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Questions and Answers
What is the primary mechanism by which reduced nephron numbers lead to progressive glomerulosclerosis?
What is the primary mechanism by which reduced nephron numbers lead to progressive glomerulosclerosis?
- Increased glomerular pressure (correct)
- Enhanced mesangial cell proliferation
- Decreased renin production
- Reduced filtration surface area
Uremia in chronic renal failure directly results from the kidney's inability to perform which critical function?
Uremia in chronic renal failure directly results from the kidney's inability to perform which critical function?
- Regulating blood pressure
- Filtering waste products (correct)
- Activating vitamin D
- Synthesizing clotting factors
In chronic renal failure, what cardiovascular change significantly contributes to mortality?
In chronic renal failure, what cardiovascular change significantly contributes to mortality?
- Mitral valve prolapse
- Right ventricular hypertrophy
- Aortic valve stenosis
- Concentric left ventricular hypertrophy (correct)
Fibrinous pericarditis, a complication of chronic renal failure, directly results from which pathological process?
Fibrinous pericarditis, a complication of chronic renal failure, directly results from which pathological process?
Which of the following best describes the underlying mechanism of kidney damage in Systemic Lupus Erythematosus (SLE)?
Which of the following best describes the underlying mechanism of kidney damage in Systemic Lupus Erythematosus (SLE)?
According to the WHO classification of SLE kidney pathology, which type is characterized by normal glomeruli with positive findings on immunofluorescence?
According to the WHO classification of SLE kidney pathology, which type is characterized by normal glomeruli with positive findings on immunofluorescence?
In SLE kidney disease, what pathological finding is particularly concerning during pregnancy?
In SLE kidney disease, what pathological finding is particularly concerning during pregnancy?
What is a potential consequence of prolonged NSAID use on the kidneys in patients with SLE?
What is a potential consequence of prolonged NSAID use on the kidneys in patients with SLE?
In the context of electron microscopy of kidney biopsies of SLE patients all immunoglobulins are typically:
In the context of electron microscopy of kidney biopsies of SLE patients all immunoglobulins are typically:
Which of the following is the primary initial event in the pathogenesis of diabetic nephropathy?
Which of the following is the primary initial event in the pathogenesis of diabetic nephropathy?
What is the typical timeframe by which clinical renal damage appears after the onset of diabetes mellitus?
What is the typical timeframe by which clinical renal damage appears after the onset of diabetes mellitus?
How does the characteristic proteinuria in diabetic nephropathy primarily arise?
How does the characteristic proteinuria in diabetic nephropathy primarily arise?
What is the significance of glycosylation of lipoproteins in the context of diabetic nephropathy?
What is the significance of glycosylation of lipoproteins in the context of diabetic nephropathy?
Which specific histological lesion is pathognomonic for diabetic nephropathy?
Which specific histological lesion is pathognomonic for diabetic nephropathy?
What long-term effect does proteinuria typically signify in patients with glomerular abnormalities?
What long-term effect does proteinuria typically signify in patients with glomerular abnormalities?
Which of the following is NOT a typical component of the definition of nephrotic syndrome?
Which of the following is NOT a typical component of the definition of nephrotic syndrome?
What is the primary mechanism of glomerular injury in post-streptococcal glomerulonephritis?
What is the primary mechanism of glomerular injury in post-streptococcal glomerulonephritis?
What is the most common cause of hematuria?
What is the most common cause of hematuria?
What pathophysiological change directly triggers reduced nephron numbers effects on the mesangium, endothelial, and epithelial cells ultimately leading to glomerulosclerosis?
What pathophysiological change directly triggers reduced nephron numbers effects on the mesangium, endothelial, and epithelial cells ultimately leading to glomerulosclerosis?
Which of the following best explains why chronic renal failure affects nearly all major body systems?
Which of the following best explains why chronic renal failure affects nearly all major body systems?
How would the glomeruli appear on FM (fluorescence microscopy) of a kidney with Type 1 SLE?
How would the glomeruli appear on FM (fluorescence microscopy) of a kidney with Type 1 SLE?
In diabetes mellitus, what vascular change is most likely to be observed?
In diabetes mellitus, what vascular change is most likely to be observed?
What is the main pathophysiological process behind nodular mesangial expansion?
What is the main pathophysiological process behind nodular mesangial expansion?
