What is the primary implication of increased glomerular pressure due to reduced nephron numbers?
Which of the following is a common clinical consequence observed in individuals with chronic renal failure (CRF)?
Which of the following is a common clinical consequence observed in individuals with chronic renal failure (CRF)?
What cardiovascular manifestation is often associated with chronic renal failure (CRF), contributing to increased mortality?
What cardiovascular manifestation is often associated with chronic renal failure (CRF), contributing to increased mortality?
In the context of Systemic Lupus Erythematosus (SLE), which of the following is a key consideration regarding thrombotic vascular lesions in the kidney of pregnant women?
In the context of Systemic Lupus Erythematosus (SLE), which of the following is a key consideration regarding thrombotic vascular lesions in the kidney of pregnant women?
In the context of the kidney, what does the finding of 'protein in the urine' typically indicate?
In the context of the kidney, what does the finding of 'protein in the urine' typically indicate?
In the context of proteinuria, what does the total amount of protein signify?
In the context of proteinuria, what does the total amount of protein signify?
In the context of diabetic nephropathy, what is the typical sequence of events leading to renal damage?
In the context of diabetic nephropathy, what is the typical sequence of events leading to renal damage?
In the context of diabetic nephropathy, what is the significance of glycosylation?
In the context of diabetic nephropathy, what is the significance of glycosylation?
In the context of diabetic nephropathy, what is the key finding?
In the context of diabetic nephropathy, what is the key finding?
What pathological process is suggested by the presence of 'Small scarred kidneys'?
What pathological process is suggested by the presence of 'Small scarred kidneys'?
In the context of SLE and the kidney, what is the primary basis for the WHO classification?
In the context of SLE and the kidney, what is the primary basis for the WHO classification?
What feature characterizes Type 1 SLE kidney disease, based on the WHO classification?
What feature characterizes Type 1 SLE kidney disease, based on the WHO classification?
Which feature primarily distinguishes Type 5 SLE kidney involvement from other types according to the WHO classification?
Which feature primarily distinguishes Type 5 SLE kidney involvement from other types according to the WHO classification?
Which of the following best describes the deposition pattern of immunoglobulins observed in the glomeruli of individuals with Systemic Lupus Erythematosus (SLE)?
Which of the following best describes the deposition pattern of immunoglobulins observed in the glomeruli of individuals with Systemic Lupus Erythematosus (SLE)?
What is the primary finding that characterizes proliferative glomerulonephritis?
What is the primary finding that characterizes proliferative glomerulonephritis?
How does proteinuria typically manifest in the context of kidney disease?
How does proteinuria typically manifest in the context of kidney disease?
What is the primary effect of reduced nephron numbers on the remaining glomeruli within the kidney?
What is the primary effect of reduced nephron numbers on the remaining glomeruli within the kidney?
In the context of Systemic Lupus Erythematosus (SLE), what is the primary concern associated with thrombotic vascular lesions found in the kidney, especially during pregnancy?
In the context of Systemic Lupus Erythematosus (SLE), what is the primary concern associated with thrombotic vascular lesions found in the kidney, especially during pregnancy?
What is the primary mechanism by which chronic hypertension contributes to renal damage?
What is the primary mechanism by which chronic hypertension contributes to renal damage?
What is the role of glycosylation in the pathogenesis of diabetic nephropathy?
What is the role of glycosylation in the pathogenesis of diabetic nephropathy?
Other than diabetes mellitus, what other disease may cause similar damage to the kidney?
Other than diabetes mellitus, what other disease may cause similar damage to the kidney?
In the context of Systemic Lupus Erythematosus (SLE), what is the primary characteristics of kidney damage?
In the context of Systemic Lupus Erythematosus (SLE), what is the primary characteristics of kidney damage?
What is 'bread and butter' what can occur in CRF?
What is 'bread and butter' what can occur in CRF?
What type of vascular lesions are of particular concern in kidney disease, especially in pregnant women with Systemic Lupus Erythematosus (SLE)?
What type of vascular lesions are of particular concern in kidney disease, especially in pregnant women with Systemic Lupus Erythematosus (SLE)?
In the context of kidney diseases, what finding is classified as an insidious indicator of glomerular abnormality?
In the context of kidney diseases, what finding is classified as an insidious indicator of glomerular abnormality?
Flashcards
Haematuria
Haematuria
Blood in the urine.
Glomerulonephritis
Glomerulonephritis
Inflammation of the glomeruli, the filtering units of the kidney
Nephrotic Syndrome
Nephrotic Syndrome
A kidney disorder characterized by proteinuria, edema, hypoalbuminemia, and hyperlipidemia.
