Renal Pathology

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• Common congenital renal anomaly horseshoe kidney connected lower
• Vessel congenital horseshoe kidney caught ascend pelvis abdomen
• Renal complications unilateral agenesis hypertrophy existing kidney hyperfilitration
• Important association bilateral renal agenesis oligohydraminos leads potter
• Components potter sequence bilateral renal agenesis lung hypoplasia
• Common areas uti's urethra urethritis bladder cystitis kidney
• Main risk factors uti's sexual intercourse urinary stasis
• Clinical presentation cystitis bladder uti's dysuria increased urine
• Main lab findings cystitis bladder uti urinalysis cloudy
• Common bugs causing cystitis bladder uti e coli
• Cystitis bladder uti suspected positive urinalysis dipstick culture
• Ascending uti kidney pyelonephritis of
• Patients pyelonephritis increased risk vesicoureteral reflex elevated pressures
• Clinical presentation patients pyelonephritis kidney uti fever  flank
• Common bug pyelonephritis e coli enterococcus faecalis klebsiella 
• Main mechanism causing chronic pyelonephritis recurrent acute interstitial
• Common chronic pyelonephritis vesicoureteral reflux children anatomic abnormality
• Physical consequences chronic pyelonephritis cortical scarring upper lower
• Atrophic tubules chronic pyelonephritis resemble thyroid follicles thyroidization
• Reason flank pain pyelonephritis sensitization kidney capsule nerves
• Patients present nephrolithiasis colicky pain w hematuria unilateral
• Kidney stones pass 5mm 5-7mm 7mm requires surgery
• Common type kidney stone adults calcium oxalate/phosphate
• Common calcium oxalate/phosphate kidney stones idiopathic hypercalciuria
• Association hypercalciuria precipitating kidney stones chron's disease ibs
• Tx hypercalciuria precipitating kidney stones hydrochlorothiazide calcium-sparing diuretic
• Common type kidney stone ammonium magnesium phosphate struvite
• Ammonium magnesium phosphate struvite kidney stones urease-positive bugs
• Characteristic quality ammonium magnesium phosphate kidney stones staghorn
• Tx ammonium magnesium phosphate kidney stones surgery staghorn
• Unique uric acid kidney stones radio-opaque show x-ray
• Common uric acid kidney stones cases
• Risk factors uric acid kidney stones hot/arid climates
• Tx patients uric acid kidney stones hydration alkalize
• Characteristic cysteine kidney stones staghorn calculi children
• Cysteine common association kidney stones cysteinuria genetic defect
• Staghorn caliculi composition children cysteine adults ammonium magnesium
• Main characteristic nephrotic syndrome proteinuria 3.5g/day
• Results nephrotic syndrome hypoalbuminemia pitting edema hypogammaglobulinemia infection
• Cell layers found normal glomerulus podocyte epithelial layer 
• Disease nephrotic syndromes arrange minimal change focal segmental
• Common nephrotic syndrome children minimal change disease mcd
• Condition minimal change disease nephrotic syndrome hodgkin's lymphoma
• Similarities minimal change disease focal segmental glomerulosclerosis share
• Minimal change distinguish disease focal segmental glomerulosclerosis causing
• Population focal segmental glomerulosclerosis commonly nephrotic syndrome hispanic
• Conditions with focal segmental glomerulosclerosis nephrotic syndrome hiv heroin
• Classically h&e stain in focal segmental glomerulosclerosis dense pink
• Minimal change disease mcd progress to focal segmental glomerulosclerosis
• Will focal segmental glomerulosclerosis progress chronic renal failure poor
• Similarities membranous nephropathy membranoproliferative glomerulonephritis causing nephrotic syndrome
• Population nephrotic syndrome commonly caused membranous nephropathy caucasian
• Membranous nephropathy commonly hepatitis b c solid tumors
• Immune complex depositions found membranous nephropathy characteristic pattern
• Genetics medullary cystic kidney disease inherited autosomal dominant
• Immune complex depositions found membranoproliferative glomerulonephritis characteristic pattern
• Type of membranoproliferative glomerulonephritis i subendothelial tram-track appearance ii
• Type i membranoproliferative glomerulonephritis hepatitis b c
• C3 type ii membranoproliferative glomerulonephritis nephritic factor stabilizes convertase
• Nephrotic syndrome can membranoproliferative glomerulonephritis nephritic syndrome 
• Histological sign diabetic nephropathy patients diabetes mellitus nonenzymatic
• Efferent/afferent glomerular arteriole undergoes sclerosis diabetic nephropathy efferent
• Hyperfiltration increased gfr lead diabetic nephropathy microalbuminuria
• Characteristics nephrotic syndrome caused diabetes mellitus sclerosis mesangium
• Slow progression hyperfiltration-induced damage diabetic nephropathy ace inhibitors
• Amyloidosis nephrotic syndrome amyloid deposits mesangium
• Diagnose amyloidosis nephrotic syndrome apple-green birefringence congo red
• Kidney inherited cystic disease dysplastic
• Unilateral dysplastic kidney bilateral distinguish pkd
• Recessive pkd autosomal dominant infants young adults ad
