Ch20-Kidney

Ch20-Kidney - KIDNEY RENAL PATHOLOGY NORMAL CONGENITAL...

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KIDNEY
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RENAL PATHOLOGY NORMAL CONGENITAL “CYSTS” GLOMERULAR TUBULAR/INTERSTITIAL BLOOD VESSELS OBSTRUCTION TUMORS
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1. Renal Vein 2. Renal Artery 3. Renal Calyx 4. Medullary Pyramid 5. Renal Cortex 6. Segmental Artery 7. InterlobAR Artery 8. Arcuate Artery interlobULAR 9. Arcuate Vein 10. Interlobar Vein 11. Segmental Vein 12. Renal Column 13. Renal Papillae 14. Renal Pelvis 15. Ureter
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S.E.M. T.E.M.
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Fluid and Electrolytes : Dehydration, Edema, Hyperkalemia, Metabolic acidosis Calcium Phosphate and Bone : Hyperphosphatemia, Hypocalcemia, Secondary hyperparathyroidism, Renal osteodystrophy Hematologic : Anemia, Bleeding diathesis Cardiopulmonary : Hypertension, Congestive heart failure, Pulmonary edema, Uremic pericarditis Gastrointestinal : Nausea and vomiting, Bleeding, Esophagitis, gastritis, colitis Neuromuscular : Myopathy, Peripheral neuropathy, Encephalopathy Dermatologic : Sallow (greenish-yellow) color, Pruritus, Dermatitis CHRONIC RENAL FAILURE
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CONGENITAL AGENESIS HYPOPLASIA ECTOPIC HORSESHOE
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AGENESIS
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HYPOPLASIA
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ECTOPIC (usually PELVIC)
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HORSESHOE
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CYSTIC DISEASES CYSTIC RENAL “DYSPLASIA” A utosomal D OMINANT ( AD -ULTS) Autosomal RECESSIVE (CHILDREN) MEDULLARY Medullary Sponge Kidney (MSK) Nephronopththisis-Medullary ACQUIRED SIMPLE
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CYSTIC RENAL DYSPLASIA ENLARGED UNILATERAL or BILATERAL CYSTIC Have “MESENCHYME” NEWBORNS VIRAL, GENETIC (rare)
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A UTOSOMAL D OMINANT HEREDITARY, PKD1, PKD2 FOLLOWS AUTOSOMAL DOMINANT PEDIGREE COMPLEX GENETICS RENAL FAILURE in 50’s
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A UTOSOMAL R ECESSIVE CHILDHOOD KIDNEYS LOOK EXACTLY LIKE THE ADULT TYPE PKHD1 PATIENTS WHO SURVIVE CHILDHOOD OFTEN DEVELOP HEPATIC FIBROSIS
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MEDULLARY CYSTS MEDULLARY SPONGE KIDNEY (MSK), usually an incidental finding on CT or US NEPHRONOPHTHISIS, cysts @ CMJ, hereditary (AR), progressive
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ACQUIRED (DIALYSIS)
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“SIMPLE” CYSTS Cortical Also called “retention” cysts Also “acquired” Incidental, asymptomatic VERY very very common
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GLOMERULAR DISEASES aka, glomerulonephropathies
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CLINICAL MANIFESTATIONS ACUTE NEPHROTIC SYNDROME RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS NEPHROTIC SYNDROME CHRONIC RENAL FAILURE ASYMPTOMATIC HEMATURIA or PROTEINURIA
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PATHOLOGIC MANIFESTATIONS CELLULAR PROLIFERATION Mesangial Endothelial LEUKOCYTE INFILTRATION CRESCENTS ( RAPIDLY progressive) BASEMENT MEMBRANE THICKENING HYALINIZATION SCLEROSIS
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Ch20-Kidney - KIDNEY RENAL PATHOLOGY NORMAL CONGENITAL...

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