Nephritic Syndrome
Nephritic Syndrome
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Post infectious Glomerulonephritis
Post infectious Glomerulonephritis
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Kidney Pathology in SLE
Kidney Pathology in SLE
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Impact of Reduced Nephrons
Impact of Reduced Nephrons
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Uraemia
Uraemia
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Left Ventricular Hypertrophy (LVH)
Left Ventricular Hypertrophy (LVH)
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Fibrinous Pericarditis
Fibrinous Pericarditis
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Kidney in Systemic Lupus Erythematosus (SLE)
Kidney in Systemic Lupus Erythematosus (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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Proteinuria
Proteinuria
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Kidney in Diabetes Mellitus (DM)
Kidney in Diabetes Mellitus (DM)
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Proteinuria (Diabetic Kidney)
Proteinuria (Diabetic Kidney)
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Nodular Mesangial Expansion
Nodular Mesangial Expansion
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Kimmelstiel Wilson Lesion
Kimmelstiel Wilson Lesion
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Thickened Glomerular BM
Thickened Glomerular BM
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Severe Arteriolar Sclerosis
Severe Arteriolar Sclerosis
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Glomerulosclerosis
Glomerulosclerosis
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Kidney in SLE
Kidney in SLE
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Butterfly rash in SLE
Butterfly rash in SLE
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Immunoglobulins in SLE
Immunoglobulins in SLE
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EM Deposits in Glomerulus
EM Deposits in Glomerulus
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Segmental Glomerular Inflammation
Segmental Glomerular Inflammation
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Diabetes Renal Damage Timing
Diabetes Renal Damage Timing
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Hypertension Renal Damage
Hypertension Renal Damage
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Glycosylation of Lipo-proteins
Glycosylation of Lipo-proteins
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Study Notes
- Pathology and immunological aspects of medical kidney disease are under discussion in Renal Pathology 5
Renal Pathology Objectives
- Pathophysiology of haematuria needs explanation, including listing the causes.
- Glomerulonephritis pathophysiology requires clarification.
- Definition of the nephrotic syndrome, including its causes and pathophysiology.
- Definition of the Nephritic syndrome, including its causes and pathophysiology.
- Pathogenesis of post-infectious glomerulonephritis needs explaining.
- Kidney pathology in SLE requires description.
Chronic Renal Failure (CRF)
- Reduced nephron numbers result in overworked remaining nephrons and increased glomerular pressure
- Effects of overworked nephrons can affect the mesangium, endothelial and epithelial cells
- Can result in progressive glomerulosclerosis
- Uraemia can result from chronic renal failure
- Can be caused by chronic disease described in previous lectures
- CRF leads to small scarred kidneys
- All systems effected by chronic renal failure
- Discussion in Medicine is substantial
- Left Ventricular Hypertrophy (LVH) can be a common cause of death in CRF
- Fibrinous pericarditis ("bread and butter") can occur
Kidney in Systemic Lupus Erythematosus (SLE)
- SLE is an immune complex deposition disease
- The WHO classification of SLE is based on severity
- Thrombotic vascular lesions are important in pregnancy
- Effects of prolonged drug therapy eg NSAIDS, are factors
- Butterfly rash is a symptom of of SLE kidney issues
- All immunoglobulins are positive on EM in SLE
- EM deposits in all components of glomerulus
- Segmental glomerular acute inflammation occurs in SLE
- Large subendothelial deposits can occur in SLE
SLE and the Kidney: WHO Classification
- Type 1: Normal glomeruli, 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 GN
- Combinations like type 5 plus type 3 or type 4 can occur
The Kidney in Diabetes Mellitus (DM)
- Types 1 and 2 diabetes are relevant
- Diabetes Mellitus typically antedates renal damage by 10 to 15 years
- There is a fallacy of pre-diabetic Type 2 renal damage,
- Damage may be due to Hypertension and drugs
- Proteinuria in the nephrotic range is seen
- Glycosylation of lipoproteins occurs in the mesangium and basement membranes, with secondary effects on epithelial cells
- Nodular mesangial expansion can occur
- Severe nodular mesangial expansion occurs
- Kimmelstiel Wilson lesion
- There is markedly thickened BM on EM
- Severe arteriolar sclerosis
Proteinuria
- Protein is present in the urine
- It is an insidious, and points to a glomerular abnormality
- The amount of protein signifies the extent/volume of glomerular involvement
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