• Infants present autosomal recessive pkd worsening renal failure
• Young adults present autosomal dominant pkd hypertension increased
• Hepatic autosomal recessive pkd infants congenital fibrosis leads
• Autosomal dominant pkd young adults berry aneurysm hepatic
• Typically autosomal dominant pkd young adults mutation apkd1/apkd2
• Medullary cystic kidney disease differentiated pkd cysts collecting
• Malignant epithelial tumor arising kidney tubules renal cell
• Classic triad presentations renal cell carcinoma hematuria palpable
• Common symptom renal cell carcinoma hematuria
• Paraneoplastic syndromes result renal cell carcinomas epo polycythemia
• Varicocele renal carcinoma left vein left-sided cell patients
• Vein varicoceles renal spermatic left left-sided right-sided cell
• Renal cell carcinoma gross examination large yellow mass
• Renal cell carcinoma microscopy clear cytoplasm
• Sporadic hereditary characteristic differences renal cell carcinomas adult
• Inactivation vhl disorder gene renal cell carcinoma von
• Tumor common malignant renal children avg age years
• Children typically present wilms tumors large unilateral flank
• Syndrome accompany wilms tumor wagr denys-drash beck-wiedemann
• Characteristics wagr syndrome w wilms tumor aniridia absence
• Genetic association wagr syndrome deletion wt1 tumor suppressor
• Characteristics denys-drash syndrome wilms tumor progressive renal glomerular
• Genetic association denys-drash syndrome mutation wt1 tumor suppressor gene
• Characteristics beckwith-wiedemann syndrome wilms tumor neonatal hypoglycemia muscular
• Genetic association beckwith-wiedemann syndrome mutations wt2 cluster igf-2
• Common malignant lower urinary tract cancer urothelial transitional
• Major risk factor urothelial carcinoma cigarette smoke
• Cigarette smoke risk factors urothelial carcinoma naphthylamine azo
• Classic presentation urothelial carcinoma painless hematuria older adults
• P53 mutations pathways urothelial carcinoma arise involves flat
• Flat papillary grade tumor develops invades difference pathway
• Urothelial meant carcinomas display field defect entire tract
• Commonly involved organ lower urinary tract carcinomas bladder
• Carcinoma types lower urinary tract urothelial squamous cell
• Squamous cell carcinomas arise bladder metaplasia
• Common risk factors developing squamous cell carcinoma bladder
• Cells affected adenocarcinoma bladder proliferation glands
• Bladder common location adenocarcinomas arise urachal remnant tumor
• Common ways adenocarcinoma bladder develop cystitis glandularis columnar
• Hallmark nephritic syndromes glomerular inflammation bleeding
• Characteristics nephritic syndromes display limited proteinuria <3.5g/day oliguria
• Glomeruli biopsy nephritic syndrome show hypercellular inflamed
• Damage pathogenesis caused nephritic syndromes immune-complex deposition activates
• Nephritogenic strains group strep formation poststreptococcal glomerulonephritis psgn
• Patients psgn present weeks group strep infection common
• Children psgn commonly adults is
• Psgn immunofluorescence granular immune-complex deposition
• Psgn electron microscopy em subepithelial humps
• Treat psgn supportive self-resolves how
• Children adults percent psgn progress rapidly progressive glomerulonephritis
• Characterizes rapidly progressive glmoerulonephritis h&e stains crescents bowman's
• Crescent shapes bowman's space composed in rapidly progressive glomerulonephritis
• Glomerulonephritis etiologies of  rapidly progressive immunofluroescence goodpasture syndrome
• Meant linear pattern anti-basement membrane antibody binding
• Meant granular immune-complex deposition what
• Goodpasture syndrome  patients progressed rapidly progressive glomerulonephritis present
• Immune-complex deposition granular diffuse proliferative glomerulonephritis sub-endothelial
• Distinguish small-vessel vasculitides etiology rapidly progressive glomerulonephritis negative
• Churgg-strauss distinguish microscopic polyangiitis  as etiology rapidly progressive
• Nephritic syndrome burger's diesease iga nephropathy
• Nephropathy common worldwide iga what
• Patients present iga nephropathy children episodic hematuria w
• Stimulates episodes hematuria children iga nephropathy mucosal infections
• Iga nephropathy progress renal failure
• Alport syndrome glomerulus thinning splitting  of glomerular basement
• Common presentations patients alport syndrome nephritis isolated hematuria
• Prostate lie relation bladder urethra base surrounding
• Components prostate glands stroma the
• Cells types glands prostate luminal layer  basal outer
• Maintains glands stroma prostate androgens
• Young adults older bacteria acute prostatitis chlamydia neisseria
• Patients present acute prostatitis dysuria fever chills
• Prostate feel acute prostatitis digital rectal exam dre
• Diagnose acute prostatitis secretions wbc's culture bacteria
• Patients present chronic prostatitis dysuria pelvic/lower back pain
• Diagnose chronic prostatitis secretions wbc's culture negative
• Hyperplasia benign prostatic bph glands stroma prostate
• Bph present men age cancer increased risk