In the context of nephropathology, which of the following statements best describes an insidious finding such as protein in the urine?
In the context of nephropathology, which of the following statements best describes an insidious finding such as protein in the urine?
What effect would increased protein in the Bowman's Capsule have on the glomerulus?
What effect would increased protein in the Bowman's Capsule have on the glomerulus?
Flashcards
Haematuria
Haematuria
The presence of 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, hypoalbuminemia, edema 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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Left Ventricular Hypertrophy (LVH)
Left Ventricular Hypertrophy (LVH)
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Fibrinous Pericarditis
Fibrinous Pericarditis
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Kidney in SLE
Kidney in SLE
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Thrombotic Lesions in SLE Kidney
Thrombotic Lesions in SLE Kidney
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SLE Kidney: Type 1 WHO
SLE Kidney: Type 1 WHO
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SLE Kidney: Type 2 WHO
SLE Kidney: Type 2 WHO
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SLE Kidney: Type 3 WHO
SLE Kidney: Type 3 WHO
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SLE Kidney: Type 4 WHO
SLE Kidney: Type 4 WHO
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SLE Kidney: Type 5 WHO
SLE Kidney: Type 5 WHO
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Butterfly Rash in SLE
Butterfly Rash in SLE
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EM Deposits in SLE Kidney
EM Deposits in SLE Kidney
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SLE Kidney Inflammation
SLE Kidney Inflammation
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Subendothelial Deposits in SLE
Subendothelial Deposits in SLE
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Kidney Damage in DM
Kidney Damage in DM
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Proteinuria
Proteinuria
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Proteinuria in Diabetes
Proteinuria in Diabetes
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Nodular expansion
Nodular expansion
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Severe nodular
Severe nodular
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Kimmelsteil Wilson
Kimmelsteil Wilson
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Study Notes
- Pathology and immunological factors are significant in medical kidney disease.
Renal Pathology 5: Key Learning Objectives
- Explain the pathophysiology and causes of haematuria.
- 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 remaining nephrons and increased glomerular pressure.
- Effects of overworked nephrons are seen on the mesangium, endothelial and epithelial cells.
- Progressive glomerulosclerosis is the result of the effects on the mesangium, endothelial and epithelial cells.
Clinical Effects of Chronic Renal Failure
- Uraemia occurs in chronic renal failure.
- Chronic renal failure is caused by chronic disease described in presentations 1 to 4.
- Small, scarred kidneys are characteristic of chronic renal failure.
- All systems are affected by chronic renal failure.
- Left ventricular hypertrophy (LVH) is a common cause of death.
- Fibrinous pericarditis (“bread and butter”) are complications that can occur.
Kidney Pathology in Systemic Lupus Erythematosus (SLE)
- SLE as it relates to the kidneys presents as an immune complex deposition disease.
- The World Health Organization (WHO) provides a classification based on the severity of kidney involvement in SLE.
- Thrombotic vascular lesions, are important in pregnancy.
- Kidney damage can be caused by prolonged use of drugs like NSAIDs.
SLE and Kidney - WHO Classification
- Type 1: Normal glomeruli but 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 together with either type 3 or type 4.
- SLE can cause a butterfly rash.
- All immunoglobulins tested are positive on Electron Microscopy (EM).
- EM deposits are seen in all components of glomerulus.
- Segmental glomerular acute inflammation is seen.
- Large subendothelial deposits are observed.
Kidney Pathology in Diabetes Mellitus (DM)
- Kidney pathology is similar for Types 1 and 2 diabetes.
- Renal damage typically happens 10 to 15 years post-diabetes.
- Pre-diabetic Type 2 renal damage is a fallacy.
- Hypertension and drug use can cause damage.
- Proteinuria (nephrotic range) is seen in diabetes.
- Glycosylation of lipoproteins occurs in the mesangium and basement membranes, with secondary effects on epithelial cells.
- Nodular mesangial expansion may be observed
- Severe nodular mesangial expansion are seen
- Lesions can be a sign of Kimmelstiel Wilson.
- There is markedly thickened Basement Membrane (BM) observed on EM.
- Severe arteriolar sclerosis.
Proteinuria
- Protein presence in the urine.
- Proteinuria is an insidious finding, indicating glomerular abnormality.
- The amount of protein in the urine signifies the extent/volume of glomerular involvement.
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