• Area prostate bph occur clinically relevant central periurethral
• Patients present bph problems starting/stopping urine flow dribbling
• Clinical tests diagnose bph microscopic hematuria prostatic-specific antigen
• Bladder complications bph impaired emptying infection hydronephrosis hypertrophy
• Treatments bph alpha(1)-antagonists relax smooth muscle 5-alpha-reductase inhibitors
• Blood helpful patients types alpha antagonists tx bph
• Alpha non-selective antagonist 1a selective give terazosin tamulosin
• Down-sides 5-alpha-reductase inhibitor tx bph takes months results
• Potentially positive side-effect 5-alpha-reductase inhibitor tx bph male
• Common cancer men prostate adenocarcinoma
• Risk developing prostate adenocarcinoma men races african american
• Patients present prostate adenocarcinoma clinically silent early arises
• Psa start screening prostate adenocarcinoma age dre levels
• Prostate confirm dx adenocarcinoma biopsy
• Examination prostate biopsy small invasive glands prominent nucleoli
• Architecture score gleason grading system grade prostate adenocarcinoma
• Common site prostate adenocarcinoma spread lumbar spine pelvis
• Additional lab findings present prostate adenocarcinoma spreads lumbar
• Perform prostatectomy prostate adenocarcinoma determined localized
• Hallmark acute renal failure azotemia increased bun creatinine
• Pre renal azotemia decreased blood flow kidneys cardiac
• Decreased bun:creatinine ratio increase pre-renal azotemia blood flow
• Bun:creatinine ratio pre-renal azotemia what
• Fena finding pre renal azotemia fractional excretion na+
• Urine osmolality pre-renal azotemia mosm/kg
• Post-renal azotemia obstruction urinary tract ureters/bladder
• Gfr decreased post-renal azotemia obstruction back-pressure renal tubules
• Bun:creatinine ratio increase early post-renal azotemia back-pressure obstruction
• Bun:creatinine ratio decrease long-standing post renal azotemia tubular
• Lab findings find long-standing post-renal azotemia bun:cr ratio
• Common acute renal failure cute t ubular n
• Decreased gfr intra-renal azotemia atn necrotic cells plug
• Urine intra-renal azotemia atn brown granular casts
• Lab findings someone with intra-renal azotemia atn bun:cr ratio
• Etiologies acute tubular necrosis ischemic decreased blood supply
• Common nephrotoxic atn aminoglycosides most
• Nephrotoxic atn aminoglycosides heavy metals myoglobinuria crush injury
• Key clinical features acute tubular necrosis oliguria brown/granular
• Tubular oliguria persist weeks full recovery acute necrosis
• Acute renal conditions lead failure tubular necrosis interstitial
• Acute interstitial nephritis inflammation connective tissue interstitium kidney
• Acute interstitial nephritis drug-induced hypersensitivity tubules interstitium
• Main drugs acute interstitial nephritis nsaids penicillin diuretics
• Patient present acute interstitial nephritis oliguria fever rash
• Key clinical sign patient acute interstitial nephritis eosinophils
• Acute renal interstitial nephritis progress failure papillary necrosis
• Patient present renal papillary necrosis gross hematuria flank
• Main renal papillary necrosis chronic analgesic abuse aspirin/phenacetin
• Ways kidney damaged point end-stage renal disease glomerular
• Diseases common lead end-stage renal diabetes mellitus hypertension
• Clinical features increased nitrogenous waste azotemia uremia chronic
• Hyper ion imbalances patients chronic renal failure k+
• Renal anemia patients chronic failure decreased erythropoietin production
• Hypo ca++ patients chronic renal failure decreased 1-alpha-hydroxylation
• Renal ca++ occurs osteitis fibrosa caused osteodystrophy chronic
• Renal osteodystrophy occurs chronic failure secondary conditions hyper-parathyroidism
• Renal side-effects dialysis treatment chronic failure cysts develop
• Dysplastic kidney disease non-inherited congenital malformation renal parenchyma
• Polycystic kidney disease inherited defect leading bilateral enlarged
• Angiomyolipoma renal hamartoma comprised blood vessels smooth muscle
• Angiomyolipomas increased frequency tuberous sclerosis
• Increased growth genes involved pathogenesis renal cell carcinoma
• Renal tumor staging t cell carcinoma based size
• Tumor staging n renal cell carcinoma noted spread
• Tumor kidney wilms malignant comprised blastema immature mesenchyme
• Wilms tumor cases sporadic 90
• Poststreptococcal glomerulonephritis psgn arises group strep infection skin
• Diffuse proliferative glomerulonephritis common type renal disease patients
• Iga nephropathy immune-complex deposition mesangium glomeruli
• Alport syndrome nephritis caused inherited x-linked defect type
• Fluid basal cells prostate secrete alkaline milky added
• Dht underlying pathlogy benign prostatic hyperplasia bph testosterone
• Reduce treat advanced cases prostate adenocarcinoma hormone suppression
• Pre-renal azotemia precedes ischemic atn often
• Hydration allopurinol prior initiation chemotherapy decrease risk urate-induced
• Renal levels ca++ osteodystrophy complication chronic failure excess

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